• Title/Summary/Keyword: Hosmer-Lemeshow Test

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Utility of the APACHE II Score as a Neurologic Prognostic Factor for Glufosinate Intoxicated Patients (Glufosinate 중독 환자의 신경학적 예후 인자로서 APACHE II Score의 유용성)

  • Yoo, Dae Han;Lee, Jung Won;Choi, Jae Hyung;Jeong, Dong Kil;Lee, Dong Wook;Lee, Young Joo;Cho, Young Shin;Park, Joon Bum;Chung, Hae Jin;Moon, Hyung Jun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.14 no.2
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    • pp.107-114
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    • 2016
  • Purpose: The incidence of glufosinate poisoning is gradually increasing, and it can be fatal if severe poisoning occurs. However, factors useful for predicting the post-discharge neurological prognosis of patients who have ingested glufosinate have yet to be identified. Our objective was to evaluate the utility of the acute physiology and chronic health evaluation (APACHE) II score measured in the emergency department for predicting the neurological prognosis. Methods: From April 2012 to August 2014, we conducted a retrospective study of patients who had ingested glufosinate. The outcome of the patients at discharge was defined by the Cerebral Performance Category Score (CPC). The patients were divided into a good prognosis group (CPC 1, 2) and a poor prognosis group (CPC 3, 4, 5), after which the APACHE II scores were compared. The Hosmer-Lemeshow test and the area under the receiver operating characteristic (ROC) curve from patients determined calibration and discrimination. Results: A total of 76 patients were enrolled (good prognosis group: 67 vs poor prognosis group: 9). The cut-off value for the APACHE II score was 12 and the area under the curve value was 0.891. The Hosmer and Lemeshow C statistic x2 was 7.414 (p=0.387), indicating good calibration for APACHE II. Conclusion: The APACHE II score is useful at predicting the neurological prognosis of patients who have ingested glufosinate.

Development of a Probability Model for Burst Risks of Water Main using the Analysis Methods of Leakage Type (매설환경에 따른 배수관망의 누수발생원인 특성분석)

  • Park, Sang-Bong;Choi, Tae-Ho;Koo, Ja-Yong
    • Journal of Korean Society of Water and Wastewater
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    • v.25 no.2
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    • pp.141-152
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    • 2011
  • In this study, we extracted effective factors of pipe burst from the status data of water asset, operating data of pressure, volume and etc. and 7 years' pipe burst and repair records. The extracted factors were sorted by each attribution and then a statistical analysis was performed to generate a pipe burst probability function using the logistic regression model. As the result, material, diameter, length, laying year, pressure and road width affected to pipe burst significantly. Especially, in case of small diameter, laying year was most effective factor and in case of steel pipe, external loading was main cause of burst, and in case of cast iron, PE, PC, HP pipes, the deterioration of joint was main cause. The other side, as a result of Hosmer-Lemeshow goodness of fit test the models are turned out significant statistically. Also the classification criteria were determined to minimize the total cost from classification errors, when the predicted probability was more than 18% this pipe could have a chance of burst.

A Study on Measures to Improve Satisfaction with Vocational Competency Development Training (직업능력개발훈련 만족도 향상을 위한 방안 연구)

  • Tae-Bok Kim;Kwang-Soo Kim
    • Journal of the Korea Safety Management & Science
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    • v.25 no.2
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    • pp.167-174
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    • 2023
  • Currently, the budget for vocational competency development training has been expanded, but the number of participants has decreased. As the budget for the Vocational Competency Development Project increases, the participation of a large number of people becomes necessary. This study aims to derive factors that affect satisfaction by selecting factors related to respondent characteristics, training institutions, training types, and job performance for satisfaction with vocational competency development training, and to study ways to improve satisfaction. Data were collected through focus group interviews (FGI), and logistic regression analysis was conducted through feasibility review and reliability analysis. As a result, in the case of the model, it was confirmed that the degree of agreement between the case actually measured and the case predicted by the model was low in the Hosmer and Lemeshow test, but the overall classification accuracy was classified as 96.0% in the classification accuracy table. As for the influence of the factors, the result was derived that the application of knowledge technology, training institution facility equipment, Business Collaboration, long-term work plan, and satisfaction with work performed have an influence in the order.

Verification of Validity of MPM II for Neurological Patients in Intensive Care Units (신경계중환자의 사망예측모델(Mortality Probability Model II)에 대한 타당도 검증)

  • Kim, Hee-Jeong;Kim, Kyung-Hee
    • Journal of Korean Academy of Nursing
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    • v.41 no.1
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    • pp.92-100
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    • 2011
  • Purpose: Mortality Provability Model (MPM) II is a model for predicting mortality probability of patients admitted to ICU. This study was done to test the validity of MPM II for critically ill neurological patients and to determine applicability of MPM II in predicting mortality of neurological ICU patients. Methods: Data were collected from medical records of 187 neurological patients over 18 yr of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009. Collected data were analyzed through $X^2$ test, t-test, Mann-Whiteny test, goodness of fit test, and ROC curve. Results: As to mortality according to patients' general and clinically related characteristics, mortality was statistically significantly different for ICU stay, hospital stay, APACHE III score, APACHE predicted death rate, GCS, endotracheal intubation, and central venous catheter. Results of Hosmer-Lemeshow goodness-of-fit test were MPM $II_0$ ($X^2$=0.02, p=.989), MPM $II_24$ ($X^2$=0.99 p=.805), MPM $II_48$ ($X^2$=0.91, p=.822), and MPM $II_72$ ($X^2$=1.57, p=.457), and results of the discrimination test using the ROC curve were MPM $II_0$, .726 (p<.001), MPM $II_24$, .764 (p<.001), MPM $II_48$, .762 (p<.001), and MPM $II_72$, .809 (p<.001). Conclusion: MPM II was found to be a valid mortality prediction model for neurological ICU patients.

Development of a Diabetic Foot Ulceration Prediction Model and Nomogram (당뇨병성 발궤양 발생 위험 예측모형과 노모그램 개발)

  • Lee, Eun Joo;Jeong, Ihn Sook;Woo, Seung Hun;Jung, Hyuk Jae;Han, Eun Jin;Kang, Chang Wan;Hyun, Sookyung
    • Journal of Korean Academy of Nursing
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    • v.51 no.3
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    • pp.280-293
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    • 2021
  • Purpose: This study aimed to identify the risk factors for diabetic foot ulceration (DFU) to develop and evaluate the performance of a DFU prediction model and nomogram among people with diabetes mellitus (DM). Methods: This unmatched case-control study was conducted with 379 adult patients (118 patients with DM and 261 controls) from four general hospitals in South Korea. Data were collected through a structured questionnaire, foot examination, and review of patients' electronic health records. Multiple logistic regression analysis was performed to build the DFU prediction model and nomogram. Further, their performance was analyzed using the Lemeshow-Hosmer test, concordance statistic (C-statistic), and sensitivity/specificity analyses in training and test samples. Results: The prediction model was based on risk factors including previous foot ulcer or amputation, peripheral vascular disease, peripheral neuropathy, current smoking, and chronic kidney disease. The calibration of the DFU nomogram was appropriate (χ2 = 5.85, p = .321). The C-statistic of the DFU nomogram was .95 (95% confidence interval .93~.97) for both the training and test samples. For clinical usefulness, the sensitivity and specificity obtained were 88.5% and 85.7%, respectively at 110 points in the training sample. The performance of the nomogram was better in male patients or those having DM for more than 10 years. Conclusion: The nomogram of the DFU prediction model shows good performance, and is thereby recommended for monitoring the risk of DFU and preventing the occurrence of DFU in people with DM.

Development of a Failure Probability Model based on Operation Data of Thermal Piping Network in District Heating System (지역난방 열배관망 운영데이터 기반의 파손확률 모델 개발)

  • Kim, Hyoung Seok;Kim, Gye Beom;Kim, Lae Hyun
    • Korean Chemical Engineering Research
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    • v.55 no.3
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    • pp.322-331
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    • 2017
  • District heating was first introduced in Korea in 1985. As the service life of the underground thermal piping network has increased for more than 30 years, the maintenance of the underground thermal pipe has become an important issue. A variety of complex technologies are required for periodic inspection and operation management for the maintenance of the aged thermal piping network. Especially, it is required to develop a model that can be used for decision making in order to derive optimal maintenance and replacement point from the economic viewpoint in the field. In this study, the analysis was carried out based on the repair history and accident data at the operation of the thermal pipe network of five districts in the Korea District Heating Corporation. A failure probability model was developed by introducing statistical techniques of qualitative analysis and binomial logistic regression analysis. As a result of qualitative analysis of maintenance history and accident data, the most important cause of pipeline damage was construction erosion, corrosion of pipe and bad material accounted for about 82%. In the statistical model analysis, by setting the separation point of the classification to 0.25, the accuracy of the thermal pipe breakage and non-breakage classification improved to 73.5%. In order to establish the failure probability model, the fitness of the model was verified through the Hosmer and Lemeshow test, the independent test of the independent variables, and the Chi-Square test of the model. According to the results of analysis of the risk of thermal pipe network damage, the highest probability of failure was analyzed as the thermal pipeline constructed by the F construction company in the reducer pipe of less than 250mm, which is more than 10 years on the Seoul area motorway in winter. The results of this study can be used to prioritize maintenance, preventive inspection, and replacement of thermal piping systems. In addition, it will be possible to reduce the frequency of thermal pipeline damage and to use it more aggressively to manage thermal piping network by establishing and coping with accident prevention plan in advance such as inspection and maintenance.

Comparison of Predict Mortality Scoring Systems for Spontaneous Intracerebral Hemorrhage Patients (자발성 뇌내출혈 환자의 예후 예측도구 비교)

  • Youn, Bock-Hui;Kim, Eun-Kyung
    • Korean Journal of Adult Nursing
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    • v.17 no.3
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    • pp.464-473
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    • 2005
  • Purpose: The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. Methods: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. Results: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H=15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. Conclusion: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.

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Does a Higher Coronary Artery Bypass Graft Surgery Volume Always have a Low In-hospital Mortality Rate in Korea? (관상동맥우회로술 환자의 위험도에 따른 수술량과 병원내 사망의 관련성)

  • Lee, Kwang-Soo;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.1
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    • pp.13-20
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    • 2006
  • Objectives: To propose a risk-adjustment model with using insurance claims data and to analyze whether or not the outcomes of non-emergent and isolated coronary artery bypass graft surgery (CABG) differed between the low- and high-volume hospitals for the patients who are at different levels of surgical risk. Methods: This is a cross-sectional study that used the 2002 data of the national health insurance claims. The study data set included the patient level data as well as all the ICD-10 diagnosis and procedure codes that were recorded in the claims. The patient's biological, admission and comorbidity information were used in the risk-adjustment model. The risk factors were adjusted with the logistic regression model. The subjects were classified into five groups based on the predicted surgical risk: minimal (<0.5%), low (0.5% to 2%), moderate (2% to 5%), high (5% to 20%), and severe (=20%). The differences between the low- and high-volume hospitals were assessed in each of the five risk groups. Results: The final risk-adjustment model consisted of ten risk factors and these factors were found to have statistically significant effects on patient mortality. The C-statistic (0.83) and Hosmer-Lemeshow test ($x^2=6.92$, p=0.55) showed that the model's performance was good. A total of 30 low-volume hospitals (971 patients) and 4 high-volume hospitals (1,087 patients) were identified. Significant differences for the in-hospital mortality were found between the low- and high-volume hospitals for the high (21.6% vs. 7.2%, p=0.00) and severe (44.4% vs. 11.8%, p=0.00) risk patient groups. Conclusions: Good model performance showed that insurance claims data can be used for comparing hospital mortality after adjusting for the patients' risk. Negative correlation was existed between surgery volume and in-hospital mortality. However, only patients in high and severe risk groups had such a relationship.

Performance of APACHE IV in Medical Intensive Care Unit Patients: Comparisons with APACHE II, SAPS 3, and MPM0 III

  • Ko, Mihye;Shim, Miyoung;Lee, Sang-Min;Kim, Yujin;Yoon, Soyoung
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.216-221
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    • 2018
  • Background: In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model $(MPM)_0$ III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients. Methods: The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and $MPM_0$ III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis. Results: For the APACHE IV, SAPS 3, $MPM_0$ III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for $MPM_0$ III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and $MPM_0$ III (chi-square, 11.128; P=0.133). Conclusions: APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

The Importance of Early Surgical Decompression for Acute Traumatic Spinal Cord Injury

  • Lee, Dong-Yeong;Park, Young-Jin;Song, Sang-Youn;Hwang, Sun-Chul;Kim, Kun-Tae;Kim, Dong-Hee
    • Clinics in Orthopedic Surgery
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    • v.10 no.4
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    • pp.448-454
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    • 2018
  • Background: Traumatic spinal cord injury (SCI) is a tragic event that has a major impact on individuals and society as well as the healthcare system. The purpose of this study was to investigate the strength of association between surgical treatment timing and neurological improvement. Methods: Fifty-six patients with neurological impairment due to traumatic SCI were included in this study. From January 2013 to June 2017, all their medical records were reviewed. Initially, to identify the factors affecting the recovery of neurological deficit after an acute SCI, we performed univariate logistic regression analyses for various variables. Then, we performed a multivariate logistic regression analysis for variables that showed a p-value of < 0.2 in the univariate analyses. The Hosmer-Lemeshow test was used to determine the goodness of fit for the multivariate logistic regression model. Results: In the univariate analysis on the strength of associations between various factors and neurological improvement, the following factors had a p-value of < 0.2: surgical timing (early, < 8 hours; late, 8-24 hours; p = 0.033), completeness of SCI (complete/incomplete; p = 0.033), and smoking (p = 0.095). In the multivariate analysis, only two variables were significant: surgical timing (odds ratio [OR], 0.128; p = 0.004) and completeness of SCI (OR, 9.611; p = 0.009). Conclusions: Early surgical decompression within 8 hours after traumatic SCI appeared to improve neurological recovery. Furthermore, incomplete SCI was more closely related to favorable neurological improvement than complete SCI. Therefore, we recommend early decompression as an effective treatment for traumatic SCI.