• 제목/요약/키워드: Diagnostic accuracy

검색결과 956건 처리시간 0.032초

심박동수 및 관상동맥 석회화가 64 절편 다중검출기 심장 CT의 관상동맥 질환 진단일치도에 미치는 영향 (The Influence of Heart Rate and Coronary Calcification on the Diagnostic Accuracy of 64-slice Multidetector Cardiac CT in Coronary Artery Disease)

  • 강영한;박종삼
    • 한국콘텐츠학회논문지
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    • 제9권12호
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    • pp.339-347
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    • 2009
  • 연구목적: 64 절편 MDCT를 이용한 심장 CT의 진단일치도를 알아보고, 심박동수와 관상동맥 석회화가 진단일치도에 영향을 미치는지 확인하여 심장 CT 검사 시 기초 자료로 활용하고자 함이다. 연구방법: 심장 CT와 관상동맥 조영술을 함께 시행한 178명(남자 84명, 여자 94명)을 대상으로 심장 CT에서 관상동맥 협착과 심박동수, 석회화 수치를 측정하였고, 관상동맥조영술에서 좌전하행동맥, 좌회선동맥, 우관상동맥의 유의한 협착($\geq50%$)이 있는지 확인하였다. 관상동맥 조영술의 결과를 표준으로 심장 CT의 민감도, 특이도, 양성예측도, 음성예측도, kappa index($\kappa$)를 계산하였다. 연구결과: 환자별 협착의 정도를 평가한 결과 심장 CT의 정확도는 96.6%였다. 혈관별로는 LAD, LCX, RCA 각각 86.5%, 84.3%, 92.1%로 높은 진단일치도를 보였다. 체질량지수와 혈압은 심장 CT의 진단일치도에 영향을 미치지 않았다. 심박동수는 60/min 미만에서 정확도 90.1%, $\kappa$값 0.78이었고, 70/min 이상에서는 정확도가 75.8%, $\kappa$값 0.52이었다. 관상동맥 석회화지수 100 미만에서는 정확도가 91.3%, $\kappa$값 0.81이었고, 석회화지수 400 이상에서는 정확도 68.6%, $\kappa$값 0.33으로 떨어졌다. 결론: 64 절편 MDCT를 이용한 심장 CT는 관상동맥 조영술과 거의 비슷한 진단일치도를 나타냈다. 하지만 심박동수 70/min 이상, 관상동맥 석회화지수 400 이상에서는 진단일치도가 저하되었기 때문에 심장 CT 검사 시 심박동수와 관상동맥 석회화지수를 확인하여 검사하여야 하고, 심박동수가 70/min 이상이면 베타차단제를 사용하여 심박동수를 조절하여야 한다.

온라인 진단시스템에 사용되는 의사용 체질진단함수의 진단정확률 연구 (A Study on the Diagnostic Accuracy Rate of the Sasang Constitution Questionnaire for Doctors Used in the On-line System)

  • 전수형;정성일;권석동;박세정;김규곤;김종원
    • 사상체질의학회지
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    • 제20권3호
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    • pp.82-93
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    • 2008
  • 1. Objective The purpose of this study was to develop and upgrade the On-line SSCQ (Sasang Constitution Questionnaire) by making an analysis of diagnostic accuracy rate of Sasang Constitution Questionnaire for doctors. 2. Methods We have collected SSCQ-D(Sasang Constitution Questionnaire for Doctors) from the dept. of Sasang constitutional medicine in the four other university. We classified data according to Sasang constitution, sex, age and BMI and made an analysis using the chiefly discriminant analysis model, additionally frequency analysis, and Cronbach's alpha coefficient. 3. Results and Conclusion 1) Diagnostic accuracy rate of the SSCQ-D was between 71.33 and 95.14%. (1) About the whole subject the accuracy rate was 71.33%. (2) About the whole female the accuracy rate was 73.26%. (3) About the whole male the accuracy rate was 81.41%. 2) The more classification variables we used in this analysis study, the higher the diagnostic accuracy rate increased.

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Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

아동에서의 적외선 체온 측정의 진단정확도 연구 : 체계적 문헌 고찰과 메타분석 (Systematic Review and Meta-Analyses of Diagnostic Accuracy of Infrared Thermometer when Identifying Fever in Children)

  • 박영주;박성희;강창범
    • 대한간호학회지
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    • 제43권6호
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    • pp.746-759
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    • 2013
  • Purpose: Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children. Methods: Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4. Results: Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low. Conclusion: The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.

상악동의 점막비후에 대한 WATERS방사선사진과 파노라마방사선사진 및 전산화단층사진의 진단능 비교 (Comparison of Waters′ radiography, panoramic radiography, and computed tomography in the diagnosis of antral mucosal thickening)

  • 현영민;이삼선;최순철
    • 치과방사선
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    • 제28권1호
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    • pp.261-269
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    • 1998
  • With the CT findings as gold standard, the sensitivity, the specificity, and the diagnostic accuracy of Waters' radiography and Waters' radiography with panoramic radiography were compared in the diagnosis of antral mucosal thickening of 16 patients. Three oral radiologists and three non-oral radiologists interpreted the Waters' radiographs and after 4 weeks, interpreted the Waters' radiographs and panoramic radiographs simultaneously. The interpretation point was the existence or the non-existence of the mucosal thickening on the medial, the posterolateral, the floor, and the roof of maxillary sinus. The obtained results were as followed : 1. In oral radiologist group, the sensitivity, specificity and diagnostic accuracy of Waters' film were 0.7250, 0.8489 and 0.7578 respectively. 2. The sensitivity and the diagnostic accuracy in oral radiologist group were higher than those of non-oral radiologist group (P<0.05), but there was no significant difference between two groups in the specificity (P>0.05), 3. There was no significant difference of the diagnostic abilities except the specificity in oral radiologist group between Waters' radiography and Waters' radiography with panoramic radiography (P>0.05). 4. The sensitivity and the diagnostic accuracy were the highest in the case of medial wall interpretation, the specificity was the highest in the posterolateral wall. 5. In the posterolateral wall and the floor, the sensitivity and the diagnostic accuracy of oral radiologist group were higher than those of non-oral radiologist group (P<0.05).

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Diagnostic accuracy of imaging examinations for peri-implant bone defects around titanium and zirconium dioxide implants: A systematic review and meta-analysis

  • Chagas, Mariana Murai;Kobayashi-Velasco, Solange;Gimenez, Thais;Cavalcanti, Marcelo Gusmao Paraiso
    • Imaging Science in Dentistry
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    • 제51권4호
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    • pp.363-372
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    • 2021
  • Purpose: This systematic review and meta-analysis assessed the diagnostic accuracy of imaging examinations for the detection of peri-implant bone defects and compared the diagnostic accuracy between titanium (Ti) and zirconium dioxide (ZrO2) implants. Materials and Methods: Six online databases were searched, and studies were selected based on eligibility criteria. The studies included in the systematic review underwent bias and applicability assessment using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and a random-effect meta-analysis. Summary receiver operating characteristic (sROC) curves were constructed to compare the effect of methodological differences in relation to the variables of each group. Results: The search strategy yielded 719 articles. Titles and abstracts were read and 61 studies were selected for full-text reading. Among them, 24 studies were included in this systematic review. Most included studies had a low risk of bias (QUADAS-2). Cone-beam computed tomography (CBCT) presented sufficient data for quantitative analysis in ZrO2 and Ti implants. The meta-analysis revealed high levels of inconsistency in the latter group. Regarding sROC curves, the area under the curve (AUC) was larger for the overall Ti group (AUC=0.79) than for the overall ZrO2 group (AUC=0.69), but without a statistically significant difference between them. In Ti implants, the AUCs for dehiscence defects(0.73) and fenestration defects(0.87) showed a statistically significant difference. Conclusion: The diagnostic accuracy of CBCT imaging in the assessment of peri-implant bone defects was similar between Ti and ZrO2 implants, and fenestration was more accurately diagnosed than dehiscence in Ti implants.

대한세포병리학회 정도관리 현황 및 결과 (Quality Control Program and Its Results of Korean Society for Cytopathologists)

  • 이혜경;김성남;강신광;강창석;윤혜경
    • 대한세포병리학회지
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    • 제19권2호
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    • pp.65-71
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    • 2008
  • In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4-5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.

림프절 세침흡인 세포검사의 진단적 유용성과 한계 - 생검으로 확진한 176 예의 분석 - (Diagnostic Usefulness and Limitation of Fine Needle Aspiration Cytology of Lymph Node - Analysis of 176 Cases Confirmed by Biopsy -)

  • 김희성;김대수;오영륜;고영혜;이회정
    • 대한세포병리학회지
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    • 제10권1호
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    • pp.35-42
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    • 1999
  • The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.

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요로 종양의 세포병리 (Cytopathology of Urinary Tract Neoplasms)

  • 홍은경
    • 대한세포병리학회지
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    • 제17권1호
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    • pp.1-17
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    • 2006
  • Urine cytology is the most useful technique for detecting either primary or recurrent neoplasms in the urinary tract. Although urine cytology is the traditional method of detecting these neoplasms, its diagnostic accuracy has been underevaluated because of low sensitivity. The cytologic interpretation of urinary samples is not an easy task, even with some expertise in this area, for many reasons. In low-grade urothelial carcinoma, no reliable or reproducible diagnostic cytologic criteria can be provided because of the lack of obvious cytologic features of malignancy, which is one of the main factors lowering its diagnostic accuracy. Many diagnostic markers have been developed recently to enhance its diagnostic yield, but the results have not been satisfactory. However, urine cytology plays a role in detecting high-grade urothelial carcinoma or its precursor lesions. It still shows higher specificity than any of the newly developed urine markers. Understanding the nature of urine samples and the nature of neoplasms of the urinary tract, recognizing their cytologic features fully, and using cytologic findings under appropriate conditions in conjunction with a detailed clinical history would make urine cytology a very valuable diagnostic tool.

Consistency check algorithm for validation and re-diagnosis to improve the accuracy of abnormality diagnosis in nuclear power plants

  • Kim, Geunhee;Kim, Jae Min;Shin, Ji Hyeon;Lee, Seung Jun
    • Nuclear Engineering and Technology
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    • 제54권10호
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    • pp.3620-3630
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    • 2022
  • The diagnosis of abnormalities in a nuclear power plant is essential to maintain power plant safety. When an abnormal event occurs, the operator diagnoses the event and selects the appropriate abnormal operating procedures and sub-procedures to implement the necessary measures. To support this, abnormality diagnosis systems using data-driven methods such as artificial neural networks and convolutional neural networks have been developed. However, data-driven models cannot always guarantee an accurate diagnosis because they cannot simulate all possible abnormal events. Therefore, abnormality diagnosis systems should be able to detect their own potential misdiagnosis. This paper proposes a rulebased diagnostic validation algorithm using a previously developed two-stage diagnosis model in abnormal situations. We analyzed the diagnostic results of the sub-procedure stage when the first diagnostic results were inaccurate and derived a rule to filter the inconsistent sub-procedure diagnostic results, which may be inaccurate diagnoses. In a case study, two abnormality diagnosis models were built using gated recurrent units and long short-term memory cells, and consistency checks on the diagnostic results from both models were performed to detect any inconsistencies. Based on this, a re-diagnosis was performed to select the label of the second-best value in the first diagnosis, after which the diagnosis accuracy increased. That is, the model proposed in this study made it possible to detect diagnostic failures by the developed consistency check of the sub-procedure diagnostic results. The consistency check process has the advantage that the operator can review the results and increase the diagnosis success rate by performing additional re-diagnoses. The developed model is expected to have increased applicability as an operator support system in terms of selecting the appropriate AOPs and sub-procedures with re-diagnosis, thereby further increasing abnormal event diagnostic accuracy.