• Title/Summary/Keyword: Outcome assessment

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The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease (슬관절의 통증과 기능장애의 평가도구에 관한 연구)

  • Jung, Chan-Yung;Kim, Eun-Jung;Hwang, Min-Seop;Cho, Hyun-Seok;Kim, Kyung-Ho;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.2
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

A Study on the Vulnerability Assessment Model for National Defense Intelligence System Using SNA (사회연결망분석 개념을 적용한 국방정보체계 취약점 분석·평가 모형 연구)

  • Jang, Youngcheon;Kang, Kyongran;Choi, Bongwan
    • Journal of the Korea Institute of Military Science and Technology
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    • v.20 no.3
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    • pp.421-430
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    • 2017
  • In this research, we propose a methodology for assessing security vulnerability of the national defense intelligence system, considering not only target elements but also the interconnection relationship of the whole system. Existing approaches decide the security vulnerability of the whole system by assessing only target elements. However, those approaches have an issue with potentially showing the same outcome for the systems that have identical target elements but the different types of interconnection relationships. We propose a more practical assessment method which takes the interconnection relationship of a whole system into consideration based on the concept of SNA(Social Network Analysis).

Development of the System Technical Maturity Assessment Model for Defense R&D Programs Decision Support (국방 연구개발사업의 의사결정 지원을 위한 시스템 성숙도 평가 모델 개발)

  • Kim, Jung-Myong;Park, Young-Won
    • Journal of the Korea Institute of Military Science and Technology
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    • v.13 no.5
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    • pp.808-817
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    • 2010
  • This paper proposes a novel appoach which can assess the system technical maturity for use in Defense R&D Program reviews. As the weapon systems become more complicated, the success and effectiveness of R&D outcome heavily depend on the application and tailoring of systems engineering process and methods. It is a difficult task to assess the system readiness level(SRL) of the system being developed. A system-focused approach for managing weapon systems development and making effective and efficient decisions during the development lifecycle is critical to ensure the success of the program. The proposed weighted average SRL can facilitate the system technical maturity assessment without expending heavy work load.

Evaluation of Nursing Documentation of Delirium Care

  • KANG, Yun
    • International Journal of Advanced Culture Technology
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    • v.7 no.1
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    • pp.112-121
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    • 2019
  • The purpose of the study was to determine whether a delirium educational program has a positive outcome on nurses' documentation in patient records of delirium care. A one group pre-post design was used. A convenient sample of 60 consecutive records that included documentation by participating nurses in four medical wards of one regional general hospital in South Korea was audited two months before and two months after a delirium educational program. Although an educational program in this study positively changed nurses' knowledge and attitudes, these positive effects did not translate to improvement in the documentations of delirium care. There was no significant increase in the frequency of nursing documentation of delirium assessment following participation in the educational program. Furthermore, there was no significant increase in the frequency of nursing documentation of the use of non-pharmacological management following the documentation of keywords associated with delirium after participation in the educational program. The findings indicate the need to develop, implement and record a systematic risk assessment for delirium and assessment and management of existing delirium based on evidence-based guidelines in clinical practice in South Korea.

A Comparative Study on the Local Governments' Environmental Impact Assessment Regulations in Korea (지방자치단체 환경영향평가 조례 비교 연구)

  • Sung, Hyun-Chan;Min, Soo-Hyun
    • Journal of Environmental Impact Assessment
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    • v.12 no.3
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    • pp.137-150
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    • 2003
  • This study aims to survey whether local governments have legislated laws and regulations on environment impact assessment system, to compare and analyze specific projects and their scale, assessment items, and procedures & discussion process, to identify issues and generate improvement plans, and to suggest a direction for future legislation to local governments that plan to legislate laws and regulations in the future. Major outcome of the study are as follows. First, terminologies used for environment impact assessment by local governments need to be unified. Also, laws and regulations need to be legislated soon. Second, in "urban development project" areas, a total of nine project areas including "quarrying of soil and stone, sand, gravel, and minerals" was essential common projects. A total of six project types were added or newly established compared to national systems. Among them, four project types were added within national-level project areas and two project types were not available under the national-level project areas and newly added due to the nature of local governments. Third, in terms of project scale, scale enhancement of "urban development project" was most common. Analysis showed that in case of clean natural environment such as Cheju Island, it is necessary to consider reinforcing project areas where development activities take place directly in forests or rivers such as "industrial base and complex development", "water resource development", and "development of tourism complex." Fourth, the discussion and review procedures of assessment reports were similar to those at government level. However, in case of Seoul city, it is required to write a "preparation plan" before drafting an assessment report. The city features partial introduction of scoping and screening, which allows to exempt discussion procedures if impact on environment is found to be minimal after drafting the assessment report. In case of national-level, it has a dual system that is split between Ministry of Construction and Transportation and Ministry of Environment. However, in case of environment impact assessment of local governments, it is a single system where city mayors and provincial governors are in charge of both project execution and environmental assessment. Therefore, the most important task is how to satisfy objectiveness and accountability.

Action Research on Math Competencies-oriented Assessment of Integrated Instruction (수업과 통합한 수학 교과 역량 중심의 평가 실행 연구)

  • Kim, Yukyung
    • Journal of Elementary Mathematics Education in Korea
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    • v.21 no.1
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    • pp.93-113
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    • 2017
  • This research analyzed the cases of math competencies-oriented assessment, integrating assessment and instruction, which had been conducted in an elementary school whose assessment system involves frequent tests from a formative perspective on assessment. The research outcome is as follows: First, the competencies-oriented assessment of integrating instruction made possible for curriculum restructuring and competencies-oriented teaching, whereas more emphasis needs to be focused on the assessment feedback. Second, assessment on math competencies involves multiple dimensions; therefore, it needs to be managed to prevent problems arising due to overlap between different competencies. Third, though it has been identified that with evaluation it is possible to recognize and gradually improve the areas short of competency, more practical studies need to be conducted in this regard. Fourth, even with the fact that various types of evaluation ensure its fairness, make an accurate interpretation of the evaluation result before arriving at a comprehensive assessment.

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Surgical Management of Massive Cerebral Infarction

  • Huh, Jun-Suk;Shin, Hyung-Shik;Shin, Jun-Jae;Kim, Tae-Hong;Hwang, Yong-Soon;Park, Sang-Keun
    • Journal of Korean Neurosurgical Society
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    • v.42 no.4
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    • pp.331-336
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    • 2007
  • Objective : The aim of this study was to analyze the treatment results and prognostic factors in patients with massive cerebral infarction who underwent decompressive craniectomy. Methods : From January 2000 to December 2005, we performed decompressive craniectomy in 24 patients with massive cerebral infarction. We retrospectively reviewed the medical records, radiological findings, initial clinical assessment using the Glasgow Coma Scale, serial computerized tomography (CT) with measurement of midline and septum pellucidum shift, and cerebral infarction territories. Patients were evaluated based on the following factors : the pre- and post-operative midline shifting on CT scan, infarction area or its dominancy, consciousness level, pupillary light reflex and Glasgow Outcome Scale. Results : All 24 patients (11 men, 13 women; mean age, 63 years; right middle cerebral artery (MCA) territory, 17 patients; left MCA territory, 7 patients) were treated with large decompressive craniectomy and duroplasty. The average time interval between the onset of symptoms and surgical decompression was 2.5 days. The mean Glasgow Coma Scale was 12.4 on admission and 8.3 preoperatively. Of the 24 surgically treated patients, the good outcome group (Group 2 : GOS 4-5) comprised 9 cases and the poor outcome group (Group1 : GOS 1-3) comprised 15 cases. Conclusion : We consider decompressive craniectomy for large hemispheric infarction as a life-saving procedure. Good preoperative GCS, late clinical deterioration, small size of the infarction area, absence of anisocoria, and preoperative midline shift less than 11mm were considered to be positive predictors of good outcome. Careful patient selection based on the above-mentioned factors and early operation may improve the functional outcome of surgical management for large hemispheric infarction.

A Critical Evaluation of the Concept and Writing of Learning Outcomes (학습성과의 개념과 작성에 대한 탐구)

  • Lee, Dong Yub;Yang, Eunbae B.
    • Korean Medical Education Review
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    • v.18 no.3
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    • pp.125-131
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    • 2016
  • Recent changes in educational paradigms that emphasize the performance or outcomes of education are redefining how learning objectives are being described as 'learning outcomes' in various academic disciplines. Medical education is not an exception to this trend. However, it has come to our attention that the key concepts and appropriate descriptions of learning outcomes have not been well understood among educators and that this lack of understanding has hindered our efforts to implement the practice in the field. This study aims to provide a direction to establish and describe learning outcomes by examining previous studies that have focused on setting learning objectives as well as learning outcomes. Setting and describing learning outcomes starts from reflection on the approach of behavioral learning objectives, which overemphasizes learner's acquired knowledge, skills, and attitude in each classroom rather than actual performance. On the other hand, the learning outcome approach focuses on what the learner is able to do as a result of a learning experience. This approach is more learner-friendly and encourages students to lead and be responsible for their learning process. Learning outcomes can best be described when the relevance of actual contexts and the hierarchy of learning objectives are considered. In addition, they should be in the form of context, task, performance, and level, as well as be planned with proper assessment and feedback procedures. When these conditions are met, the learning outcome approach is beneficial to students as it presents a curriculum that is more open to learners. Despite these advantages of the learning outcome approach, there is a possible concern that setting the learning outcomes and describing them can restrict evaluation to lower cognitive skills if the concept of learning outcome is narrowly interpreted or is set too low. To avoid such narrow applications, it is important for educators to understand the comprehensiveness of the learning outcome setting and to consider long-term outcomes embedded in an organizational vision rather than only short-term behavioral outcomes.

Bayesian Network Model to Evaluate the Effectiveness of Continuous Positive Airway Pressure Treatment of Sleep Apnea

  • Ryynanen, Olli-Pekka;Leppanen, Timo;Kekolahti, Pekka;Mervaala, Esa;Toyras, Juha
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.346-358
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    • 2018
  • Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).

Association between Optic Nerve Sheath Diameter/Eyeball Transverse Diameter Ratio and Neurological Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jinsung Kim;Hyungoo Shin;Heekyung Lee
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.664-671
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    • 2023
  • Objective : The optic nerve sheath diameter (ONSD)/eyeball transverse diameter (ETD) ratio is a more reliable marker of intracranial pressure than the ONSD alone. We aimed to investigate the predictive value of the ONSD/ETD ratio (OER) for neurological outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods : Adult patients with aSAH who visited the emergency department of a tertiary hospital connected to a South Korean university between January 2015 and December 2021 were included. Data on patient characteristics and brain computed tomography scan findings, including the ONSD and ETD, were collected using a predefined protocol. According to the neurological outcome at hospital discharge, the patients were divided into the unfavorable neurological outcome (UNO; cerebral performance category [CPC] score 3-5) and the favorable neurological outcome (FNO; CPC score 1-2) groups. The primary outcome was the association between the OER and neurological outcomes in patients with aSAH. Results : A total of 171 patients were included in the study, of whom 118 patients (69%) had UNO. Neither the ONSD (p=0.075) nor ETD (p=0.403) showed significant differences between the two groups. However, the OER was significantly higher in the UNO group in the univariate analysis (p=0.045). The area under the receiver operating characteristic curve of the OER for predicting UNO was 0.603 (p=0.031). There was no independent relationship between the OER and UNO in the multivariate logistic regression analysis (adjusted odds ratio, 0.010; p=0.576). Conclusion : The OER was significantly higher in patients with UNO than in those with FNO, and the OER was more reliable than the ONSD alone. However, the OER had limited utility in predicting UNO in patients with aSAH.