• Title/Summary/Keyword: Evidence Based Diagnosis

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Value of Contrast-Enhanced Ultrasonography in the Differential Diagnosis of Enlarged Lymph Nodes: a Meta-Analysis of Diagnostic Accuracy Studies

  • Jin, Ya;He, Yu-Shuang;Zhang, Ming-Ming;Parajuly, Shyam Sundar;Chen, Shuang;Zhao, Hai-Na;Peng, Yu-Lan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2361-2368
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    • 2015
  • Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

A Study on Community Perceptions of Common Cancers, Determinants of Community Behaviour and Program Implementation in New Delhi, India

  • Seth, Tulika;Kotwal, Atul;Thakur, Rakesh Kumar;Ganguly, K.K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.6
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    • pp.2781-2789
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    • 2012
  • Assessment of perceptions of the community, the determinants and development of their behavior regarding common malignancies, helps in establishing evidence-based activities for prevention and early diagnosis of cancer. However information on this important aspect is lacking in our country. Qualitative methods were here used to obtain information through in depth interviews and Focus Group Discussions (FGDs) with all categories of identified stakeholders. Most were unaware of the activities of the cancer control program. Even the providers were not fully conversant. All respondents mentioned lack of diagnostic and treatment facilities in government, primary and secondary level facilities. Perceptions of different categories of stakeholders regarding why many community members did not attend screening camps and other services reflect the determinants of community behavior, acting independently as well as in combination. The cancer control program was thought to be restricted only to some private facilities and overcrowded government tertiary care facilities where the visits were time consuming. Almost all the facilities were considered curative oriented. Issues of supervision, monitoring and feedback were inadequately addressed by providers who were inadequately trained in many program activities. The program lacked effective planning, coordination and appropriate implementation at the grass roots level in Delhi. Social mobilization was grossly inadequate, as most of the community members were unaware of the existence of the program. Misconceptions about the risk factors, signs and symptoms, diagnosis, and treatment were common amongst community members as well as many of the providers. Thus the national cancer control program in our country needs further community participation and social mobilization. Accessibility, availability, acceptability and affordability of various preventive, curative and rehabilitative activities, as well as intersectoral coordination, training, supervision and monitoring of program activities, all need to be addressed to ensure the success of this important public health program.

A Nation-Wide Epidemiological Study of Newly Diagnosed Primary Spine Tumor in the Adult Korean Population, 2009-2011

  • Sohn, Seil;Kim, Jinhee;Chung, Chun Kee;Lee, Na Rae;Sohn, Moon Jun;Kim, Sung Hwan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.195-204
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    • 2017
  • Objective : This 2009-2011 nation-wide study of adult Koreans was aimed to provide characteristics, medical utilization states, and survival rates for newly diagnosed patients with primary nonmalignant and malignant spine tumors. Methods : Data for patients with primary spine tumors were selected from the Korean Health Insurance Review and Assessment Service database. The data included their age, sex, health insurance type, co-morbidities, medical cost, and hospital stay duration. Hospital stay duration and medical costs per person occurring in one calendar year were used. In addition, survival rates of patients with primary malignant spine tumors were evaluated. Results : The incidence rate of a primary spine tumor increased with age, and the year of diagnosis ($p{\leq}0.0001$). Average annual medical costs ranged from 1627 USD (pelvis & sacrum & coccyx tumors) to 6601 USD (spinal cord tumor) for primary nonmalignant spine tumor and from 12137 USD (spinal meningomas) to 20825 USD (pelvis & sacrum & coccyx tumors) for a primary malignant spine tumor. Overall survival rates for those with a primary malignant spine tumor were 87.0%, 75.3%, and 70.6% at 3, 12, and 24 months, respectively. The Cox regression model results showed that male sex, medicare insurance were significantly positive factors affecting survival after a diagnosis of primary malignant spine tumor. Conclusion : Our study provides a detailed view of the characteristics, medical utilization states, and survival rates of patients newly diagnosed with primary spine tumors in Korea.

A Case of Catamenial Hemoptysis treated successfully with Gonadotropin-releasing Hormone (GnRH) Analogue (Gonadotropin-releasing Hormone (GnRH) Analogue로 치유된 Catamenial Hemoptysis 1예)

  • Kim, Dae-Han;Suh, Yo-Ahn;Kim, Sang-IL;Choi, Kui-Sung;Son, Hyun-Bae;Kwon, Yoong-Ju;Kim, Sung-Ho;Kim, Cheol-Hyeon;Lee, Jae-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.53 no.3
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    • pp.349-353
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    • 2002
  • Catamenial hemoptysis is syndrome characterized by bleeding from the bronchial trees and lungs that occurs synchronously with the female menstrual cycle. Etiologic mechanism of pulmonary endometriosis is still controversial, and the diagnosis is usually made on the basis of the clinical history and exclusion of other causes of recurrent hemoptysis. Serial computed tomograms of the chest during and in the interval between menstruations have been proved to be a useful confirmatory test. We experienced a 33-year-old female patient who had been previously diagnosed as pelvic endometriosis pathologically, experienced cyclic hemoptysis during menstruations. The diagnosis of pulmonary endometriosis was made based on her history and changes in the character of the lesions as documented on radiologic studies of the chest. She was treated successfully with GnRH analogue and there is no evidence of recurrence.

Analysis of Medical Care Utilization of Allergic Rhinitis Patients in Western Medicine and Korean Medicine between 2010 and 2016 : A Study of the Health Insurance Review and Assessment Service National Patients Sample Database (알레르기 비염 환자의 의과·한의과 의료 이용 현황 분석 : 2010-2016년 청구 데이터 분석)

  • Ryu, Ji-In;Kim, Jeong-Hun;Kang, Chae-Yeong;Hwang, Jin-Seub;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.34 no.2
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    • pp.21-37
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    • 2021
  • Objectives : Allergic rhinitis(AR) is a common chronic disease that accounts for 10-40% of the world's population. This study aims to analyze the status of claims, prevalence, and medical utilization of allergic rhinitis patients using representative patients sample data. Methods : This study used the National Patients Sample(HIRA-NPS) of the Health Insurance Review and Assessment Service for 7 years(2010-2016). And we defined AR patients as all statements including J30 or a subcategory of J30 as the main disease, using the Korean Standard Classification of Diseases(KCD-7). The trend of AR patients by year was divided into Western medicine(WM) and Korean medicine(KM), and analyzed by subgroup analysis such as inpatient/outpatient, gender, age, insurance type, and care institution. Results : Patients with AR were mainly claimed for first sub diagnosis in WM and major diagnosis in KM, and the number of claims increased about 1.3 times and 1.4 times compared to 2010 in WM and KM, respectively. In addition, the total annual medical expenses in 2016 increased 1.3 times and 1.7 times compared to 2010, respectively. Conclusions : Both WM and KM are showing a steadily increasing trend in medical use due to allergic rhinitis. Further research is needed by considering genetic and environmental factors and individual characteristics, and linking with additional data.

Incidence and management of condylar resorption after orthognathic surgery: An overview

  • Barone, Selene;Cosentini, Giorgio;Bennardo, Francesco;Antonelli, Alessandro;Giudice, Amerigo
    • The korean journal of orthodontics
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    • v.52 no.1
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    • pp.29-41
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    • 2022
  • Objective: Condylar resorption (CR) is one of the major post-surgical complications of orthognathic surgery. This systematic review (SR) aimed to evaluate epidemiological data, risk factors, and therapeutical management of CR. Methods: Six databases were screened by two investigators until September 2020 to obtain all SRs. After reading the titles and abstracts, eligible SRs were determined and data extraction was performed. Using the latest version of A Measurement Tool to Assess Systematic Reviews, the methodological quality of the included SRs was determined. Results: Ten SRs with low or critically-low methodological quality were included in this review. Mandibular hypoplasia on the sagittal plane and hyperdivergent growth pattern on the vertical plane were the most common skeletal alterations in which CR could occur after orthognathic surgery. Post-operative condylar changes were analyzed both on two-dimensional and three-dimensional (3D) radiographic examinations. The incidence of CR was not related to the fixation method. Based on the severity of the pathological conditions, management of CR can include conservative or surgical therapy. Conclusions: Despite the limited evidence in literature, CR is considered a consequence of orthognathic surgery. However, an accurate diagnosis of CR and a better orthognathic surgical planning must include 3D radiographic examinations to improve pre- and post-surgical comparison. Well-designed studies with long-term follow-up and 3D data are needed to clarify the findings of this analysis..

Musculoskeletal Ultrasound Findings of Knee Pain Patients: A Retrospective Observational Study (근초음파 진단기기를 활용한 슬관절 통증 환자의 초음파 소견: 후향적 관찰연구)

  • Lee, Sang-Hyun;Park, Hye-Jin;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Hwang, Eui-Hyoung;Shin, Byung-Cheul;Hwang, Man-Suk
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.163-171
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    • 2022
  • The study aimed to understand the knee condition of patients with knee joint pain who visited an Korean Medicine hospital by performing musculoskeletal ultrasound. From July 1, 2021 to October 31, 2021, information on the gender, age, diagnosis, and ultrasound findings of knee joint pain patients were retrospectively collected. To examine the condition of the knee joint, images were taken in a total of three postures. All images were analyzed by an examiner. 7 cases of osteoarthritis, 1 case of medial collateral ligament rupture, and 1 case of quadriceps tendon calcification were collected. It was able to check the condition of articular cartilage, lipoma arborescens, and the formation of osteophytes through musculoskeletal ultrasound. The implementation of musculoskeletal ultrasound can enable Korean medicine doctors to give more active treatment for patients through accurate and scientific diagnosis. Based on more evidence, it is thought that the use of medical devices by Korean medicine doctors will need to be made in the future.

A Study for Diagnostic Correspondent Rates between DSOM and Korean Medical Doctors' Diagnosis about Menstrual Pain (월경통 환자에 대한 한방진단시스템의 진단일치도 연구)

  • Lee, In-Seon;Cho, Hye-Sook;Ji, Gyu-Yong;Lee, Yong-Tae;Kim, Jong-Won;Jeon, Soo-Hyung;Kim, Gyeong-Min;Kim, Gyeong-Cheol;Ki, Kyu-Kon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.3
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    • pp.1-10
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    • 2015
  • Objectives Diagnosis System of Oriental Medicine (DSOM) was made as a computerized assistant program for oriental medicine doctors to be able to diagnose with statistical basis. Then DSOM uses questionnaires filled out by respondents with explanatory guide. But if the respondents misunderstand the meaning of the passages, the results were quite the opposite. Methods This study was designed to investigate the diagnostic correspondent rates between DSOM and TKM practitioners. First, let the respondents answer to DSOM. After that, three doctors diagnosed the respondents and marked 'p' when they diagnose that the respondent had the pathogenic factors, marked 'n' when they diagnose that the respondent had the pathogenic factors but not severs, and did not marked when they diagnose that the respondent didn't have the pathogenic factors. Finally, this study was investigated the correspondent rates of diagnosis between DSOM and doctors. Results In the pathogenic factor of three including insufficiency of Yin (陰虛), the correspondent rates were 90%. In the pathogenic factor of nine including deficiency of qi (氣虛), the correspondent rates were 80%. In the pathogenic factor of four including blood stasis (血瘀), the correspondent rates were 70%. In HH and HL, they showed the correspondent rates of 61.77%. The correspondent rate of heat (熱) was highest (96.88%). The correspondent rate of insufficiency of Yang (陽虛) was lowest (0%). In LH and LL, they showed the correspondent rates of 88.31%. The correspondent rate of blood stasis (血瘀) was lowest (71.76%). They all showed the correspondent rates of over 70%. Conclusions In DSOM and Doctors' diagnose, they showed the correspondent rates of 83.60%.

Material Diagnosis of Metalbased Pigments in Paintings Using Terahertz Imaging (테라헤르츠 이미징을 이용한 금속 성분 회화 재료 진단 연구)

  • Baek Nayeon;Lee Hanhyoung;Song Youna
    • Conservation Science in Museum
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    • v.29
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    • pp.111-132
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    • 2023
  • Terahertz radiation cannot pass through metal and therefore reflect and return most signals. Utilizing this property, this study analyzed information on paintings to verify the usage of metal materials on paintings and the scope of their application. First, the study tested specimens of metal-based pigments and synthetic pearl pigments with metallic colors and textures in order to compare basic characteristics of terahertz images, such as signal severance caused by metallic substances, traits reflected in cross-section images, and high degree of reflection. Subsequently, based on the collected information, the study diagnosed various types of paintings including Korean traditional paintings and oil paintings using the terahertz imaging technique to confirm the usage of metal-based pigments in the inner layers of paintings and their scope of application. The terahertz imaging technique could has the potential to provide scientific evidence for previously-undiscovered information and art-historical records about various types of paintings that used metalbased pigments, thereby rendering significant utility for the conservation and authentication of paintings.

A Human Case of Ballbladder Fascioliasis in Korea (담석을 동반한 담낭내 간질 감염 1례)

  • 홍성태;이순형
    • Parasites, Hosts and Diseases
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    • v.24 no.1
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    • pp.89-94
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    • 1986
  • The authors would record the fifth case of human fascioliasis in Korea, occurring in a 48 year old Korean man who lived in Munkyong, Kyongsangbuk-do. The diagnosis was based on the morphology and measurements of the eggs which were collected in necrotic debris from the tunnel-like ulcerations of the gallbladder wall which was surgically removed for a gall stone. Although we failed to find out the fluke in the specimen, there found an evidence of once presence of Fasciola in the inflamed wall of the gallbladder in this patient.

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