• 한국소음진동공학회논문집
• /
• 제25권4호
• /
• pp.299-305
• /
• 2015

A statistical annoyance model to railway noise at platform was proposed by jury evaluation test performed in hearing laboratory. ITX-Saemaeul and Mugunghwa were chosen as the noise sources of the test, and announcement sound was included to simulate real situation. Logistic regression analysis produced %HA_LAB curve. Hosmer-Lemeshow test and classification accuracy test were used to verify the model's statistical significance. It was shown that the model which was generated from relatively small number of samples is statistically significant.

• Journal of Preventive Medicine and Public Health
• /
• 제38권2호
• /
• pp.132-140
• /
• 2005

Objectives: To propose a risk-adjustment model from insurance claims data, and analyze the changes in cesarean section rates of healthcare organizations after adjusting for risk distribution. Methods: The study sample included delivery claims data from January to September, 2003. A risk-adjustment model was built using the 1st quarter data, and the 2nd and 3rd quarter data were used for a validation test. Patients' risk factors were adjusted using a logistic regression analysis. The c-statistic and Hosmer-Lemeshow test were used to evaluate the performance of the risk-adjustment model. Crude, predicted and risk-adjusted rates were calculated, and compared to analyze the effects of the adjustment. Results: Nine risk factors (malpresentation, eclampsia, malignancy, multiple pregnancies, problems in the placenta, previous Cesarean section, older mothers, bleeding and diabetes) were included in the final risk-adjustment model, and were found to have statistically significant effects on the mode of delivery. The c-statistic (0.78) and Hosmer-Lemeshow test ($x^2$=0.60, p=0.439) indicated a good model performance. After applying the 2nd and 3rd quarter data to the model, there were no differences in the c-statistic and Hosmer-Lemeshow $x^2$. Also, risk factor adjustment led to changes in the ranking of hospital Cesarean section rates, especially in tertiary and general hospitals. Conclusion: This study showed a model performance, using medical record abstracted data, was comparable to the results of previous studies. Insurance claims data can be used for identifying areas where risk factors should be adjusted. The changes in the ranking of hospital Cesarean section rates implied that crude rates can mislead people and therefore, the risk should be adjusted before the rates are released to the public. The proposed risk-adjustment model can be applied for the fair comparisons of the rates between hospitals.

• 보건행정학회지
• /
• 제26권4호
• /
• pp.359-372
• /
• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• 대한교통학회지
• /
• 제32권3호
• /
• pp.198-206
• /
• 2014

경찰청 통계에 따르면, 우리나라에서 신호위반사고는 심각한 안전문제로 대두되고 있다. 본 연구에서는 청주시 신호교차로에서의 신호위반사고를 다루고 있으며, 연구 목적은 신호위반사고와 비신호위반사고의 특성을 비교분석하고 이항 로지스틱 모형을 이용하여 영향요인을 파악하기 위함이다. 이를 위해 본 연구에서는 2007-2011년간 청주에서 발생한 2천246건의 신호위반사고와 3천884건의 비신호위반사고 자료를 이용하여 두 집단 간의 차이를 검증하고자 한다. 주요 연구결과는 다음과 같다. 첫째, 신호위반사고는 야간시간대 및 직진상태에서 많이 발생하였다. 둘째, 신호위반사고와 비신호위반사고에 영향을 주는 변수로는 충돌형태, 충돌전 진행방향, 운전자 연령대(30대, 50대), 음주운전 및 사고유형 등으로 나타났다. 마지막으로, 이항 로지스틱 회귀분석에 의해 통계적으로 유의한 모형식이 개발되었다(Hosmer and Lemeshow test: 7.052, p-value:0.531).

• 가정∙방문간호학회지
• /
• 제30권1호
• /
• pp.48-58
• /
• 2023

Purpose: The purpose of this study was to construct a nomogram for predicting difficulty in peripheral intravenous cannulation (DPIVC) for adult inpatients. Methods: This study conducted a secondary analysis of data from the intravenous cannulation cohort by intravenous specialist nurses at a tertiary hospital in Seoul. Overall, 504 patients were included; of these, 166 (32.9%) patients with failed cannulation in the first intravenous cannulation attempt were included in the case group, while the remaining 338 patients were included in the control group. The nomogram was built with the identified risk factors using a multiple logistic regression analysis. The model performance was analyzed using the Hosmer-Lemeshow test, area under the curve (AUC), and calibration plot. Results: Five factors, including vein diameter, vein visibility, chronic kidney disease, diabetes, and chemotherapy, were risk factors of DPIVC. The nomogram showed good discrimination with an AUC of 0.81 (95% confidence interval: 0.80-0.82) by the sample data and 0.79 (95% confidence interval: 0.74-0.84) by bootstrapping validation. The Hosmer-Lemeshow goodness-of-fit test showed a p-value of 0.694, and the calibration curve of the nomogram showed high coherence between the predicted and actual probabilities of DPIVC. Conclusion: This nomogram can be used in clinical practice by nurses to predict DPIVC probability. Future studies are required, including those on factors possibly affecting intravenous cannulation.

• Clinical and Experimental Pediatrics
• /
• 제51권11호
• /
• pp.1158-1164
• /
• 2008

목 적: 저자들은 중환자실에 입원하는 환아들에 대한 소아사망률지표 2 (pediatric index of mortality 2, PIM2)와 소아사망위험도 III (pediatric risk of mortality III, PRISM III)의 유효성을 평가하고자 하였다. 방 법: 2003년 1월부터 2007년 12월까지 단일 기관 중환자실에 입실하여 치료받았던 환아의 의무기록을 후향적으로 조사하였다. 중환자실에 입실하여 2시간 이내에 사망하거나 절망적인 상태의 퇴원인 경우는 제외하였다. 환아들의 일반적인 특성에 대해서 Student's t-test와 ANOVA를, PIM2와 PRISM III 항목에 대해서 생존한 환아와 사망한 환아 사이에 상관분석을 시행하였다. 또한, 사망률 예측의 정도에 대한 정확성을 위해서 Hosmer-Lemeshow 적합도에 대한 다중회귀분석과 수용자 작업특성곡선을 사용하였으며 예측사망율의 과대 또는 과소 평가는 표준화된 사망비를 이용하여 검증하였다. 결 과: 193 증례의 의무기록을 검토하였으나 3예가 중환자실에 입실한 2시간이내에 사망하여 190예에 대하여 분석을 시행하였다. PIM2의 항목들은 수술이나 술기 후에 입원한 경우와 저위험군의 항목을 제외하고 생존과 연관성이 있었다. PRISM III에서는 심혈관/신경계 징후, 동맥혈가스분석의 항목이 관련성이 있었으나 생화학과 혈액학적 검사소견은 연관성이 유의하지 않았다. 수용자 작업특성곡선으로 확인한 예측도는 모두 의의가 있었으며 PIM2의 곡선하면적이 0.858 (95% 신뢰도: 0.779-0.938), PRISM III가 0.798 (95%신뢰도: 0.686-0.891)이었다. 또한, 표준화된 사망비는 두 가지 지표 모두 1에 가까웠으며 다중회귀분석을 이용한 Hosmer-Lemeshow 적합도에서 PRISM III가 ${\chi}^2(13)=12.899$, P=0.456이었으며, PIM2는 ${\chi}^2(13)=14.986$, P=0.308이었다. 그러나 PIM2가 가능도비검정에서 PRISM III보다 유의한 특성을 가지고 있었다(${\chi}^2(4)=55.3$, P<0.01). 결 론: 저자들은 중환자실에 입실하는 소아 환자에서 사망률을 예측하는 두 가지 지표(PIM2, PRISM III)가 의미가 있다는 사실을 확인하였다. 저자들은 PIM2가 PRISM III보다 보다 정확하고 적절하다고 생각된다.

• Journal of the Korean Data and Information Science Society
• /
• 제24권6호
• /
• pp.1465-1475
• /
• 2013

The chi-square type test statistic is the most commonly used test in terms of measuring testing goodness-of-fit for multinomial logistic regression model, which has its grouped data (binomial data) and ungrouped (binary) data classified by a covariate pattern. Chi-square type statistic is not a satisfactory gauge, however, because the ungrouped Pearson chi-square statistic does not adhere well to the chi-square statistic and the ungrouped Pearson chi-square statistic is also not a satisfactory form of measurement in itself. Currently, goodness-of-fit in the ordinal setting is often assessed using the Pearson chi-square statistic and deviance tests. These tests involve creating a contingency table in which rows consist of all possible cross-classifications of the model covariates, and columns consist of the levels of the ordinal response. I examined goodness-of-fit tests for a proportional odds logistic regression model-the most commonly used regression model for an ordinal response variable. Using a simulation study, I investigated the distribution and power properties of this test and compared these with those of three other goodness-of-fit tests. The new test had lower power than the existing tests; however, it was able to detect a greater number of the different types of lack of fit considered in this study. I illustrated the ability of the tests to detect lack of fit using a study of aftercare decisions for psychiatrically hospitalized adolescents.

• 대한교통학회지
• /
• 제34권1호
• /
• pp.29-42
• /
• 2016

과속은 교통안전에 있어서 중요한 영향요인이며, 사고 심각도에 영향을 끼칠 뿐만 아니라 사고 위험성과 밀접한 관련성이 있다. 본 연구는 청주시의 신호교차로에 설치된 36개 다기능단속카메라(신호 및 과속)에서 수집한 27,968건의 속도위반 자료에 대한 분석 결과를 제시하고 있다. 이 자료에는 위반자의 3년간 위반이력을 포함한 다양한 인구통계학적 특성들을 포함하고 있다. 따라서 본 연구의 목적은 속도위반과 인적, 차량 및 도로 환경요인들 간의 관련성을 알아보기 위함으로 분석방법은 통계프로그램 SPSS 20의 기술통계와 이항로지스틱 회귀분석을 이용하였다. 주요 연구 결과는 다음과 같다. 첫째, 속도위반은 지방부와 도시외곽부 지역에서 많이 일어났다. 둘째, 속도위반 운전자의 약 25.6%는 제한속도 대비 20km/h 이상의 심각한 수준의 과속운전을 한다. 셋째, 과속운전자와 정상속도 운전자에 영향을 주는 변수로는 교차로의 공간적 위치와 운전자의 성별 및 연령이 선정되었다. 마지막으로, 이항 로지스틱 회귀분석에 의해 통계적으로 유의한 모형이 개발되었다(Hosmer and Lemeshow test : 11.586, p-value: 0.171).

• Journal of Chest Surgery
• /
• 제39권10호
• /
• pp.749-753
• /
• 2006

배경: 본 연구는 관상동맥 우회로술의 수술위험도를 예측할 수 있는 스코어 시스템을 만들고자 하였다. 대상 및 방법: 2000년 1월부터 2005년 9월까지 본원에서 시행되었던 관상동맥 우회로술 2,993예를 대상으로 여러 가지 수술 전후의 인자들에 대하여 후향적 연구를 진행하였다. 결과: 총 조기 수술사망률은 2.4%였으며 조기 사망에 통계적으로 의의 있게 연관된 것으로 나타난 7가지 인자(수술 전의 좌심실기능 부전(좌심실 구출률 30% 이하), 수술 전 신부전의 진단, 수술 전 1주일 이내 심근 경색, 재수술, 복합수술, 수술 전 심전도상에서의 심방 세동, 수술 전 대동맥 내 풍선 삽입술의 시행)의 베타지수(beta coefficient)를 지수화하여 스코어 시스템을 구하였다. 이 스코어 시스템에 대하여 ROC 커브와 Hosmer and Lemeshow goodness of fit test를 시행하여 적정성을 검증하였다. 결론: 본 시스템은 적정성 검사 결과 적정함을 나타냈지만 이후 더 많은 증례와 다른 병원과의 공조를 통하여 더 좋은 시스템의 확립이 중요하다.

• Journal of Preventive Medicine and Public Health
• /
• 제34권4호
• /
• pp.337-346
• /
• 2001

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.