• Korean Journal of Radiology
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• 제24권1호
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• pp.51-61
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• 2023

Objective: To develop and test a machine learning model for classifying human papillomavirus (HPV) status of patients with oropharyngeal squamous cell carcinoma (OPSCC) using ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET-derived parameters in derived parameters and an appropriate combination of machine learning methods in patients with OPSCC. Materials and Methods: This retrospective study enrolled 126 patients (118 male; mean age, 60 years) with newly diagnosed, pathologically confirmed OPSCC, that underwent ¹⁸F-FDG PET-computed tomography (CT) between January 2012 and February 2020. Patients were randomly assigned to training and internal validation sets in a 7:3 ratio. An external test set of 19 patients (16 male; mean age, 65.3 years) was recruited sequentially from two other tertiary hospitals. Model 1 used only PET parameters, Model 2 used only clinical features, and Model 3 used both PET and clinical parameters. Multiple feature transforms, feature selection, oversampling, and training models are all investigated. The external test set was used to test the three models that performed best in the internal validation set. The values for area under the receiver operating characteristic curve (AUC) were compared between models. Results: In the external test set, ExtraTrees-based Model 3, which uses two PET-derived parameters and three clinical features, with a combination of MinMaxScaler, mutual information selection, and adaptive synthetic sampling approach, showed the best performance (AUC = 0.78; 95% confidence interval, 0.46-1). Model 3 outperformed Model 1 using PET parameters alone (AUC = 0.48, p = 0.047) and Model 2 using clinical parameters alone (AUC = 0.52, p = 0.142) in predicting HPV status. Conclusion: Using oversampling and mutual information selection, an ExtraTree-based HPV status classifier was developed by combining metabolic parameters derived from ¹⁸F-FDG PET/CT and clinical parameters in OPSCC, which exhibited higher performance than the models using either PET or clinical parameters alone.

• 한국콘텐츠학회논문지
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• 제13권3호
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• pp.271-277
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• 2013

본 연구에서는 부산지역 H치과병원에 내원하고 있는 18세 이상의 환자 151명을 대상으로 자료를 분석하여 의료소비자의 치과진료기관 선택기준을 살펴봄으로써 향후 병원경영 및 이미지 향상에 기초자료로 제공하고자 하였다. 연구대상자의 성별 의료기관 선택 기준별 중요도 교차분석에서 청결위생(78.1%), 시설장비(60.9%), 경력입소문(57.6%), 의료진 친절(57.6%), 이용 편리성(32.5%), 기관 규모(22.5%)의 순으로 나타났고, 평균비교에서도 청결위생, 진료진 친절, 시설, 장비, 경력, 입소문 순으로 교차분석과 비슷하게 나타났으며, 연구대상자가 의료기관 선택 시 최우선적으로 고려하는 부분은 통증처치(31.8%), 감염관리(30.5%), 진료비(29.8%), 진료시간(7.9%)의 순이었다. 성별로 최우선적으로 고려하는 부분은 남자는 통증처치(39.2%), 여자는 진료비(39.1%)가 가장 많았다(p<0.001). 의료소비자의 치과의료기관 선택 시 청결위생상태 및 감염관리를 비중있게 생각하는 것으로 나타나 의료소비자의 의료기관 재 이용의사에도 어느 정도 영향을 주고 있으므로 이에 부응하기 위해 의료소비자를 만족시킬 수 있는 치과의료진의 청결위생과 감염관리의 인식과 실천이 필요할 것으로 사료된다.

• 대한불안의학회지
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• 제9권1호
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• pp.54-60
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• 2013

Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

• Journal of Preventive Medicine and Public Health
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• 제25권1호
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• pp.53-63
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• 1992

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

• 대한방사선협회지
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• 제25권1호
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• pp.311-316
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• 1999

• 대한정형외과스포츠의학회지
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• 제2권1호
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• pp.15-19
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• 2003

Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

• 한국병원경영학회지
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• 제23권2호
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• pp.42-53
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• 2018

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

• Journal of Korean Neurosurgical Society
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• 제59권4호
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• pp.327-333
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• 2016

Adult spinal deformity (ASD) is one of the most challenging spinal disorders associated with broad range of clinical and radiological presentation. Correct selection of fusion levels in surgical planning for the management of adult spinal deformity is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. In this study, we describe our new simple decision making algorithm and selection of fusion level for ASD surgery in terms of adult idiopathic idiopathic scoliosis vs. degenerative scoliosis.

• 대한관절경학회지
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• 제1권1호
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• pp.36-40
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• 1997

Anterior Cruciate Ligament (ACL) plays an important biomechanical role for the stability of knee joint. ACL injury often leads to injuries of articular cartilage, menisci, or other supporting structures, and subsequent development of degenerative arthritis. Controversies still exist in the best treatment modalities of ACL injuries. hut the author considers it most important to make the appropriate patient selection for operative reconstruction or nonoperative treatment. and describes the treatment principles of ACL injury, including diagnosis, patient selection and the treatment modalities for successful treatment of ACL injury.

• 한국산학기술학회논문지
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• 제14권6호
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• pp.2819-2827
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• 2013

본 연구는 신경계 재활전문병원의 이탈환자에 대한 환경적 요인과 의료적 요인에 관해서 조사하는 것이다. 대상자는 107명의 입원환자를 대상으로 조사하였다. 수집된 자료는 SPSS Win 19.0을 이용하여 분석하였다. 그 결과 첫째, 일반적 병원선택에서는 추천이 35.5%, 환경적 불만족 요인에는 병원시설이 37.4%, 병원 선택인에는 지인이 23.4%로 장 높게 나타났다. 둘째, 전문성, 친절성 및 설명성에 대한 만족도 조사에서 만족도가 가장 낮은 그룹은 간병사 그룹이고 만족도가 가장 높은 그룹은 물리치료사와 작업치료사 그룹으로 나타났다. 셋째, 원무(행정)절차, 진료절차, 대기시간 및 의료비용에 관한 만족도는 모두 '보통'의 선택 안이 가장 높은 분포를 보였다. 결론적으로 환경적 불만족 요인에서 높은 비율을 차지한 병원시설은 신경계전문병원의 수가 적어서 환자의 밀집현상으로 인해 발생한 것으로 보여 환자이탈의 요소로 간주될 수 있고, 의료적 불만족 요인에서는 환자와 많은 시간을 할애하는 간병사(care worker)에 대한 만족도(전문성, 친절성, 설명성)가 가장 낮아서 환자 이탈의 중요한 요인이 됨을 알 수 있었다. 따라서 간병사에 대한 서비스 만족도와 불만족도에 미치는 요인을 조사하고 문제점을 해결하여 간병사의 서비스 질을 향상시킬 수 있는 방안을 모색해야 할 것으로 사료된다.