• Journal of Preventive Medicine and Public Health
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• 제50권5호
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• pp.294-302
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• 2017

Objectives: The objectives of this study were to investigate the agreement between medical history questionnaire data and claims data and to identify the factors that were associated with discrepancies between these data types. Methods: Data from self-reported questionnaires that assessed an individual's history of hypertension, diabetes mellitus, dyslipidemia, stroke, heart disease, and pulmonary tuberculosis were collected from a general health screening database for 2014. Data for these diseases were collected from a healthcare utilization claims database between 2009 and 2014. Overall agreement, sensitivity, specificity, and kappa values were calculated. Multiple logistic regression analysis was performed to identify factors associated with discrepancies and was adjusted for age, gender, insurance type, insurance contribution, residential area, and comorbidities. Results: Agreement was highest between questionnaire data and claims data based on primary codes up to 1 year before the completion of self-reported questionnaires and was lowest for claims data based on primary and secondary codes up to 5 years before the completion of self-reported questionnaires. When comparing data based on primary codes up to 1 year before the completion of selfreported questionnaires, the overall agreement, sensitivity, specificity, and kappa values ranged from 93.2 to 98.8%, 26.2 to 84.3%, 95.7 to 99.6%, and 0.09 to 0.78, respectively. Agreement was excellent for hypertension and diabetes, fair to good for stroke and heart disease, and poor for pulmonary tuberculosis and dyslipidemia. Women, younger individuals, and employed individuals were most likely to under-report disease. Conclusions: Detailed patient characteristics that had an impact on information bias were identified through the differing levels of agreement.

• 한국환경복원기술학회지
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• 제11권3호
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• pp.28-38
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• 2008

The purpose of this study are to compare existing presence-absence predictive models and to predict suitable habitat for Goral (Nemorhaedus caudatus raddeanus) that is an endangered and protected species in Seoraksan national park using the best model among existing predictive models. The methods of this study are as follows. First, 375 location data and 9 environmental data layers were implemented to build a model. Secondly, 4 existing presence-absence models : Generalized Linear Model (GLM), Generalized Addictive Model (GAM), Classification and Regression Tree (CART), and Artificial Neural Network (ANN) were tested to predict the Goal habitat. Thirdly, ROC (Receiver Operating Characteristic) and Kappa statistics were used to calculate a model performance. Lastly, we verified models and created habitat suitability maps. The ROC AUC (Area Under the Curve) and Kappa values were 0.697/0.266 (GLM), 0.729/0.313 (GAM), 0.776/0.453 (CART), and 0.858/0.559 (ANN). Therefore, ANN was selected as the best model among 4 models. The models showed that elevation, slope, and distance to stream were the significant factors for Goal habitat. The ratio of predicted area of ANN using a threshold was 31.29%, but the area decreased when human effect was considered. We need to investigate the difference of various models to build a suitable wildlife habitat model under a given condition.

• 디지털융복합연구
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• 제14권2호
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• pp.519-527
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• 2016

이 연구는 BMI 분류기준과 9점-신체상평정척도 분류기준의 일치도를 조사하여 현장적용의 유용성을 확인하고, 여대생들이 체형에 대해 실제로 인식하고 정도를 파악하여 체형인식의 왜곡에 대한 올바른 정보와 비만의 기준에 대한 정보 제공에 목적이 있다. BMI 분류기준과 신체상평정척도 분류기준의 일치도, 그리고 여대생의 BMI에 따른 신체상 인식 정도를 알아보기 위하여 교차분석, Spearman의 등위차상관계수 및 카파통계량을 산출하였다. 분석결과 일반 여자대학생이 판정한 신체상 평정척도 분류기준과 BMI 분류기준은 통계적으로 ${\rho}=.719$(p<.001)로 높은 상관과 ${\kappa}=.506$(p<.001)로 보통 수준의 일치도를 나타냈다. 이러한 결과를 바탕으로 차후 신체상과 관련하여 인종의 특성에 따른 크기와 형태를 조정할 필요가 있으며 인구통계학적 특성이 다르거나 비만도가 높은 대상자를 선별하여 그들의 체형인식과 심리적인 측면에 관한 추가적인 연구가 필요하다.

• Radiation Oncology Journal
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• 제36권2호
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• pp.114-121
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• 2018

Purpose: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. Materials and Methods: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. Results: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. Conclusions: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.387-391
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• 2015

Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.

• 한국산학기술학회논문지
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• 제14권1호
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• pp.184-193
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• 2013

본 연구는 Holland의 RIASEC 모형을 중심으로 초등학생의 직업기대와 능력지각 및 흥미 일치도를 분석하는데 그 목적이 있다. 이를 위해 서울과 경기 지역에 거주하는 초등학생 659명을 대상으로 직업기대, 능력지각, 흥미 검사결과를 토대로 Kappa 일치 지표를 이용하여 각 변인들의 일치도 분석과 성별, 학년에 따른 일치도 분석을 실시하여 검증하였다. 연구결과 직업기대-능력지각, 직업기대-흥미, 능력지각-흥미 일치도는 일반 Kappa, 가중치 Kappa 두 지표 모두 유의미하게 검증되었다. 초등학생의 성별에 따른 일치도 분석 결과 직업기대-능력지각에서는 남자, 여자 모두 유의미한 일치도를 나타냈다. 직업기대-흥미, 능력지각-흥미에서는 남자만 유의미한 일치도를 나타냈고, 학년에 따른 일치도 분석은 직업기대-능력지각에서는 5학년, 6학년 모두 유의미한 일치도를 나타냈다. 직업기대-흥미, 능력지각-흥미에서는 5학년만 유의미한 일치도를 나타냈고, 6학년은 흥미 항목에 대해 C(관습형)로 응답한 사람이 없었기 때문에 통계량을 계산할 수 없었다. 전체적으로 초등학생의 직업기대, 능력지각, 흥미 간에는 유의미한 일치 관계가 있음을 나타냈다. 이는 초등학교 5, 6학년이 되면 직업인식에서 능력과 흥미요인을 고려한다는 것을 뜻하며, 진로지도와 교육에 있어 이를 고려해야 함을 시사한다.

• Korean Journal of Radiology
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• 제24권4호
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• pp.284-293
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• 2023

Objective: To validate a simplified ordinal scoring method, referred to as modified length-based grading, for assessing coronary artery calcium (CAC) severity on non-electrocardiogram (ECG)-gated chest computed tomography (CT). Materials and Methods: This retrospective study enrolled 120 patients (mean age ± standard deviation [SD], 63.1 ± 14.5 years; male, 64) who underwent both non-ECG-gated chest CT and ECG-gated cardiac CT between January 2011 and December 2021. Six radiologists independently assessed CAC severity on chest CT using two scoring methods (visual assessment and modified length-based grading) and categorized the results as none, mild, moderate, or severe. The CAC category on cardiac CT assessed using the Agatston score was used as the reference standard. Agreement among the six observers for CAC category classification was assessed using Fleiss kappa statistics. Agreement between CAC categories on chest CT obtained using either method and the Agatston score categories on cardiac CT was assessed using Cohen's kappa. The time taken to evaluate CAC grading was compared between the observers and two grading methods. Results: For differentiation of the four CAC categories, interobserver agreement was moderate for visual assessment (Fleiss kappa, 0.553 [95% confidence interval {CI}: 0.496-0.610]) and good for modified length-based grading (Fleiss kappa, 0.695 [95% CI: 0.636-0.754]). The modified length-based grading demonstrated better agreement with the reference standard categorization with cardiac CT than visual assessment (Cohen's kappa, 0.565 [95% CI: 0.511-0.619 for visual assessment vs. 0.695 [95% CI: 0.638-0.752] for modified length-based grading). The overall time for evaluating CAC grading was slightly shorter in visual assessment (mean ± SD, 41.8 ± 38.9 s) than in modified length-based grading (43.5 ± 33.2 s) (P < 0.001). Conclusion: The modified length-based grading worked well for evaluating CAC on non-ECG-gated chest CT with better interobserver agreement and agreement with cardiac CT than visual assessment.

• 응용통계연구
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• 제29권1호
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• pp.41-59
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• 2016

지속적인 사망률 개선으로 인한 평균 수명연장은 인구 고령화의 주요인이며 연금 공급자의 재정건전성에 심각한 영향을 미치는 원인으로 지목되기에 정확한 미래 사망률의 예측은 현 시점에서 선행되어야할 중요한 과제다. 본 연구는 미래 사망률을 예측하는 대표적인 확률적 사망률 모형인 Lee-Carter 모형을 사용하여 과거 생명표로 산출한 왜도를 기반으로 미래 사망률 지수를 간접적으로 예측하는 왜도예측방식을 제시한다. 기존의 Lee-Carter 모형을 이용한 사망률 예측방식은 사망률 지수를 추정하고 미래값을 직접 예측함으로써 미래 사망률이 지나치게 개선되는 현상을 보이며, 이를 바탕으로 산출된 연금액과 지급기간 추정 등 연금 공급자의 리스크 관리에 영향을 미친다. 본 연구는 기존 예측 방식의 사망률 예측 결과와 제시한 왜도 예측 방식의 사망률 예측 결과를 비교함으로써 기존 사망률 예측 방식의 문제점을 지적한다. 분석결과 왜도 예측을 통한 Lee-Carter 모형의 사망률 예측은 기존 방식보다 사망률 개선효과를 더 적게 반영하며 장수리스크를 덜 왜곡한다는 데 의의가 있다고 할 수 있다. 하지만 기존 방식 간 차이를 감안하여 적정한 미래 사망률 수준을 찾기 위해 임의로 부여한 가중치에 대해 향후 검토가 필요할 것으로 보인다.

• Communications for Statistical Applications and Methods
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• 제25권1호
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• pp.15-27
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• 2018

Parametric method of flood frequency analysis involves fitting of a probability distribution to observed flood data. When record length at a given site is relatively shorter and hard to apply the asymptotic theory, an alternative distribution to the generalized extreme value (GEV) distribution is often used. In this study, we consider the beta-P distribution (BPD) as an alternative to the GEV and other well-known distributions for modeling extreme events of small or moderate samples as well as highly skewed or heavy tailed data. The L-moments ratio diagram shows that special cases of the BPD include the generalized logistic, three-parameter log-normal, and GEV distributions. To estimate the parameters in the distribution, the method of moments, L-moments, and maximum likelihood estimation methods are considered. A Monte-Carlo study is then conducted to compare these three estimation methods. Our result suggests that the L-moments estimator works better than the other estimators for this model of small or moderate samples. Two applications to the annual maximum stream flow of Colorado and the rainfall data from cloud seeding experiments in Southern Florida are reported to show the usefulness of the BPD for modeling hydrologic events. In these examples, BPD turns out to work better than $beta-{\kappa}$, Gumbel, and GEV distributions.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.361-371
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• 1998

Recent increases of asthma and allergies in childhood made the need for a standardized approach to international and regional comparisons of their prevalence and severity. To address these issues, 'International Study of Asthma and Allergies in Childhood (ISAAC)' is currently underway. In Korea, 'Nationwide Study of Asthma and Allergies in Korean Children' began in 1995 according to ISAAC protocol. ISAAC written and video questionnaires were used in this survey, but their reliability and validity were not evaluated properly yet. In this study, our aim was to evaluate the reliability and validity of two kinds of questionnaires and their usefulness in international and regional comparisons. The test and retest of two questionniares were completed by male(n=110) and female(n=111) middle school students with two and three weeks interval each. Kappa(or weighted kappa) were calculated from each questions and validity coefficients were estimated from those statistics. In Korean version of written questionnaire, the questions for allergic rhinitis, atopic dermatitis, allergic conjunctivitis, and food allergy proved to have high kappa values (or weighted kappa values) and validity coefficients and they can be used in further studies without any correction. But some questions about asthma(especially nocturnal cough, wheezing in exercise, and severe asthma) and drug allergy need to be revised for better under-standing to study subjects. Video questionnaire has the same degree of reliability and validity when compared to written questionnaire and this is the unexpected result. Accordingly, it also need to be revised to overcome the racial and cultural differences of the study subjects. In conclusion, the Korean version of written and video questionnaires may be considered to be useful methods in international and regional comparisons of asthma and allergic diseases in childhood after correction of some questions.