• Title/Summary/Keyword: ICD-10

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A Basic Study for Development of Clinical Practice Guidelines of Korean Medicine in Autism Spectrum Disorder -Based on Pre-existing Clinical Practice Guidelines of Autism Specturm Disorder- (자폐스펙트럼장애의 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구 -기존에 개발된 자폐스펙트럼장애 가이드라인을 중심으로-)

  • Kim, Sang Min;Lee, Jin Yong;Lee, Sun Haeng;Chang, Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.31 no.1
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    • pp.52-62
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    • 2017
  • Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

Measuring Symptom Exaggeration in Posttraumatic Stress Disorder using the MMPI-2 and the Personality Assessment Inventory Symptom Validity Scales (MMPI-2와 Personality Assessment Inventory 타당도 척도를 이용한 외상후 스트레스 장애 환자의 증상과장 평가)

  • Kong, Sung-Whoi;Chae, Jeong-Ho;Lee, Jong-Hun;Hahn, Sang-Woo;Park, Eun-Jin;Choi, Kyeong-Sook
    • Anxiety and mood
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    • v.8 no.1
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    • pp.22-30
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    • 2012
  • Objective : We investigated whether Posttraumatic stress disorder patients have a higher tendency to exaggerate the extent of their psychological symptoms compared to other psychiatric patients. Methods : Medical records of patients, who had received psychiatric treatment at four university hospitals in Korea between January 2009 and December 2010, were retrospectively reviewed. We compared a group of 37 patients diagnosed with PTSD, and another group of 41 patients diagnosed with neurotic, stress-related and somatoform disorders according to the ICD-10. To compare the extent of malingering in the two groups, we compared the validity scales of MMPI-2 and Personality Assessment Inventory. We determined the number of participants in both groups feigning their responses by using various cutoff scores of the validity indicators. Results : The PTSD group showed significantly higher scores on the F (p=0.001), F (B)(p=0.000), F (P)(p=0.030), F-K (p=0.003) scale of the MMPI-2 compared to the other group of psychiatric patients. The PTSD group had a significantly higher NIM score (p=0.001) but a lower PIM score (p=0.020) of the PAI compared to the other group of psychiatric patients. Using the cutoff scores, the PTSD group showed a significantly higher number of patients who feigned responses compared to the other group ($Fb{\geq}75$ (p=0.010), $F-K{\geq}1$ (p=0.005), $F-K{\geq}10$ (p=0.011) from the MMPI-2, and $NIM{\geq}80$ (p=0.001) from the PAI). Conclusion : These results suggest that PTSD patients have a tendency to exaggerate their symptom. This group of patients overreported the severity of their condition during standardized personality assessment that included the MMPI-2 or PAI compared to patients diagnosed with other psychiatric disorders. Additional research is required to determine the factors influencing symptom exaggeration in PTSD.

Assessment of the Availability of Health Insurance Data for Epidemiologic Study of Childhood Aseptic Meningitis (소아 무균성 뇌막염의 역학적 연구를 위한 건강보험자료원의 유용성 평가)

  • Park, Sue-Kyung;Ki, Mo-Ran;Son, Young-Mo;Kim, Ho;Cheong, Hae-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.36 no.4
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    • pp.349-358
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    • 2003
  • Objectives : Aseptic meningitis is a major cause of Korean childhood morbidity late spring and early summer. However, the nationwide incidences of the disease have not been reported. This study was conducted to evaluate the availability of National Health Insurance data (NHID) for the study of an epidemiological trend in the surveillance of aseptic meningitis in children. Methods : All the claims, under A87, A87.8, and A87.9 by ICD-10, among children below 15 years of age, to the National Health Insurance Corporation, between January and December 1998, were extracted. A survey of the medical record of 3,874 cases from 136 general hospitals was peformed. The availability of the NHID was evaluated by the three following methods: 1) The diagnostic accuracy (the positive Predictive value : proportion of the confirmed aseptic meningitis among the subjects registered as above disease-codes in NHID) was evaluated through a chart review, and according to age, gender, month and region of disease-occurrence. 2) The distribution of confirmed cases was compared with the distribution of total subjects from the NHID, for subjects in General hospitals, or the subjects surveyed. 3) The proportion of confirmed CSF test was confirmed, and the relating factor, which was the difference in CSF-test rate, analyzed. Results : Among 3,874 cases, CSF examinations were peformed on 1,845 (47.6%), and the CSF-test rates were different according to the medical utility (admission vs. OPD visit) and the severity of the symptoms and signs. The diagnostic accuracy for aseptic meningitis, and during the epidemic (May-Aug) and sporadic (Sept-Apr) periods, were 85.0 (1,568/1,845), 86.0 (1,239/l,440) and 81.2% (329/405), respectively. The distributions by age, sex, month or period (epidemic/sporadic) and region, in the confirmed cases, were similar to those in the NHID, in both the subjects at General hospitals and in those surveyed, to within ${\pm}7%$. Conclusions : In this paper, the NHID for the subjects registered with an aseptic meningitis disease-code might be available for an epidemiological study on the incidence-estimation of childhood aseptic meningitis, as the NHID could include both the probable and definite cases. On the basis of this result, further studies of time-series and secular trend analyses, using the NHID, will be peformed.

Comparison of Energy Metabolisms between Laying and Non- laying Hen (산란계와 비산란계의 에너지대사 비교 시험)

  • 이영철
    • Korean Journal of Poultry Science
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    • v.13 no.1
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    • pp.31-40
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    • 1986
  • The energy metabolism with the normal laying hen and progesterone injected non-laying hen are compared. 1. The FHP of 109.7Kcal for laying hen was 25.5 percent higher than the 87.4 Kcal found for non-laying hen. 2. The MEm's of laying hen and non-laying hen were 149, and 135Kcal/Kg$\^$0.75/day and NAME's of the diets were 77 and 83 percent, respectively. For the laying hen shown negative retention in body energy during the experiment, the 77 percent NAME was the value of supporting egg production. For the non-laying hen shown the positive retention in body energy and zero egg production, the 83 percent NAME was of growth. 3. A change in body weight of 1g was comparable to 3.54 Kcal for laying hen, and 5.0 Kcal for non-laying hen, when calculated on regression equations between body weight change and body energy retention(BE). The figures indicate that the tissue energy is used with an efficiency of 70 percent for egg production. 4. Plasma level of triiodothyronine(T3) for the laying hen is appeared to be higher than that of non-laying hen, although the levels of thyroxine (T4) are equal both in laying and non-laying hen. 5. Activities of four hepatic enzymes(ATP citrate lyase, fructose diphosphate aldolase, isocitrate dehydrogenase and glutamte pyruvic transaminase) were significantly greater in the laying hen than in the non-laying hen.

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The societal cost of rotavirus infection in South Korea (한국에서 로타바이러스 급성 위장관염의 질병 부담)

  • Yang, Bong Min;Jo, Dae Sun;Kim, Youn Hee;Hong, Ji Min;Kim, Jung Soo
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.977-986
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    • 2008
  • Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

A Nested Case Control Study on Risk Factors for Coronary Heart Disease in Korean (관상동맥질환 위험요인 구명을 위한 코호트내 환자-대조군 연구)

  • Kim, Ki-Soon;Park, Jong;Park, Jong-Ku;Kim, Chun-Bae;Chun, Byung-Yeol;Lee, Tae-Yong;Lee, Kang-Sook;Lee, Duk-Hee;Koh, Kwang-Wook;Jee, Sun-Ha;Suh, Il;Ryu, So-Yeon
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.149-156
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    • 2001
  • Objective : To elucidate risk factors for coronary heart diseases among Korean males. Methods : A nested case control study was conducted among a Korea Medical Insurance Cooperation(KMIC) cohort composed of 108,802 males. The eases included 246 male patients who were admitted to hospital due to coronary heart diseases from 1993 to 1997 (120-25 by ICD) and whose diagnosis was confirmed by the protocol by WHO MONICA Project(1994). The control group was composed of 483 patients selected by frequency matching considering age and resident area from an inpatient care group without coronary heart disease during the same period. For study cases and the controls, the results of a health check-up in 1990 and a questionnaire on life style in 1992 were received through the KMIC. Some additional information was collected by telephone interviews during October 1999. Results : Multiple logistic regression analysis showed that the odds ratio(OR) of coronary heart diseases among past smokers and current smokers as compared to non-smokers were 1.94(95% CI : 1.14-3.31) and 2.20(55% CI : 1.35-3.59), respectively. The OR among persons who drank 4 cups or more of caffeinated beverages such as coffee or tea daily as compared to persons who drank one cup for 2-3 days was 2.50(95% CI : 1.07-6.12). The OR among persons with high normal BP and stage 3 hypertension against normotension were 2.51 (95% CI : 1.44-4.37) and 5.08(95% CI : 2.38-10.84). The OR among persons whose blood cholesterol were 240 mg/dL or mere against lower than 200mg/dL was 2.24(95% CI : 1.43-3.49). Conclusion : Smoking, drinking of excessive caffeinated beverages, hypertension and high blood cholesterol were proven to be significant risk factors for coronary heart diseases among Korean males.

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The Research on the Classification of Soeumin Symptomatology and the Standardized Symptom (소음인(少陰人) 병증(病證) 분류체계와 표준증후 연구)

  • Song, Eun-Young;Park, Byung-Joo;Song, An-Na;Lee, Eui-Ju;Koh, Byung-Hee;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.23 no.4
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    • pp.429-444
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    • 2011
  • 1. Objective This study is aimed to present the effective classification of Soeumin symptomatology and the standardized signs for classification which can be applied for KCD, ICD and the insurance codification system. 2. Methods 1) Differentiate Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 2) Investigate the standard signs and symptoms to claasify Soeumin symptomatology based on exterior-interior patterns, favorable-unfavorable patterns, and mild-severe-dangerous-urgent patterns. 3. Results and Conclusions 1) The diagnosis criteria for Soeumin exterior-interior disease is based upon signs & symptoms of cold/heat, condition of stool, state of digestive system(such as digestion and appetite)among others. 2) The diagnosis criteria for Soeumin favorable-unfavorable disease is generally based upon whether the vital force of the spleen is damaged or not. More specifically, for the exterior disease, whether or not sweating is present. For the interior disease, whether or not dry mouth, body ache(a main symptom of the exterior state), and anxiousness are present. 3) For the Soeumin Wool-gwang disease, the diagnosis criteria of mild-severe disease is whether or not chills is present and the degree of body fever. 4) For Soeumin Mang-yang disease, the diagnosis criteria of dangerous-urgent disease is whether or not chills is, the degree of sweating and urine condition. 5) For the Soeumin Greater-Yin disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are early state signs, Jaundice pattern is mild-state sign, edema & Greater-Yang disease Yin-toxin pattern are terminal state signs. 6) For the Soeumin interior disease, Abdominal-pain bowel irritability pattern and Epigastric discomfort pattern are of the dangerous state pattern, Jang-gual and Exuberant-Yin-repelling-Yang pattern are of the urgent state patterns.

Research on Poisoning Data Collection using Toxic Exposure Surveillance System: Retrospective Preliminary Survey (중독감시체계를 이용한 중독정보 수집 및 분석: 후향적 기초조사)

  • Oh Bum-Jin;Kim Won;Cho Gyu-Chong;Kang Hui-Dong;Shon Yoo-Dong;Lee Jae-Ho;Lim Kyoung-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.4 no.1
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    • pp.32-43
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    • 2006
  • Purpose: Toxic Exposure Surveillance System (TESS) is widely used for poisoning data collection and making a counterplan. But, there were few reports about poisoning data collection using TESS in Korea. The aim was to collect poisoning data using TESS report form and investigate the recognition of emergency physician about the necessity of TESS as preliminary survey. Methods: Retrospectively, we gathered data from hospital records about the patient who admitted hospital emergency room due to poisoning. Date were gathered by paper and/or web client system report form in patients recruited by ICD-10 codes Results: From Jun 2004 to May 2005,3,203 patients were enrolled in 30 hospitals and their mean age was $44.9{\pm}20.3years$ old(male: female = 1,565: 1,638). The most frequent site of exposure was their own residence (73.2%, 2,345/3,203) and most of reported patients were older than 20 years(89.7%, 2,871/3,203). Frequent substances involved in poisoning were medication(41.9%) and pesticide(33.3%). Intentional poisoning was 60.7%(1,954). In fatality, overall frequency was 5.1%(162/3,203) and the most frequent route of exposure was ingestion(96.3%, 156/162) and the most frequent substance was pesticide(85.2%, 138/ 162). Antidotes were administered in 202 patients(2-PAM, atropine, antivenin, N-acetylcystein, vitamin K, flumazenil, ethanol, methylene blue, naloxone, calcium compound). 19 of 20 emergency physicians agreed with necessity of TESS. Conclusion: Data collection using TESS report form showed preliminary poisoning events in Korea. Frequent poisoning substance were medication and pesticide. The fatality was mainly related with pesticide ingestion. Many doctors in emergency room recognized the necessity of TESS.

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Design and Development of a System for Mapping of Medical Standard Terminologies (표준 의학 용어체계의 매핑을 위한 시스템의 설계 및 개발)

  • Lee, In-Keun;Kim, Hwa-Sun;Cho, Hune
    • Journal of the Korean Institute of Intelligent Systems
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    • v.21 no.2
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    • pp.237-243
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    • 2011
  • Various standard terminologies in medical field are composed individually to different structure. Therefore, information on crosswalking between the terminologies is needed to combine and use the terminologies. Lots of mapping tools have been developed and used to create the information. However, since those tools deal with specific terminologies, the information is restrictly created. To overcome this problem, some tools have been developed, which perform mapping tasks by composing various terminologies. However, the tools also have difficulty of composing automatically the terminologies because the terminologies have different structures. Therefore, in this paper, we propose a method for composing and using the terminologies in the developed mapping system with keeping the original structure of the terminologies. In the proposed method, additional terminologies could be added on the mapping system and used by making metadata involving information on location and structure of the terminologies. And the mapping system could cope flexibly with the changes of the structure or context of the terminologies. Moreover, various types of mapping information could be defined and created in the system because mapping data are constructed as triplets in ontology. Therefore, the mapping data can be transformed and distributed in different formats such as OWL, RDF, and Excel. Finally, we confirmed the usefulness of the mapping system based on the proposed method through the experiments about creating mapping data.

Socioeconomic Costs of Stroke in Korea: Estimated from the Korea National Health Insurance Claims Database (건강보험 청구자료를 이용한 우리나라 뇌졸증 환자의 사회경제적 비용 추계)

  • Lim, Seung-Ji;Kim, Han-Joong;Nam, Chung-Mo;Chang, Hoo-Sun;Jang, Young-Hwa;Kim, Se-Ra;Kang, Hye-Young
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.4
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    • pp.251-260
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    • 2009
  • Objectives : To estimate the annual socioeconomic costs of stroke in Korea in 2005 from a societal perspective. Methods : We identified those 20 years or older who had at least one national health insurance (NHI) claims record with a primary or a secondary diagnosis of stroke (ICD-10 codes: I60-I69, G45) in 2005. Direct medical costs of the stroke were measured from the NHI claims records. Direct non-medical costs were estimated as transportation costs incurred when visiting the hospitals. Indirect costs were defined as patients and caregivers productivity loss associated with office visits or hospitalization. Also, the costs of productivity loss due to premature death from stroke were calculated. Results : A total of 882,143 stroke patients were identified with prevalence for treatment of stroke at 2.44%. The total cost for the treatment of stroke in the nation was estimated to be 3,737 billion Korean won (KRW) which included direct costs at 1,130 billion KRW and indirect costs at 2,606 billion KRW. The per-capita cost of stroke was 3 million KRW for men and 2 million KRW for women. The total national spending for hemorrhagic and ischemic stroke was 1,323 billion KRW and 1,553 billion KRW, respectively, which together consisted of 77.0% of the total cost for stroke. Costs per patient for hemorrhagic and ischemic stroke were estimated at 6 million KRW and 2 million KRW, respectively. Conclusions : Stroke is a leading public health problem in Korea in terms of the economic burden. The indirect costs were identified as the largest component of the overall cost.