• 한국임상수의학회지
• /
• 제32권4호
• /
• pp.319-323
• /
• 2015

The performance of diagnostic test accuracy is usually summarized by a variety of statistics such as sensitivity, specificity, predictive value, likelihood ratio, and kappa. These indices are most commonly presented when evaluations of competing diagnostic tests are reported, and it is of utmost importance to compare the accuracies of diagnostic tests to decide on the best available test for certain medical disorder. However, it is important to emphasize that specific point values of these indices are merely estimates. If parameter estimates are reported without a measure of uncertainty (precision), knowledgeable readers cannot know the range within which the true values of the indices are likely to lie. Therefore, when evaluations of diagnostic accuracy are reported the precision of estimates should be stated in parallel. To reflect the precision of any estimate of a diagnostic performance characteristic or of the difference between performance characteristics, the computation of confidential interval (CI), an indicator of precision, is widely used in medical literatures in that CIs are more informative to interpret test results than the simple point estimates. The majority of peer-reviewed journals usually require CIs to be specified for descriptive estimates, whereas domestic veterinary journals seem less vigilant on this issues. This paper describes how to calculate the indices and associated CIs using practical examples when assessing diagnostic test performance.

• Tuberculosis and Respiratory Diseases
• /
• 제60권5호
• /
• pp.497-509
• /
• 2006

Until recently, the tuberculin skin test (TST) has been the only tool available for diagnosing a latent TB infection. However, the development of new diagnostic tools, using the Mycobacterium tuberculosis (MTB)-specific early secreted antigenic target 6 (ESAT-6) and culture filtrate protein 10 (CFP-10) antigens, should improve the control of tuberculosis (TB) by allowing a more accurate identification of a latent TB infection (LTBI). Antigen-specific interferon-gamma ($IFN-{\gamma}$) assays have greater specificity in BCG-vaccinated individuals, and as less biased by nontuberculous mycobacterial infections. Many comparative studies have suggested that those assays have a higher specificity than the TST, and the sensitivity of these assays are expected to remarkably improved if more MTB-specific antigens can become available. Nevertheless, the major obstacle to the widespread use of these tests is the limited financial resources. Similar to other diagnostic tests, the predictive value of $IFN-{\gamma}$ assays depends on the prevalence of a MTB infection in the population being tested. Therefore, prospective studies will be meeded to establish the applicability of these new assays at multiple geographic locations among patients of different ethnicities, and to determine if the $IFN-{\gamma}$ responses can indicate those with a high risk of progressing to active TB.

• 한국동물위생학회지
• /
• 제30권3호
• /
• pp.385-391
• /
• 2007

A novel enzyme linked immunosorbent assay (ELISA) is described and compared with other established serologic tests for bovine brucellosis, namely the rose bengal test (RBT), the complement fixation test (CFT), and the tube agglutination test (TAT) approved and used in Korea. A total of 109 bovine serum samples were tested using all the 4 assays and analyzed as to specificity, sensitivity, reproducibility and predictive value. The ELISA showed 100% agreement with the CFT. The least agreement between ELISA was observed with the TAT. The agreement between the ELISA and RBT was not significantly different from that observed between the CFT and the ELISA. It is concluded that the new assay would be a good candidate for routine serologic survey for brucellosis in Korea. A protocol combining the ELISA and the CFT would increase the power for detection of serologically positive individuals and herds.

• Clinical and Experimental Pediatrics
• /
• 제50권11호
• /
• pp.1061-1066
• /
• 2007

목 적 : 소아의 발달 장애는 조기에 발견하면 조기 치료가 가능하게 되어 치료 효과가 높아지고 후유 장애를 최소화할 수 있다. 발달 장애의 조기 발견을 위하여 기존에 사용해 오던 정식 발달 선별검사는 대부분 시간이 오래 걸리고, 복잡하며, 의료인력이 추가로 필요하기 때문에 바쁜 소아과 외래에서 모든 소아에게 적용하기는 어렵다. 기존의 발달검사 대신에 부모가 작성한 내용을 토대로 평가하는 발달 설문 양식들 중 Ages and Stages Questionnaire (ASQ)는 60개월 이전의 소아의 발달 선별을 목적으로 개발된 검사이다. 본 연구의 목적은 소아과 외래에서 시행하는 발달 지연의 선별 도구로서 ASQ의 타당성을 알아보기 위한 것이다. 방 법 : 가톨릭대학교 의과대학 부속 성모병원 소아과 외래를 방문한 소아의 부모에게 진료 전 대기 시간 동안 한국형 ASQ (K-ASQ)를 완성하도록 하였다. 설문지를 완성한 총 150명 중 만삭 출생아이며 이전에 발달지연의 진단을 받은 적이 없고, 기타 선천성 기형, 경련성 질환을 포함한 신경학적 이상, 유전성 질환의 경력이 없는 소아 67명을 대상으로 하였다. K-ASQ는 각 영역별로 평균에서 2 표준편차(SD) 아래 점수보다 낮으면 "실패"로 판정하며, 한 발달 분야 이상에서 "실패"가 있는 경우를 "선별검사 양성"으로 하였다. 최종 발달평가는 Bayley Scales of Infant Development-II (BSID-II)를 사용하여 판단하였으며, 지능 혹은 운동발달 지수가 평균보다 -1 SD 미만인 경우는 발달지연으로 판정하였다. K-ASQ의 결과를 BSID-II와 비교하여 분석하였다. 결 과 : 1) 대상아의 평균 연령은 $16.4{\pm}7.4$개월($6{\pm}30$개월 범위, 중앙치 14개월)이었다. 10명(14.9%)은 출생 시 부당경량아였으며, 평균 출생체중 $3.1{\pm}0.6kg$, 재태기간 $38.8{\pm}1.4$주이었다. 9명(13.4%)이 쌍생아였고, 33명(49.0%)이 남아였다. 대상 소아들의 모친의 평균 교육 기간은 $13.6{\pm}2.4$년, 53명(79.1%)이 고등학교 졸업 이상의 학력을 가졌고, 21명(31.3%)이 정규직 근무자였다. ASQ 설문지를 완성하는데 평균 $10.2{\pm}3.0$분이 소요되었다. (2) 17명(25.4%)이 ASQ 선별검사 양성이었는데, 그 중 4명은 발달이 지연되었고, 나머지 13명의 발달은 정상이었다. BSID-II로 판정한 발달 지연아 8명 중 4명은 ASQ 선별검사에서 양성이었고, 다른 4명은 선별검사 음성이었다. ASQ 선별검사 음성인 50명 중 4명이 발달지연으로 판단되었다. (3) BSID-II와 비교한 K-ASQ의 민감도(sensitivity)는 50.0%, 특이도(specificity) 78.0%, 양성 예측치 (positive predictive value) 23.5%, 음성 예측치(negative predictive value)는 92.0%로 나타났다. 결 론 : K-ASQ는 높은 음성 예측치를 보여 소아과 외래에서 소아 발달 지연의 선별 도구로서 사용하는 것이 타당한 것으로 판단되었다.

• Clinical and Experimental Reproductive Medicine
• /
• 제29권1호
• /
• pp.57-66
• /
• 2002

Objective : This study was designed to investigate the interrelationship and clinical usefulness of sperm morphology by strict criteria (SM), acrosome reaction following ionophore challenge test (ARIC) and sperm penetration assay (SPA) using zona-free hamster ova as prognostic factors in in vitro fertilization. Materials and Methods: Semen samples were provided by 83 patients undergoing IVF. We first evaluated the differences between normal fertilization group and poor fertilization group on three andrologic tests. Secondly, we analyzed the relationship between the three andrologic tests and in vitro fertilization on IVF settings. Finally, we evaluated the effectiveness of the three andrologic tests as the prognostic indicators for fertilizing ability. Results: The fertilization rate of all men in the poor fertilization group was less than 30%; but there was no evidence that this poor fertilization was due to oocyte defects. The results of three andrologic tests were significatly higher in normal fertilization group. Fertilization rate (%) in vitro was highly correlated (p<0.001) with % normal sperm by SM, ARIC value (%), and SPA result. By using Receiver-Operator-Characteristic curve (ROC), we evaluated the effectiveness of these three tests. The sensitivity and specificity of SM, ARIC test and SPA in predicting fertilization potential in IVF setting were 76% and 75%, 84% and 90%, and 76% and 95%, respectively. Conclusion: Our data suggest that the three andrologic tests can be reliable tools as prognostic factors of sperm fertilizing ability. Among these test, ARIC test and SPA gave more accurate information on fertilizing capacity. ARIC test was shown to have a predictive value for fertilizing ability comparable to that of SPA that appears to be a simple and cost-effective addition to current andrology laboratory. Combined application of these three tests may give more information on predicting sperm fertilizing capacity.

• 한국도로학회논문집
• /
• 제20권1호
• /
• pp.87-95
• /
• 2018

PURPOSES : A geo-grid pavement, e.g., a stress-absorbing membrane interlayer (SAMI), can be applied to an asphalt-overlay method on the existing surface-pavement layer for pavement maintenance related to reflection cracking. Reflection cracking can occur when a crack in the existing surface layer influences the overlay pavement. It can reduce the pavement life cycle and adversely affect traffic safety. Moreover, a failed overlay can reduce the economic value. In this regard, the objective of this study is to evaluate the bonding properties between the rigid pavement and a SAMI by using the direct shear test and the pull-off test. The predicted fractural energy functions with the shear stress were determined from a numerical analysis of the moving average method and the polynomial regression method. METHODS : In this research, the shear and pull-off tests were performed to evaluate the properties of mixtures constructed using no interlayer, a tack-coat, and SAMI with fabric and without fabric. The lower mixture parts (describing the existing pavement) were mixed using the 25-40-8 joint cement-concrete standard. The overlay layer was constructed especially using polymer-modified stone mastic asphalt (SMA) pavement. It was composed of an SMA aggregate gradation and applied as the modified agent. The sixth polynomial regression equation and the general moving average method were utilized to estimate the interlayer shear strength. These numerical analysis methods were also used to determine the predictive models for estimating the fracture energy. RESULTS : From the direct shear test and the pull-off test results, the mixture bonded using the tack-coat (applied as the interlayer between the overlay layer and the jointed cement concrete) had the strongest shear resistance and bonding strength. In contrast, the SAMI pavement without fiber has a strong need for fractural energy at failure. CONCLUSIONS : The effects of site-reflection cracking can be determined using the same tests on cored specimens. Further, an empirical-mechanical finite-element method (FEM) must be done to understand the appropriate SAMI application. In this regard, the FEM application analy pavement-design analysis using thesis and bonding property tests using cored specimens from public roads will be conducted in further research.

• Computers and Concrete
• /
• 제19권5호
• /
• pp.467-475
• /
• 2017

The purpose of this study is to establish a prediction model for the electrical resistivity ($E_r$) of self-consolidating concrete by using waste LCD (liquid crystal display) glass as part of the fine aggregate and then, to analyze the results obtained from a series of laboratory tests. A hyperbolic function is used to perform nonlinear multivariate regression analysis of the electrical resistivity prediction model, with parameters such as water-binder ratio (w/b), curing age (t) and waste glass content (G). Furthermore, the relationship of compressive strength and electrical resistivity of waste LCD glass concrete is also found by a logarithm function, while compressive strength is evaluated by the electrical resistivity of non-destructive testing (NDT). According to relative regression analysis, the electrical resistivity and compressive strength prediction models are developed, and the results show that a good agreement is obtained using the proposed prediction models. From the comparison between the predicted analysis values and test results, the MAPE value of electrical resistivity is 17.0-18.2% and less than 20%, the MAPE value of compressive strength evaluated by $E_r$ is 5.9-10.6% and nearly less than 10%. Therefore, the prediction models established in this study have good predictive ability for electrical resistivity and compressive strength of waste LCD glass concrete. However, further study is needed in regard to applying the proposed prediction models to other ranges of mixture parameters.

• 한국동물위생학회지
• /
• 제31권3호
• /
• pp.315-329
• /
• 2008

A total of 710 bovine serum samples which are composed 532 bovine serum samples showed negative reaction and 178 bovine serum samples showed positive reaction with tube agglutination test (TAT) from North area of Gyeong-nam, Korea were tested using all the 3 assays which are Rose-Bengal test(RBT), tube agglutination test (TAT) and enzyme-linked immunosorbent assay (ELISA, two types) and analyzed for evaluation of specificity, sensitivity, reproducibility and predictive value. In the comparison of serum antibody titer agglutination test, RBT showed almost agreement with TAT. In the comparison of TAT and two types of ELISA method, they showed difference in specificity and sensitivity about 5%. But there is no significant difference in detecting sensitivity between two types of ELISA method and TAT. In serologic tests for bovine brucellosis, the new assay ELISA would be a good candidate for serologic survey for bovine brucellosis in Korea because it is efficient in detecting many test samples quickly. But the serum agglutination tests (RBT, TAT) are more economical and easy assay for detection. In the test of comparison of antibody titer between first day of finding and 10 days after finding by TAT, there was no change in 55% (76/139) of positive cattle.

• 한국임상수의학회지
• /
• 제26권2호
• /
• pp.130-133
• /
• 2009

검사키트의 신속성과 간편성이 보편화되면서 진단목적으로 키트를 사용하는 빈도가 증가하고 있다. 그러나 대부분의 검사키트는 민감도와 특이도가 100% 완벽하지 못하기 때문에 진단검사의 특성과 이러한 특성에 영향을 미치는 요인을 이해하지 못할 경우 검사결과를 해석하는데 오류를 범하게 된다. 임상의는 검사결과 양성 혹은 음성일 때 환자가 실제로 질병에 감염되어 있을 확률이 어느 정도인지에 관심을 두기 때문에 본 연구에서는 예측도를 이용하여 유병율에 따른 결과 해석방법을 개 심장사상충 진단키트를 예로 들어 설명하였다. 문헌고찰 결과 심장사상충 진단용 키트검사의 평균 민감도와 특이도는 DiroChek 78.1-95.2%, SNAP 66.3-98.1%, Solo Step 69.5-97.5%를 보였다. 혈액학적 검사법(Modified Knott's, direct smear, capillary tube)의 민감도와 특이도는 각각 38.4-81.8%, 96.9-100%의 범위를 보여 검사법에 따라 상당한 차이를 보였다. 또한 국내 개 심장상충의 자충과 항원 유병율은 지역별로 차이가 있으며 키트검사의 예측도는 유병율에 매우 민감하다는 점을 고려하면 개 심장사상충에 대한 검사결과에 근거하여 감염확률을 추정할 때 유병율이 상이한 임상환경에서는 양성 혹은 음성결과에 대하여 신중하게 해석할 필요가 있다.

• Journal of Genetic Medicine
• /
• 제17권1호
• /
• pp.11-15
• /
• 2020

Purpose: The objective of this study was to analyze the results of several noninvasive prenatal tests (NIPTs) from a single center and confirm their efficacy and reliability. In addition, we aimed to confirm the changes in the number of invasive tests performed after introducing NIPT. Materials and Methods: NIPT data from a large single center from March 2014 to November 2018 were analyzed. Karyotyping was confirmed based on chorionic villus sampling, amniocentesis, or postnatal cord/peripheral blood sampling. Data on maternal age, gestational age, fetal fraction, and ultrasonographic results were analyzed. As the secondary outcome, the number of amniocentesis cases before and after the introduction of NIPT was compared. Results: Overall, 1,591 single pregnancy cases that underwent NIPT were enrolled. The mean maternal age was 36.05 (22-45) years. The average gestational age and fetal fraction were 12⁺¹ (9⁺³ to 27⁺¹) weeks and 10.95% (3.6% to 31.3%), respectively. A total of 1,544 cases (97.0%) were reported to have negative NIPT results and 40 (2.5%) had positive NIPT results. The sensitivity and specificity of the overall abnormalities in NIPT were 96.29% and 99.36%, respectively. The positive predictive value (PPV) and negative predictive value were 72.22% and 99.93% respectively. The mean number of amniocentesis cases were 21.7 per month (21.7±3.9), which significantly decreased from 31.5 per month (31.5±4.8) before conducting NIPT as a screening test. Conclusion: NIPT is currently a useful, powerful, and safe screening test. In particular, trisomy 21 is highly specific due to its high PPV. NIPT can reduce the potential risks of procedure-related miscarriages during invasive testing.