• Title/Summary/Keyword: Diagnostic assessment

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Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis (Braden 욕창위험사정도구의 예측 타당도 메타분석)

  • Park, Seong-Hi;Park, Yu-Sun
    • Journal of Korean Academy of Nursing
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    • v.44 no.6
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    • pp.595-607
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    • 2014
  • Purpose: The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development. Methods: Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. 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: Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies. Conclusion: The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

Clinical Perspectives of Food Allergy in Infants and Young Children (영유아 식품알레르기의 임상적 조망)

  • Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.14 no.2
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    • pp.113-121
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    • 2011
  • Food allergies affect 7~8% of infants and young children, and their prevalence appears to have increased in recent years. Food allergy refers to an abnormal immunological reaction to a specific food. These reactions can be recurrent each time the food is ingested. Food allergy manifests itself with a wide spectrum of clinical characteristics including IgE-mediated diseases as immediate reactions, non-IgE-mediated disorders as delayed reactions, and mixed hypersensitivities. As a consequence, the clinical picture of a food allergy is pleomorphic. A well-designed oral food challenge is the most reliable diagnostic test for infants and young children whose clinical history and physical examination point towards a specific food allergy. Food specific IgE antibody tests (RAST, MAST, skin prick test, Uni-CAP, etc) are an alternative tool to determine oral food challenge for IgE-mediated disorders, but not for non-IgE-mediated allergies. Moreover, parents often impose their children on unnecessary diets without adequate medical supervision. These inappropriate dietary restrictions may cause nutritional deficiencies. This review aims to introduce clinical perspectives of food allergy in infants and young children and to orient clinicians towards different strains of diagnostic approaches, dietary management, and follow-up assessment of tolerance development.

A Case Report of migraine and a case report of restless legs syndrome treated with Osuyu-tang based on Shanghanlun Provisions (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 오수유탕(吳茱萸湯)을 투여한 편두통 증례 및 하지불안증후군 증례 각 1례)

  • Heo, Joo;Lee, Wook-jea;Jeong, Jae-won
    • 대한상한금궤의학회지
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    • v.11 no.1
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    • pp.125-138
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    • 2019
  • Objective : This study was intended to evaluate if treatment with Osuyu-Tang following the disease pattern identification diagnostic system based on Shanghanlun provisions (DPIDS) worked analyzing the progress of patients with migraine and restless legs syndrome and to reinterpret the provision of 309 Soyinbing Osuyu-Tang based on the analysis of whether it worked. Methods : Two cases treated with Soyinbing Osuyu-Tang were analyzed using DPIDS. The migraine and restless legs syndrome in both cases were evaluated using the migraine disability assessment (MIDAS) and the Korean versions of the international restless legs scale (K-IRLS), respectively. Results : In the first case, during 45 days of treatment, the MIDAS decreased from 10 days to 3 days. In the second case, during 30 days of treatment, the K-IRLS decreased from 30 to 9. In both cases, Soyinbing was associated with the disease, although the activity was less; and Leng (冷) was associated with numbness in the kneeling position. Conclusions : It was confirmed that treatment with Osuyu-Tang was effective against migraine and restless legs syndrome and that Leng could be associated with numbness in the kneeling position. The etymological analysis of the Shanghanlun characters suggested the possibility of further clarifying the clinical significance and interpretation of Shanghanlun.

Automatic Segmentation of Retinal Blood Vessels Based on Improved Multiscale Line Detection

  • Hou, Yanli
    • Journal of Computing Science and Engineering
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    • v.8 no.2
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    • pp.119-128
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    • 2014
  • The appearance of retinal blood vessels is an important diagnostic indicator of serious disease, such as hypertension, diabetes, cardiovascular disease, and stroke. Automatic segmentation of the retinal vasculature is a primary step towards automatic assessment of the retinal blood vessel features. This paper presents an automated method for the enhancement and segmentation of blood vessels in fundus images. To decrease the influence of the optic disk, and emphasize the vessels for each retinal image, a multidirectional morphological top-hat transform with rotating structuring elements is first applied to the background homogenized retinal image. Then, an improved multiscale line detector is presented to produce a vessel response image, and yield the retinal blood vessel tree for each retinal image. Since different line detectors at varying scales have different line responses in the multiscale detector, the line detectors with longer length produce more vessel responses than the ones with shorter length; the improved multiscale detector combines all the responses at different scales by setting different weights for each scale. The methodology is evaluated on two publicly available databases, DRIVE and STARE. Experimental results demonstrate an excellent performance that approximates the average accuracy of a human observer. Moreover, the method is simple, fast, and robust to noise, so it is suitable for being integrated into a computer-assisted diagnostic system for ophthalmic disorders.

Developing evaluation criteria for quality management systems adoption by using delphi technique (델파이 기법을 활용한 품질경영시스템 조직 진단 항목개발에 관한 연구)

  • Choi, Jaewoong;Jun, Byoungho;Choi, Jaeyoung
    • Journal of Korea Society of Digital Industry and Information Management
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    • v.12 no.2
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    • pp.87-102
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    • 2016
  • The customer requirements are constantly changing in the hyper-competition and competition is becoming increasingly intensified. In order to ensure the competitive advantage in the industry should focus on the management activities to enhance customer satisfaction. High quality means pleasing customers, not just protecting them from annoyances. It is due to continuous and requires the establishment of a quality management system that meets the characteristics and systematization need to manage a stable quality and productivity, which should be done in a company-wide quality management activities. The purpose of this study is to identify a suitable organizational diagnostic model for considering to adopt ISO 9001 quality management systems. We used the three-round delphi techniques on a panel of 30 experts. A total of 26 assessment indicators were developed through this panel. First, it is important to evaluate the strategy about quality. Second, it is important to evaluate the systems about periodically communicating quality agenda. Third, it is important to evaluate the responsibility of overall business process. In conclusion, this study empirically shows how firms can develop an organizational diagnostic model to increase their quality management systems.

Assessment of Organ Dose in Mammoplasty Patient by Monte Carlo Simulation during Mammography (유방촬영 시 몬테칼로 전사모사를 이용한 유방 성형 환자의 장기선량 평가)

  • Kim, Ji-Soo;Cho, Yong-In;Kim, Jung-Hoon
    • Journal of radiological science and technology
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    • v.43 no.5
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    • pp.337-341
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    • 2020
  • Although the screening with a mammography has been shown to be economical, simple and effective in detecting breast cancer, it is accompanied by the risk from radiation. Therefore, this study analyzed the glandular dose and organ dose according to the target-filter combination and the presence and absence of implants using Monte Carlo simulation. The results indicate that at a tube voltage of 30 kV and a tube current of 50 mAs, the dose increased in the order of Mo/Mo. Mo/Rh, Rh/Rh and W/Rh in proportion to the atomic number of the target-filter. In addition, in phantom without implant a reduction in dose was seen when compared to the phantom with implant. The organ dose was highest in the lens except for the breast on the examination side regardless of the presence or absence of the implant. These results may contribute to use basic data for the diagnostic reference level of breast plastic surgery patients.

The Methodological Review on the Accuracy Study of Questionnaire for Sasang Constitution Diagnosis (체질진단설문지 정확률 연구의 연구방법론 고찰)

  • Kim, Sang-Hyuk;Jang, Eun-Su;Koh, Byung-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.24 no.3
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    • pp.1-16
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    • 2012
  • Objectives For the methodological review on the accuracy study of questionnaire for Sasang constitution diagnosis, we searched the various diagnostic accuracy study of the questionnaires for Sasang constitution. Methods We searched MEDLINE, the Cochrane Library, KISS, and DBPIA. Additionally, We hand-searched the main oriental medical journals. All articles were independently reviewed and selected by two evaluators. And selected articles were assessed by "Quality Assessment of Diagnostic Accuracy Studies Tool"(QUADAS Tool) for the methodological review. Results The twenty eight studies initially identified studies were included in the methodological review. The part of "Acceptable reference standard", "Uninterpretable results reported" and "Withdrawals explained" was very weak in the risk of bias. The part of "Representative spectrum", "Acceptable delay between tests", "Incorporation avoided", "Reference standard results blinded", "Index test results blinded" was unclear in the description. Conclusions For the further study on the accuracy study of Sasang constitution diagnosis, we have to improve the aforementioned errors. Additionally, the checklist for the description of study might be needed.

Functional Assessment of Vestibular System and Dizziness Diagnosis (전정기능 평가 및 질병 진단을 위한 정현파 회전자극기 개발)

  • Jeong, Ho-Chun;Lim, Seung-Kwan;Kim, Kuy-Kem;Chin, Dal-Bok
    • Proceedings of the KIEE Conference
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    • 1996.07b
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    • pp.1027-1030
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    • 1996
  • The purpose of this study was to develop systematic diagnostic system testing easily, rapidly vestibular function of patients suffered from vestibular syndrome such as nausea vomiting, dizzness, ataxia. Diagnostic system composed of rotatory chair system which rotated sinusoidally patients against their vertical axis for purpose of invoking eye movement by vestibulo-ocular reflex and the softwares which storaged eye movement into computer and analyzed eye movement. Rotatory chair system consisted of comfortable chair and DC servomotor with reducer(1:80) by controlled servo in field of nonlinear motor control, double feedback loops system containing velocity feedback loop and position feedback loop was applied to this sever controlled rotatory chair system. Maximum rotatory velocity of rotatory chair was upto 60 degree per second and frequency range was 0.01 to 0.64 Hz. These above results suggest that clinical rotatory chair system may test easily, rapidly vestibular function and diagnose etiology of dizziness, thus giving effective assistance on the treatment of dizziness patients.

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Evaluation of the Humpty Dumpty Falls Scale: An Analysis of Electronic Medical Records (소아 낙상위험 측정도구 (Humpty Dumpty Falls Scale) 평가: 전자의무기록을 이용하여)

  • Cho, Yun Hee;Kim, Young Ju
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.142-150
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    • 2019
  • Purpose: The aim of this study was to evaluate the efficiency of the Humpty Dumpty Falls Scale as one of the falls risk assessment tools, and also to evaluate risk factors as predictors of falls in pediatric patient populations. Methods: In a retrospective, case-control design with data from the electronic medical records of 13 pediatric patients who fell and 1,941 who did not fall before matching and 429 who did not fall after matching by gender, age, diagnosis, and length of stay. Results: All the variables showed no significant differences after matching. At the cutoff score of 13, sensitivity, specificity, negative and positive predictive values were 92.3%, 37.1%, 99.9%, and 0.01%, respectively. The area under the Receiver Operating Characteristics was 0.597. The results from the logistic regression showed that the pediatric inpatient population who had higher risk scores was significantly associated with falls. The odds ratios ranged from 1.31 to 4.71 with 90% confidence interval. Conclusion: The saturation impairments criterion as one of the diagnostic parameter was negatively associated with falls, but the relative risk score was higher than the other criteria. Therefore, it seems that the diagnostic parameter seems to be required to verify results through large sample studies.

Fast Real-Time Cardiac MRI: a Review of Current Techniques and Future Directions

  • Wang, Xiaoqing;Uecker, Martin;Feng, Li
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.252-265
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    • 2021
  • Cardiac magnetic resonance imaging (MRI) serves as a clinical gold-standard non-invasive imaging technique for the assessment of global and regional cardiac function. Conventional cardiac MRI is limited by the long acquisition time, the need for ECG gating and/or long breathhold, and insufficient spatiotemporal resolution. Real-time cardiac cine MRI refers to high spatiotemporal cardiac imaging using data acquired continuously without synchronization or binning, and therefore of potential interest in overcoming the limitations of conventional cardiac MRI. Novel acquisition and reconstruction techniques must be employed to facilitate real-time cardiac MRI. The goal of this study is to discuss methods that have been developed for real-time cardiac MRI. In particular, we classified existing techniques into two categories based on the use of non-iterative and iterative reconstruction. In addition, we present several research trends in this direction, including deep learning-based image reconstruction and other advanced real-time cardiac MRI strategies that reconstruct images acquired from real-time free-breathing techniques.