• Korean Journal of Radiology
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• 제25권3호
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• pp.267-276
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• 2024

Objective: To evaluate the diagnostic performance of susceptibility map-weighted imaging (SMwI) taken in different acquisition planes for discriminating patients with neurodegenerative parkinsonism from those without. Materials and Methods: This retrospective, observational, single-institution study enrolled consecutive patients who visited movement disorder clinics and underwent brain MRI and ¹⁸F-FP-CIT PET between September 2021 and December 2021. SMwI images were acquired in both the oblique (perpendicular to the midbrain) and the anterior commissure-posterior commissure (AC-PC) planes. Hyperintensity in the substantia nigra was determined by two neuroradiologists. ¹⁸F-FP-CIT PET was used as the reference standard. Inter-rater agreement was assessed using Cohen;s kappa coefficient. The diagnostic performance of SMwI in the two planes was analyzed separately for the right and left substantia nigra. Multivariable logistic regression analysis with generalized estimating equations was applied to compare the diagnostic performance of the two planes. Results: In total, 194 patients were included, of whom 105 and 103 had positive results on ¹⁸F-FP-CIT PET in the left and right substantia nigra, respectively. Good inter-rater agreement in the oblique (κ = 0.772/0.658 for left/right) and AC-PC planes (0.730/0.741 for left/right) was confirmed. The pooled sensitivities for two readers were 86.4% (178/206, left) and 83.3% (175/210, right) in the oblique plane and 87.4% (180/206, left) and 87.6% (184/210, right) in the AC-PC plane. The pooled specificities for two readers were 83.5% (152/182, left) and 82.0% (146/178, right) in the oblique plane, and 83.5% (152/182, left) and 86.0% (153/178, right) in the AC-PC plane. There were no significant differences in the diagnostic performance between the two planes (P > 0.05). Conclusion: There are no significant difference in the diagnostic performance of SMwI performed in the oblique and AC-PC plane in discriminating patients with parkinsonism from those without. This finding affirms that each institution may choose the imaging plane for SMwI according to their clinical settings.

• Physical Therapy Rehabilitation Science
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• 제12권3호
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• pp.259-267
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• 2023

Objective: Rehabilitative ultrasound imaging is a safe and noninvasive technique for evaluating muscle thickness. A dual probe-fixing frame (DPF) can provide visual feedback during exercises targeting specific muscles. The purpose of this research was to verify the reliability and validity of the DPF for dual-probe ultrasound (DPU)-based visual feedback exercises, allowing users to use both hands freely. Design: This cross-sectional study used repeated measures to compare muscle thickness measurements obtained using the handheld device and DPF with DPU. Methods: Twenty healthy adults participated in the study. Measurements were taken over two sessions, with a two-day interval between the sessions. The thicknesses of the rectus abdominis (RA) and transverse abdominis (TrA) muscles were measured using DPU. The DPF with DPU developed by the research team, was used along with a laptop-based muscle viewer. Bland-Altman analysis and intraclass correlation coefficients (ICCs) calculations were used in statistical analyses to evaluate agreement and reliability, respectively. Results: The results of the Bland-Altman analysis showed small average differences between the handheld and DPF methods for both RA and TrA muscle thicknesses. Inter-rater reliability analysis showed high ICC values for DPF measurements of both RA (0.908-0.912) and TrA (0.892-741) muscle thicknesses. Intra-rater reliability analysis also showed good ICC values for measurements taken by a single examiner over two days. Conclusion: The findings of this study demonstrate that the DPF provides reliable and valid measurements of muscle thickness during visual feedback exercises using the DPU.

• Physical Therapy Rehabilitation Science
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• 제5권2호
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• pp.53-62
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• 2016

Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were 'home program', 'home intervention', 'compliance', 'adherence', 'vestibular rehabilitation', 'motion sickness', and 'motion sensitivity'. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (${\kappa}$=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients' HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.

• Physical Therapy Rehabilitation Science
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• 제13권2호
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• pp.179-186
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• 2024

Objective: This study aims to assess the reliability and validity of the new hand-held spirometer as a potential substitute for traditional pulmonary function testing (PFT) devices. Design: Cross-sectional study. Methods: In this study, thirty healthy adults underwent spirometry using both the new hand-held spirometer and the MIR spirometer, which is a standard PFT device. Parameters including peak expiratory flow (PEF), forced expiratory volume in one second (FEV₁), and forced vital capacity (FVC) were measured and analyzed for validity and reliability. Inter-rater reliability and validity were evaluated through 95% limits of agreement (LOA) and intraclass correlation coefficients (ICC). Statistical analyses, including the Bland-Altman plots and the ICC, were utilized to assess agreement between the two devices. Results: The new hand-held spirometer exhibited a good agreement with intra-class coefficient (ICC [2,1]) ranging 0.762 to 0.956 and 95% LOA of -1.94 to 1.80 when compared with MIR. The test-retest reliability of the hand-held spirometer analyzed using - ICC [2,1] demonstrated a good level of consistency (ICC [2,1] =0.849-0.934). Conclusions: In conclusion, the study aimed to assess the potential of the new hand-held spirometer as a viable alternative to traditional PFT devices, with a specific focus on its reliability and validity in spirometric measurements. The new hand-held spirometer exhibited good test-retest reliability across all measured variables, suggesting its potential as a valid and reliable tool for simultaneous PFT measurements.

• Human Ecology Research
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• 제52권1호
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• pp.1-10
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• 2014

The purpose of this study was to analyse the principles and methods of Taegyo-Singi with regard to emotion and to review basic informations on Taegyo programs for promoting prenatal development. Taegyo-Singi was analyzed as follows. First, the contents of Taegyo-Singi were classified into principles and methods of Taegyo. Second, the domains of emotion were categorized into emotional perception, emotional expression, emotional understanding, and emotional regulation based on the classification of Mayer and Salovey, and Moon. Third, the contents of Taegyo-Singi were classified into the four domains of emotion. Finally, the reliability and validity of the classification were obtained through inter-rater agreement and analysis of content validity. The results indicated that first, the principles of Taegyo presuppose parental influence on temperament formation, and that the emotional states of the mother in the prenatal and prepregnancy period is the most influential variable in a child's temperament formation. Second, the methods of Taegyo presuppose that the human mind interacts with their behavior. Therefore, through emotional support of family members, 'jon-sim (the serene mind)' and 'chung-sim (the mind from rectitude)' are the key methods of Taegyo. This means that the Korean tradition of Taegyo focused on the emotional domain of development, especially emotional regulation. This coincides with the emotion-focused temperament theory that individual differences in temperament reflect individual differences in emotion.

• Investigative Magnetic Resonance Imaging
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• 제17권3호
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• pp.215-223
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• 2013

목적: 간 섬유화를 평가하기 위한 MR elastography (MRE)의 경직도 (stiffness value)에 미치는 gadoxetic acid의 영향을 평가하고자 하였다. 대상과 방법: 임상적으로 만성 간 질환이 의심되어 자기공명영상을 촬영한 환자 중 조영제 (gadoxetic acid) 주입전과 후에 MRE를 촬영한 32명의 환자를 대상으로 하였다. 두 명의 영상의학과 의사가 간 실질의 경직도를 개별적으로 측정 하였다. 조영 전과 후의 평균 간경직도를 paired t-test를 사용하여 비교하였으며, 평가자내 및 평가자간 상관 관계는 intraclass correlation coefficient (ICC)를 사용하여 분석 하였다. MRE의 F2 이상의 간섬유화 진단의 판별수치로 3.1 kPa을 이용하여 진단의 정확도, 민감도, 특이도를 구하였다. 결과: 조영 전과 후에 측정된 간 경직도의 평균값은 유의한 차이가 없었으며 (p > 0.05), 조영 전 후 모두에서 평가자 내 및 평가자간 우수한 상관 관계가 관찰되었다 (ICC = 0.988 for pre-contrast and ICC = 0.993 for post-contrast, ICC = 0.998 for rater 1 and ICC = 0.996 for rater 2). 간섬유화정도 F2 이상을 진단하는 MRE 의 정확도, 민감도, 특이도는 조영 전후 모두에서 각각 71%, 60%, 그리고 100%로 같은 값을 보였다. 결론: MRE를 이용한 gadoxetic acid 조영 전과 후에 측정된 간경직도는 유의한 차이를 보이지 않았기에 조영 후 MRE 영상도 간 섬유화 평가에 이용될 수 있다.

• 말소리와 음성과학
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• 제10권1호
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• pp.75-81
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• 2018

Diplophonia is generally defined as the perception of more than one fundamental frequency component in a voice. Its perceptual aspect has traditionally been used to evaluate diplophonia because the perceptions can be easily evaluated, but there are limitations in the validity of the reliability of the intra- and inter-raters, examination situation, and variation of voice sample. Therefore, the purpose of this study is to confirm the reliability and accuracy of auditory perceptual evaluation by comparing non-invasive indirect assessment methods (sound waveform and EGG analysis), and to identify their usefulness with diplophonia. A total of 28 diplophonic voices and 39 non-periodic voices were assessed. Three raters assessed the diplophonia by performing an auditory perception evaluation and identifying the quasi-periodic perturbations of the acoustic waveform and EGG. Among the three discrimination methods, intra- and inter-rater reliability, sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio were examined, and the McNemar test was performed to compare the discriminant agreement. The accuracy of the auditory perceptual evaluation (86.57%) was not significantly different from that of sound waveform acoustic (88.06%), but it was significantly different from that of EGG (83.33%). The reading time (6.02 s) for the auditory perceptual evaluation was significantly different from that for sound waveform analysis (30.15 s) and EGG analysis (16.41 s). In the discrimination of diplophonia, auditory perceptual evaluation has sufficient reliability and accuracy as compared to sound waveform and EGG. Since immediate feedback is possible, auditory perceptual evaluation is more convenient. Therefore, it can continue to be used as a tool to discriminate diplophonia in clinical practice.

• Journal of Nutrition and Health
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• 제47권5호
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• pp.351-363
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• 2014

본 연구는 도시지역의 식품상점 환경을 측정하기 위한 조사도구를 개발하고, 활용가능성 및 신뢰도를 검증하기 위해 실시하였다. 문헌고찰을 통해 기 개발된 식품상점 조사도구를 검토하여, 우리나라 실정에 맞는 식환경 조사도구를 개발하였고, 크게 식품상점의 특성, 접근성, 식품의 이용가능성에 대한 문항으로 구성하였다. 개발된 조사도구의 현장 적용성 검토를 위해 소요시간, 응답수월성, 참여의사, 현장조사의 어려움, 사용된 용어의 적절성 등을 평가한 결과, 조사시간이 상점의 특성에 따라 차이가 있다는 점을 제외하고는, 모든 측면에서 현장적용성이 높았다. 그리고 식품의 이용가능성 문항에 대해 신뢰도를 검증한 결과, 조사자간 및 조사자내 일치율이 매우 높았다. 건강이 강조된 식품의 경우에는 일반식품에 비해 상대적으로 일치율이 낮았으나, 여전히 높은 일치율 수준을 보였다. 본 연구에서 개발한 식환경 조사도구는 현장적용성과 신뢰도가 높은 것이 확인되었으므로, 추후에 객관적인 식환경 측정이 필요한연구에 다양하게 활용될 수 있을 것이다.

• 성인간호학회지
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• 제21권6호
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• pp.559-569
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• 2009

Purpose: This study was to examine the reliability and validity of Patient-Generated Subjective Global Assessment (PG-SGA) as a nutritional measurement for stroke patients. Methods: This was a methodological study performed from May 6 to June 10, 2009 at a tertiary university hospital in Seoul. For reliability of PG-SGA, inter-rater reliability was used for statistics. For concurrent validity, BMI and biomarkers were compared between PG-SGA 0 ~ 8 and ${\geq}$ 9. In addition, sensitivity, specificity, and predictive value of PG-SGA compared with SGA were calculated using a contingency table. For predictive validity, hospital day, complications, and readmission within 1-month after discharge were compared between PG-SGA 0 ~ 8 and ${\geq}$ 9. Results: Correlation of PG-SGA score between two observers was 0.83, and kappa value for the agreement of severe malnutrition was 0.78(all $p_s$ < .001). The scored PG-SGA showed high sensitivity and specificity (100% and 96.7%, respectively). Severe undernourished patients (PG-SGA ${\geq}$ 9) had significantly low TLC, protein, albumin, and prealbumin (all $p_s$ < .01) compared with non-undernourished patients (PG-SGA 0 ~ 8). Also, in severe undernourished patients, complications and readmission (all $p_s$ = 0.01) were more often represented, and hospital days (p = .013) were significantly delayed. Conclusion: PG-SGA is a reliable and valid measurement to assess nutritional status for stroke patients.

• 대한임상독성학회지
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• 제15권1호
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• pp.31-39
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• 2017

Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.