• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.19 no.4
• /
• pp.444-452
• /
• 2012

Purpose: To explore the usefulness of previous fall history as a triage variable for inpatients. Methods: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. Results: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. Conclusion: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.33 no.4
• /
• pp.367-374
• /
• 2007

Purpose: The diagnostic relevancies and characteristics and of clinical methods in the diagnosis of internal derangement(ID) were tested by comparing the results of them with those of magnetic resonance imaging(MRI). Methods: 75 patients(150 temporomandibular joints; TMJs), who were suspected to have ID by clinical diagnoses, were included. Clinical diagnoses including mouth opening pathway and TMJ sound were conducted and MRI takings were done. Accuracies, sensitivities, specificities, positive predictive values, and negative predictive values of clinical diagnosis, mouth opening pathway, and TMJ sound were calculated by comparing with diagnoses with MRIs. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clinical diagnosis were 59.3%, 83%, 49%, 81%, and 51%. They were 59%, 82%, 25%, 73%, and 35% for mouth opening pathways. Although deviation was somewhat accurate for representing disc displacement with reduction(ADDWR), other discrepancies on opening pathways were not clinically relevant. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of clicking sounds were 85%, 49%, 78%, 85%, and 37%. TMJs with crepitus were only three. But all TMJs with crepitus were diagnosed to have disc displacement without reduction(ADDWOR). Conclusion: When compared with diagnoses with MRIs, clinical diagnoses for ID were not so accurate. But they were suitable for screening tests for ID. Opening pathways and TMJ sounds were not so relevant in the diagnoses of IDs and so it was concluded that considerations for other factors must be included in the diagnoses of IDs.

• Quality Improvement in Health Care
• /
• v.22 no.2
• /
• pp.15-25
• /
• 2016

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

• Journal of The Korean Dental Society of Anesthesiology
• /
• v.12 no.1
• /
• pp.17-23
• /
• 2012

Background: This study evaluated pulp vitality of anterior permanent teeth using pulse oximetry (PO), which is already used for monitoring of patient's $SpO_2$ and pulse rates (PR). Also we compared with ice tests and electric pulp test (EPT). Methods: 9 teeth, endodontic treated, were selected as non-vital teeth group. 17 vital teeth were selected as control group. Our aim is to compare sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of ice test, electric pulp test and pulse oximetry, respectively. Pulse oximetry has two test results, $SpO_2$ and pulse rates. Also we calculated correlation and statistical significances by Pearson's test between EPT and pulse oximetry. Results: Sensitivity, specificity, PPV, NPV were calculated on each tests. Ice test has results of 1.00, 0.89, 0.94 and 1.00, respectively. EPT has results of 0.94, 0.78, 0.89 and 0.88 respectively. $SpO_2$ has results of 0.94, 1.00, 1.00 and 0.90, respectively. PR has results of all 1.00. Conclusions: PO showed relatively accurate, stable and objective results on both $SpO_2$ and PR. Percentage of ability of accurate diagnosis for vital teeth is 94% for ice test, 89% for EPT, 100% for $SpO_2$ and PR. Percentage of ability of accurate diagnosis for non-vital teeth is 100% for ice test, 88% for EPT, 90% for $SpO_2$ and 100% for PR. In additions, PR could be more accurate and significant tests than $SpO_2$.

• The Korean Journal of Pain
• /
• v.28 no.4
• /
• pp.244-253
• /
• 2015

Background: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. Methods: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. Results: A total of 301 children with a mean age of $7.56{\pm}2.61$ years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. Conclusions: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results.

• Clinical and Experimental Pediatrics
• /
• v.59 no.2
• /
• pp.80-90
• /
• 2016

Purpose: Studies have been conducted to identify predictive factors of resistance to intravenous immunoglobulin (IVIG) for Kawasaki disease (KD). However, the results are conflicting. This study aimed to identify laboratory factors predictive of resistance to high-dose IVIG for KD by performing meta-analysis of available studies using statistical techniques. Methods: All relevant scientific publications from 2006 to 2014 were identified through PubMed searches. For studies in English on KD and IVIG resistance, predictive factors were included. A meta-analysis was performed that calculated the effect size of various laboratory parameters as predictive factors for IVIG-resistant KD. Results: Twelve studies comprising 2,745 patients were included. Meta-analysis demonstrated significant effect sizes for several laboratory parameters: polymorphonuclear leukocytes (PMNs) 0.698 (95% confidence interval [CI], 0.469-0.926), C-reactive protein (CRP) 0.375 (95% CI, 0.086-0.663), pro-brain natriuretic peptide (pro-BNP) 0.561 (95% CI, 0.261-0.861), total bilirubin 0.859 (95% CI, 0.582-1.136), alanine aminotransferase (AST) 0.503 (95% CI, 0.313-0.693), aspartate aminotransferase (ALT) 0.436 (95% CI, 0.275-0.597), albumin 0.427 (95% CI, -0.657 to -0.198), and sodium 0.604 (95% CI, -0.839 to -0.370). Particularly, total bilirubin, PMN, sodium, pro-BNP, and AST, in descending numerical order, demonstrated more than a medium effect size. Conclusion: Based on the results of this study, laboratory predictive factors for IVIG-resistant KD included higher total bilirubin, PMN, pro-BNP, AST, ALT, and CRP, and lower sodium and albumin. The presence of several of these predictive factors should alert clinicians to the increased likelihood that the patient may not respond adequately to initial IVIG therapy.

• 대한예방의학회:학술대회논문집
• /
• 1994.02b
• /
• pp.142-149
• /
• 1994

Substitution of graphic representation for extensive lists of numerical statistical data is highly desirable by both editors and readers of medical journals, faced with an exploding abundance of contemporary medical literature. A novel graphic tool. the 'double-ring diagram', is described herein which permits visual representation of information regarding certain statistical variables used to describe the performance of a test or physical sign in the diagnosis of a disease. The diagram is relatively easy to construct on the basis of a number of primary data such as the prevalence and the true positive, true negative. false positive and false negative test results. These values are reflected in the diagram along with the values of other statistical variables derived from them. such as the sensitivity. specificity, predictive values for positive and negative test result. and accuracy. This diagram may be useful in visualizing a test's performance and facilitating visual comparison of performance of two or more tests.

• 대한예방의학회:학술대회논문집
• /
• 1994.02b
• /
• pp.154-157
• /
• 1994

The evaluation of diagnostic tests attempts to obtain one or more statistical parameters which can indicate the intrinsic diagnostic utility of a test. Sensitivity. specificity and predictive value are not appropriate for this use. The likelihood ratio has been proposed as a useful measure when using a test to diagnose one of two disease states (e.g. disease present or absent). In this paper, we generalize the likelihood ratio concept to a situation in which the goal is to diagnose one of several non-overlapping disease states. A formula is derived to determine the post-test probability of a specific disease state. The post-test odds are shown to be related to the pre-test odds of a disease and to the usual likelihood ratios derived from considering the diagnosis between the target diagnosis and each alternate in turn. Hence, likelihood ratios derived from comparing pairs of diseases can be used to determine test utility in a multiple disease diagnostic situation.

• English Language & Literature Teaching
• /
• v.13 no.3
• /
• pp.1-22
• /
• 2007

The study examined the effects of explicit derivational morphology instruction (henceforth DMI) on the incidental vocabulary acquisition and reading comprehension of 132 Korean 1st-year high school students who responded to a battery of tests (two vocabulary tests and a reading comprehension test). Multiple statistical tools were used to analyze the data: Analysis of Covariance (ANCOVA), Analysis of Variance (ANOVA), Simple Regression Analysis, Tests of Simple Main Effects, and effect size computation using Cohen's d. The results indicated that (a) DMI enhanced students' ability to infer word meanings in context, (b) DMI promoted high proficiency students' reading comprehension, whereas it impeded intermediate proficiency students' reading comprehension, (c) vocabulary knowledge has a strong positive predictive value for reading comprehension, and (d) the gaps of vocabulary knowledge across proficiency levels were still substantial, despite the observation that DMI promoted students' vocabulary acquisition. These results have a bearing on English as Foreign Language (EFL) reading pedagogy.

• Journal of Families and Better Life
• /
• v.26 no.4
• /
• pp.41-54
• /
• 2008

The purpose of this study was to investigate predictors concerning preschoolers' ability to read words, in terms of their sub-skills of alphabet knowledge, phonological awareness, and phonological processing. Fourteen literacy sub-tests and three types of reading tasks were administered to 289 kindergartners aged 4 to 6 in Busan. The main results are as follows. Sub-skills that predicted reading ability varied with children's age. Irrespective of children's age groups, knowledge of consonant names and digit naming speed commonly explained the reading of real words. In contrast, skills of syllable deletion and phoneme substitution and knowledge of alphabet composition principles were related to only 4-year-olds' reading skills. Exclusively included was digit memory in predicting 5-year-olds' reading abilities, and knowledge of vowel sounds in 6-year-olds' reading skills. The type of reading task also influenced reading ability. A few common variables such as knowledge of consonant names and vowel sounds, digit naming speed, and phoneme substitution skill explained all types of word reading. Syllable counting skills, however, had predictive value only for the reading of real words. Phoneme insertion skills and digit memory had predictive value for the reading of pseudo words and low frequency letters. Likewise, knowledge of consonant sounds and vowel stroke-adding principles were significant only for the reading of low frequency letters.