• 디지털융복합연구
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• 제17권2호
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• pp.217-230
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• 2019

본 연구는 기존 동반질환을 이용한 중증도 보정 방법의 제한점을 보완하기 위해 급성심근경색증 환자의 맞춤형 중증도 보정방법을 개발하고, 이의 타당성을 평가하기 위해 수행되었다. 이를 위하여 질병관리본부에서 2006년부터 2015년까지 10년간 수집한 퇴원손상심층조사 자료 중 주진단이 급성심근경색증인 한국표준질병사인분류(KCD-7) 코드 I20.0~I20.9의 대상자를 추출하였고, 동반질환 중증도 보정 도구로는 기존 활용되고 있는 CCI(Charlson comorbidity index), ECI(Elixhauser comorbidity index)와 새로이 제안하는 CCS(Clinical Classification Software)를 사용하였다. 이에 대한 중증도 보정 사망예측모형 개발을 위하여 머신러닝 기법인 로지스틱 회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신기법을 활용하여 비교하였고 각각의 AUC(Area Under Curve)를 이용하여 개발된 모형을 평가하였다. 이를 평가한 결과 중증도 보정도구로는 CCS 가 가장 우수한 것으로 나타났으며, 머신러닝 기법 중에서는 서포트 벡터 머신을 이용한 모형의 예측력이 가장 우수한 것으로 확인되었다. 이에 향후 의료서비스 결과평가 등 중증도 보정을 위한 연구에서는 본 연구에서 제시한 맞춤형 중증도 보정방법과 머신러닝 기법을 활용하도록 하는 것을 제안한다.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.126-136
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• 2018

본 연구는 머신러닝을 활용하여 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발을 목적으로 시행하였다. 전국 단위의 퇴원손상심층조사 2006~2015년 자료 중 한국표준질병사인분류(Korean standard classification of disease-KCD 7)에 따라 뇌졸중 코드 I60-I63에 해당하는 대상자를 추출하여 분석하였다. 동반질환 중증도 보정 도구로는 Charlson comorbidity index(CCI), Elixhauser comorbidity index(ECI), Clinical classification software(CCS)의 3가지 도구를 사용하였고 중증도 보정 모형 예측 개발은 로지스틱회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신 기법을 활용하여 비교해 보았다. 뇌졸중 환자의 동반질환으로는 ECI에서는 합병증을 동반하지 않은 고혈압(hypertension, uncomplicated)이 43.8%로, CCS에서는 본태성고혈압(essential hypertension)이 43.9%로 다른 질환에 비해 가장 월등하게 높은 것으로 나타났다. 동반질환 중중도 보정 도구를 비교해 본 결과 CCI, ECI, CCS 중 CCS가 가장 높은 AUC값으로 분석되어 가장 우수한 중증도 보정 도구인 것으로 확인되었다. 또한 CCS, 주진단, 성, 연령, 입원경로, 수술유무 변수를 포함한 중증도 보정 모형 개발 AUC값은 로지스틱 회귀분석의 경우 0.808, 의사결정나무 0.785, 신경망 0.809, 서포트 벡터 머신 0.830로 분석되어 가장 우수한 예측력을 보인 것은 서포트 벡터머신 기법인 것으로 최종 확인되었고 이러한 결과는 추후 보건의료정책 수립에 활용될 수 있을 것이다.

• 대한한방내과학회지
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• 제42권4호
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• pp.510-531
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• 2021

Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases. Methods: Articles published from 2011 to 2021 that used the keywords "NRS", "Multi-center", and "RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7). Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups. Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.

• 동의생리병리학회지
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• 제27권3호
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• pp.289-298
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• 2013

The purposes of this article are understanding the meaning of yin deficiency interpreted with a perspective of Traditional Korean Medicine and a modern perspective a study and assigning modern diseases to yin deficiency pattern types. Clinical papers were searched in China National Knowledge Infrastructure(CNKI) from 1995 to 2013. Results are as follows. First, yin deficiency written in the "Neijing" has been understood in many ways. It is translated such as deficiency of yin qi, inner qi, essence, cubit pulse, yin meridians qi, viscera yin and kidney. Second, yin deficiency pattern are related with disorders of the endocrine system, immunity, energy metabolism, blood circulation, cytokine, microelements, lipid metabolism and capability of getting rid of oxygen free radicals. Third, from pattern types, diverse diseases classified in types involving the heat from yin deficiency, which reflects pathologic conditions of deficiency heat which is distinct characteristics of yin deficiency pattern. Various diseases classified in types related with liver or kidney are reported, which reflects two viscera are more related with yin deficiency than other viscera. Fourth, levels of pattern types surveyed are more specific than Korean Standard Classification of Diseases(KCD) and specific enough to be applied clinically. This article surveyed the categories of modern diseases yin deficiency pattern types is assigned to but the detailed relation between them will be necessary to be studied in the future.

• 동의생리병리학회지
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• 제27권5호
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• pp.487-496
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• 2013

This article is a study on to which categories of modern diseases qi deficiency pattern types are assigned by reference to modern clinical papers to analyze and understand modern diseases with the perspective of Korean Medicine. Clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI) from 1994 to 2013. Conclusions are as follows. First, qi deficiency pattern types are roughly classified as qi deficiency pattern, qi-yin dual deficiency pattern and qi deficiency pattern related with viscera and bowels. Second, there are many patterns combined with static blood, qi stagnation, phlegm, dampness, heat, toxin, water or fluid deficiency and the level of pattern designation is more specific than pattern types in Korean Standard Classification of Diseases(KCD), which makes the pattern types more useful to clinical application. Third, static blood due to qi deficiency is the most frequent combined pattern and diseases related with blood circulation such as angina, atherosclerosis, hyperlipidemia and chronic obstructive pulmonary disease(COPD) were reported on that pattern. The detailed relation between modern diseases and pattern types can be an another topic.

• 대한예방한의학회지
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• 제19권2호
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• pp.113-121
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• 2015

Objective : This study was aimed to classify diseases that Traditional Chinese Medicine(TCM) is better at treating. Method : Literature was searched on China National Knowledge Infrastructure(CNKI) and categorized according to literature type, published date and research method. Studied six types of research papers and four types of published books. Results : Experts were surveyed and interviewed, medical records were studied retrospectively, and doubleblind method was used in selecting diseases that TCM was better at treating. There were a total of 372 diseases that TCM was better at treating. By the KCD classification, 45 were in gastrointestinal (12.1%), 39 in urogenital (10.5%), 36 in circulatory (9.7%), 35 in musculoskeletal or connective tissues (9.4%). Conclusion : Total of 372 diseases were classified as diseases that TCM was better at treating, and if the results are used adequately, the values of western and TCM can be maximized and benefit the government, patients and the medical practitioners.

• 대한한의진단학회지
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• 제17권2호
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• pp.156-168
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• 2013

Objectives Although there have been someone who pointed out declining tendency of pure traditional diagnosis, there are no objective survey results on present state of diagnosis among Korean Medicine Doctors (KMDs). So we did a descriptive survey study to show traditional diagnostic modality usage among them. Materials and methods: 73 samples of responded questionnaire in Busan area were collected and descriptively studied. Results (1) U code (in KCD-6) usage showed low level (28.7%). (2) Diagnostic apparatuses for traditional medicine are rarely used. For example, pulse diagnosis machine was reported to be used only by 9.7 % of KMDs. (3) KMDs still prefer the treatment based on pattern identification and symptomatic therapy rather than treatments based on disease identification of modern biomedicine. Conclusion Overall, the portion of pattern identification is still high among KMDs, some kind of diagnostic methods which support pattern identification showed lack of usage.

• 한국임상약학회지
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• 제27권3호
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• pp.136-142
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• 2017

Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

• 대한예방한의학회지
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• 제22권2호
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• pp.55-63
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• 2018

Objectives : This study was conducted to survey on the research trends of Pharmacopuncture in Korea. Methods : We searched Korean research database by using keyword 'Pharmacopuncture', 'Bee venom'. Korean research databases were Korean Studies Information Service System(KISS), Research Information Service System(RISS), National Digital Science Library(NDSL) and Korean Medicine Information System(OASIS). We classified articles identified by publish year, type of research and diseases. Results : We analyzed 533 studies. Clinical studies and non-clinical studies except literature studies were decreased from 2015. However, Literature studies had not shown particular change over the past decade. Pharmacopuncture treated disease was classified by Korean standard classification of disease(KCD), M-code (37.8%), G-code(18.4%) were frequently used. Conclusions : A variety of disease was treated by pharmacopuncture. It is necessary to increase the level of evidence of pharmacopuncture. through additional studies in the future.

• 지역사회간호학회지
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• 제12권3호
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• pp.746-754
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• 2001

In order to analyze the health problems of school-aged children. daily health records from a convenient sample of two primary schools were analyzed. Diseases were classified into 21 categories according to the KCD (Korea Standard Classification of Diseases). The mean number of visits to health care rooms during school per student was 1.98 during 212 school days from Mar. 2000 to Feb. in 2001 and the mean number of daily visits was 11.66. Male students and 3rd graders visited health care rooms more frequently than female students and other graders. The total spell base incidence rate was 1976.8 per 1.000 students in a year: the incidence rate from injuries was 960.0: 542.4 were for digestive diseases: and 415.2. for respiratory diseases, 97% of all diseases were injuries, digestive diseases and respiratory diseases. The most frequent diseases for male students resulted from trauma, and those for female students. from digestive and respiratory symptoms. The services that nursing teachers implemented were wound treatment (48.8%), medication (44.6%), and so on. Therefore, the findings of this research can serve as the basis for developing school health service program and health education program.