• Convergence Security Journal
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• v.19 no.5
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• pp.25-36
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• 2019

With the development of information and communication technology, hospitals that electronically process and manage medical information of patients are increasing. However, if medical information is processed electronically, there is still room for infringing personal information of the patient or medical staff. Accordingly, in 2017, the International Organization for Standardization (ISO) published ISO TS 25237 Health Information - Pseudonymization[1]. In this paper, we examine the re - identification process based on ISO TS 25237, the procedure and the problems of our proposed method. In addition, we propose a new processing scheme that adds a re-identification procedure to our secure differential privacy method [2] by keeping a mapping table between de-identified data sets and original data as ciphertext. The proposed method has proved to satisfy the requirements of ISO TS 25237 trust service providers except for some policy matters.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.43-83
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• 2013

Medical treatment has great potential for conflict. Even the best-trained doctors can commit medical malpractice that result in continuing physical or mental disabilities or even death. Medical conflicts have been increasing over years. The medical conflicts between patient and medical professionals that result from medical professionals' mistakes are often fueled by a violation on the pretext of the injuries form medical malpractice and can lead to litigation. The litigation usually cost a lot of money and time. The extension of the litigation period as well as expensive cost and lack of medical knowledge placing a great burden on patients. Alternative Dispute Resolution(ADR) is more efficient than litigation. In 1988, the medical dispute mediation system has been introduces as the Act on Remedy for Damage from Medical Accident and Medical Dispute Mediation by Korean Medical Association came into effect after 23 years of enactment efforts. Medical Dispute Mediation Act(hereinafter referred to as the "MDMA") has finally entered into force from 8 April 2012. The purpose of the MDMA is to promptly and fairly redress injuries caused by medical malpractice and create a stable environment for medical services of public health or medical professionals by providing for matters regarding the mediation and arbitration of medical disputes(MDMA ${\S}1$). In an effort to secure the fair, speedy and inexpensive resolution of every malpractice case, the Korea Medical Dispute Mediation and Arbitration Agency(hereinafter referred to as the "K-MEDI") was established. Following the MDMA, the K-MEDI shall endeavor to ensure the medical dispute mediation or arbitration proceedings are conducted in a prompt, fair, and efficient manner, and patients and medical professionals shall attend proceedings in good faith with mutual trust and understanding when they participate in medical dispute mediation or arbitration proceedings.

• Korean Journal of Adult Nursing
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• v.13 no.2
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• pp.233-246
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• 2001

Spiritual health is an important indicator in the quality of life of patients with cancer. The purpose of this study was to validate a Spiritual Health Inventory (SHI) for patients with cancer developed by Highfield (1989). The SHI was translated into Korean, back-translated into English. The study sample was 96 patients with cancer. The data were collected from September, 1999 to February, 2000 for 6 months. Statistic analysis was done with the SPSS PC+ (Version 10.0) program: descriptive statistics, factor analysis, Pearson correlation coefficient, and one-way ANOVA. The results are as follows : 1. The reliability score was examined using Cronbach's ${\alpha}$ and found to be .79. 2. Construct validity was examined using factor analysis. Four factors were identified and named : (1) Peace of mind (19.1% of variance), (2) Hope (9.7%), (3) Self-esteem (6.4%), (4) Trust (6.0%). The total of 41.2 percent of the variance. 3. The Pearson correlation coefficient score of 4 factors was between r = .24~ .42. 4. SHI was identified as multidimension, that is (1) The relationship with GOD, as absolute being, (2) the relationship with others, (3) the relationship within oneself. 5. There were differences in response in items especially related to GOD. The following recommendations can be made on the above findings : 1. Replicate with a minimum sample of 150 and test for concurrent validity. 2. Since spirituality is a dynamic concept, longitudinal study is also necessary. 3. Concept analysis using a qualitative study based on religious preference is recommended. 4. The items such as 12, 13, 15, 17, 19, 22, 24, 26 indicated conceptual ambiguity for Korean populations and further study is needed on item deletion or new items.

• Archives of Plastic Surgery
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• v.43 no.4
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• pp.328-338
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• 2016

Nipple-sparing mastectomy (NSM) is increasingly popular as a procedure for the treatment of breast cancer and as a prophylactic procedure for those at high risk of developing the disease. However, it remains a controversial option due to questions regarding its oncological safety and concerns regarding locoregional recurrence. This systematic review with a pooled analysis examines the current literature regarding NSM, including locoregional recurrence and complication rates. Systematic electronic searches were conducted using the PubMed database and the Ovid database for studies reporting the indications for NSM and the subsequent outcomes. Studies between January 1970 and January 2015 (inclusive) were analysed if they met the inclusion criteria. Pooled descriptive statistics were performed. Seventy-three studies that met the inclusion criteria were included in the analysis, yielding 12,358 procedures. After a mean follow up of 38 months (range, 7.4-156 months), the overall pooled locoregional recurrence rate was 2.38%, the overall complication rate was 22.3%, and the overall incidence of nipple necrosis, either partial or total, was 5.9%. Significant heterogeneity was found among the published studies and patient selection was affected by tumour characteristics. We concluded that NSM appears to be an oncologically safe option for appropriately selected patients, with low rates of locoregional recurrence. For NSM to be performed, tumours should be peripherally located, smaller than 5 cm in diameter, located more than 2 cm away from the nipple margin, and human epidermal growth factor 2-negative. A separate histopathological examination of the subareolar tissue and exclusion of malignancy at this site is essential for safe oncological practice. Long-term follow-up studies and prospective cohort studies are required in order to determine the best reconstructive methods.

• KIPS Transactions on Computer and Communication Systems
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• v.10 no.1
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• pp.1-6
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• 2021

Recently, incidents such as proxy surgery (unlicensed medical practice) have been reported in the media that threaten the safety of patients. Alternatives such as the introduction of operating room surveillance camera devices to prevent proxy surgery are emerging, but there are practical difficulties in implementing them due to strong opposition from the medical community. However, the social credibility of doctors is falling as incidents such as proxy surgery occur frequently. In this paper, we propose a medical staff identification system combining Beacon and iris recognition. The system adds reliability by operating on the blockchain network. The system performs primary identification by performing user authentication through iris recognition and proves that the medical staff is in the operating room through beacons. It also ensures patient trust in the surgeon by receiving beacon signals in the background and performing iris authentication at random intervals to prevent medical staff from leaving the operating room after only performing initial certification.

• The Journal of the Korea Contents Association
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• v.21 no.12
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• pp.13-22
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• 2021

The clinical decision support system uses accumulated medical data to apply an AI model learned by machine learning to patient diagnosis and treatment prediction. However, the existing black box-based AI application does not provide a valid reason for the result predicted by the system, so there is a limitation in that it lacks explanation. To compensate for these problems, this paper proposes a system model that applies XAI that can be explained in the development stage of the clinical decision support system. The proposed model can supplement the limitations of the black box by additionally applying a specific XAI technology that can be explained to the existing AI model. To show the application of the proposed model, we present an example of XAI application using LIME and SHAP. Through testing, it is possible to explain how data affects the prediction results of the model from various perspectives. The proposed model has the advantage of increasing the user's trust by presenting a specific reason to the user. In addition, it is expected that the active use of XAI will overcome the limitations of the existing clinical decision support system and enable better diagnosis and decision support.

• The Journal of the Convergence on Culture Technology
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• v.7 no.4
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• pp.577-582
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• 2021

This study was conducted to find ways to restore the domestic medical tourism industry, which was seriously hit by a sharp drop in foreign patients after the COVID-19 Pandemic. Kendall's W verification was used by asking expert panel for keyword advice by ranking. The conclusion of the study is that institutions attracting foreign patients need an opportunity to turn the crisis situation into an opportunity by expanding treatment for severe foreign patients. In addition, it is possible to gain familiarity and trust in hospitals in situations where it is difficult to visit overseas through virtual and augmented reality, and to prevent the risk of infection and protect patients in the untact era. In addition, the blockchain can maintain patient information supplementation, share it safely, minimize customer inconvenience by using payment means using virtual currency, and finally, smart healthcare can manage and provide information to patients regardless of location.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.199-247
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• 2012

According to the review and analysis of medical cases that are assigned to the Supreme Court and all local High Court in 2011 and that are presented in the media, it was found that the following categories were taken seriously, medical and pharmaceutical product liability, the third principle of trust between medical institutions, negligence and causation estimation, responsibility limit, the meaning of medical records and related judgment of disturbed substantiation, Oriental doctors' duties to explain the procedures, IMS events, whether one can claim for each medical care operated by non-physician health care institutions to the nonmedical domain in the National Health Insurance Corporation, and the basis of norms for each claim. In the cases related to medical pharmaceutical product liability, Supreme Court alleviated burden of proof for accidents with medical and pharmaceutical products prior to the practice of Product Liability Law and onset the point of negative prescription as the time of damage strikes to condition feasibility of the specific situation. In the cases related to the 3rd principle of trust between medical institutions, the Supreme Court refused to sentence the doctor who has trusted the judgment of the same third-party doctors the violations of the care duty. With respect to proof of a causal relationship and damages in a medical negligence case, the Supreme Court decided that it is unjust to deny negligence by the materials of causal relationship rejecting the original verdict and clarified that the causal relationship shall not deny the reasons to limit doctors' responsibilities. In order not put burden on patients with disadvantages in which medical records and the description of the practice or the most fundamental and important evidence to prove negligence and causation are being neglected, the Supreme Court admitted in the hospital's responsibility for the case of the neonate death of suffocation without properly listed fetal heart rate and uterine contraction monitor. On the other hand, the Seoul Western District Court has admitted alimony for altering and forging medical records. With respect to doctors' obligations to description, the Supreme Court decided that it is necessary to explain the foreseen risks by the combination of oriental and western medicines emphasizing the right of patient's self-determination. However, questions have arisen whether it is realistically feasible or not. In a case of an unlicensed doctor performing intramuscular stimulation treatment (IMS), the Supreme Court put off its decision if it was an unlicensed medical practice as to put limitation of eastern and western medical practices, but it declared that IMS practice was an acupuncture treatment therefore the plaintiff's conduct being an illegal act. In the future, clear judgment on this matter should be made. With respect to the claim of bills from non-physical health care institutions, the Supreme Court decided to void it for the implementation of the arrangement is contrary to the commitments made in the medical law and therefore, it is invalid to claim. In addition, contrast to the private healthcare professionals, who are subject to redemption according to the National Healthcare Insurance Law, the Seoul High Court explicitly confirmed that the non-professionals who receive the tort operating profit must return the unjust enrichment and have the liability for damages. As mentioned above, a relatively wide range of topics were discussed in medical field of 2011. In Korea's health care environment undergoing complex changes day by day, it is expected to see more diverse and in-depth discussions striding out to the development in the field of health care.

• Korean Journal of Psychosomatic Medicine
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• v.28 no.1
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• pp.53-62
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• 2020

Objectives : This study investigated lifetime experiences of trauma, treatment retention, and psychiatric symptoms among outpatients with panic disorder after initiation of pharmacotherapy. Our research hypothesis was that panic patients with childhood trauma would display more severe symptoms and less treatment retention compared to those without such history. Methods : A total of 135 first-visit outpatients with DSM-IV panic disorder were approached during the period from March 2012 to August 2016. Fifty-three patients (39%) either refused or returned incomplete questionnaires, leading to a final sample size of 82. Participants completed the Trauma History Screen, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Abbreviated PTSD checklist. Results : The number of lifetime trauma was significantly correlated with treatment retention (rho=-0.269, p=0.015). Among subtypes of trauma, only childhood physical abuse was significantly correlated with treatment retention (rho=-0.298, p=0.007). Conclusions : Our results indicated that psychological trauma, particularly of an interpersonal nature from childhood, can affect pharmacotherapy treatment retention in panic disorder. This may be mediated by poor patient-doctor relationships originating from trust issues among childhood trauma survivors or lack of perceived improvement due to the more severe symptoms and unfavorable course experienced by those with childhood trauma. Further studies are needed to explore the reasons for poor treatment adherence in this population.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.10
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• pp.2959-2965
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• 2009

This research is based on the medical information record of a university hospital on analysis of outpatients, inpatients and delivery related information in gynecology area. The result of application having analysis of patients as basic material for hospital management is as follows. The number of new patients in average was 140.9, and as the year passes by, it seemed to decrease noticeably(p=0.000). In the first year (2001) the number was only 212.6, but increased to 140 by the year of 2007, showing increase of 80.9. The actual number of patients in the hospital was 124.6 in average and it showed noticeable decrease after each year (p=0.000), from 144.6 patients on the first year 2001, to 104.8 patients in 2007, showing approximately 40 patients decreased. Multiple regression analysis was performed having independent variables as characteristics of patients and cause of delivery related factors, and dependent variables as the number of patients in the hospital. According to analysis, the cause of affecting the number of patients in the hospital was selected as the number of new patients, the number of delivery per year. The reliability rate was recorded as 62.8%. Therefore, apart from the services on marketing and patient management which must come first, the effect of inviting them cannot be avoided, which directly links to trust resulting from the consideration to patients.