• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6177-6186
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• 2015

Sensitivity and specificity are the two most important indicators in selection of medical imaging devices for cancer screening. Breast images taken by conventional or digital mammography, ultrasound, MRI and optical mammography were collected from 2,143,852 patients. They were then studied and compared for sensitivity and specificity results. Optical mammography had the highest sensitivity (p<0.001 and p<0.006) except with MRI. Digital mammography had the highest specificity for breast cancer imaging. A comparison of specificity between digital mammography and optical mammography was significant (p<0.021). If two or more breast diagnostic imaging tests are requested the overall sensitivity and specificity will increase. In this literature review study patients at high-risk of breast cancer were studied beside normal or sensitive women. The image modality performance of each breast test was compared for each.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6283-6286
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• 2014

In patients with microscopic hematuria there is a need for better identification of those who are at greater risk of harbouring bladder tumors. The RisikoCheck(C) questionnaire has a strong correlation with the presence of urothelial carcinoma (UC) of the bladder and in combination with other available tests may help identify patients who require detailed clinical investigations due to increased risk of presence of bladder tumors. This study aimed to evaluate the efficacy of RisikoCheck(C) questionnaire together with NMP-22(R) (BladderChek(R)) as a point-of-care urine test in predicting the presence of bladder tumors in patients presenting with microscopic hematuria as the sole finding. In this multi-institutional prospective evaluation of 303 consecutive patients without a history of urothelial carcinoma (UC), RisikoCheck(C) risk group assessment, urinary tract imaging and cystourethroscopy as well as urine cytology and Nuclear Matrix Protein-22 (NMP-22 BladderChek) testing were performed where available. The sensitivity, specificity, negative predictive value (NPV), and positive predictive values (PPV) for the risk adapted approach were calculated. All patients underwent cystoscopy, and tumors were detected in 18 (5.9%). Urine cytology and NMP-22 was positive for malignancy in 9 (3.2%) and 12 (7.5%) of patients, respectively. A total of 43 (14%) patients were in the high risk group according to the RisikoCheck(C) questionnaire. The sensitivity and specificity of the questionnaire in detecting a bladder tumor was 61.5 % and 84.0 % in the high risk group. In patients with either a positive NMP-22 test or high risk category RisikoCheck(C), 23.6% had bladder tumors with a corresponding sensitivity of 54.2% and specificity of 88.6%. If both tests were negative only 3.3% of the patients had bladder tumors. The results of our study suggest that the efficacy of diagnostic evaluation of patients with microscopic hematuria may be further enhanced by combining RisikoCheck(C) questionnaire with NMP-22.

• 대한지역사회영양학회지
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• 제15권6호
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• pp.796-805
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• 2010

This study investigated the correlations and risk distribution differences between high sensitivity C-reactive protein (hs-CRP) and the diagnosis factors of metabolic syndrome among the residents of a rural community. Two thousand adults aged from 40 to 70 were recruited and 1,968 subjects were included in the study after excluding those with infectious disease or with hs-CRP higher than 10 mg/L in blood. The subjects were then divided into three groups of hs-CRP to examine the correlations and risk ratio with the risk factors of metabolic syndrome. There was a tendency of hs-CRP increasing according to the number of risk factors of metabolic syndrome. The risk ratio with hs-CRP according to metabolic syndrome significantly increased by 2.0 and 2.2 times in the intermediate and high risk group, respectively, compared with the low risk group. The risk ratio with the risk factors of metabolic syndrome according to hs-CRP rose in abdominal obesity, triglyceride, and W/Ht in the intermediate risk group of hs-CRP. The risk ratio also surged in high pressure, W/Ht, ex-drinking (1.7 times), exsmoking (2.0 times) and current smoking (2.0 times) in the high risk group. The results indicate that hs-CRP is related to the risk factors of metabolic syndrome and that it's very important to manage obesity including abdominal obesity and W/Ht and everyday habits including drinking and smoking.

• 대한지역사회영양학회지
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• 제14권3호
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• pp.340-353
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• 2009

It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.

• Nutrition Research and Practice
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• 제10권4호
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• pp.411-417
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• 2016

BACKGROUND/OBJECTIVES: Metabolic syndrome (MetS) is a set of interrelated metabolic risk factors that increase the risk of cardiovascular morbidity and mortality. Studies regarding the specificity and sensitivity of serum levels of leptin and uric acid as predictors of MetS are limited. The aim of this study was to evaluate the serum levels of leptin and uric acid in terms of their specificity and sensitivity as predictors of MetS in the studied Jordanian group. SUBJECTS/METHODS: In this cross sectional study, 630 adult subjects (308 men and 322 women) were recruited from the King Hussein Medical Center (Amman, Jordan). The diagnosis of MetS was made according to the 2005 International Diabetes Federation criteria. Receiver operating characteristic curves were used to determine the efficacy of serum levels of leptin and uric acid as predictors of MetS in the studied Jordanian group. RESULTS: Study results showed that for identification of subjects with MetS risk, area under the curve (AUC) for leptin was 0.721 and 0.683 in men and women, respectively. Serum uric acid levels in men showed no significant association with any MetS risk factors and no significant AUC, while uric acid AUC was 0.706 in women. CONCLUSION: Serum leptin levels can be useful biomarkers for evaluation of the risk of MetS independent of baseline obesity in both men and women. On the other hand, serum uric acid levels predicted the risk of MetS only in women.

• Nutrition Research and Practice
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• 제9권6호
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10683-10690
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• 2015

The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..

• 한국산업보건학회지
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• 제32권3호
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• pp.253-267
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• 2022

Objectives: This study was performed to check whether the CRS (Chemical Ranking and Scoring) system is appropriate as a method to determine substances as candidates for substances subject to permission and to apply this system to the selection of candidates for substances subject to permission. Methods: A risk score was obtained by multiplying the hazard score and the exposure score and then ranking them. The hazard sub-indicators are carcinogenicity, germ cell mutagenicity, reproductive toxicity, specific target organ toxicity-repeated exposure, respiratory sensitization and endocrine disrupting chemicals. Exposure sub-indicators are persistence, bioaccumulation and emission volume. Sensitivity analysis was performed for missing values. Correlation analysis and multivariable linear regression analysis were performed among hazard, exposure and risk in order to confirm that CRS was an appropriate method. Results: As a result of the sensitivity analysis on missing values, it was confirmed that the effect on the risk ranking was not sensitive. Correlation and regression analysis confirmed that exposure had a greater effect on risk than hazard. Conclusions: The CRS system, which derives a risk score using a hazard and exposure score, is judged to be appropriate as a method for the selection of preliminary of candidates for substances subject to permission. Benzene, cadmium, nickel, and cobalt were selected as priority candidates for substances subject to permission.

• Child Health Nursing Research
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• 제20권3호
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• pp.215-224
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• 2014

목적 본 연구는 입원 환아의 낙상위험 요인을 확인하여 낙상위험 예측도구를 개발하고 민감도와 특이도를 확인하기 위한 것이다. 방법 문헌고찰과 서울시내 1개 어린이 병원에 2006년 1월부터 2009년 8월까지 3년 8개월 동안 입원한 환아 중 낙상한 경험이 있는 환아 48명 전체와 2009년 5월 25일부터 6월 24일까지 한 달 동안 입원한 환아 중 낙상 경험이 없는 환아 149명을 비교한 자료를 바탕으로 낙상위험요인 8개를 추출하였으며, 로지스틱 회귀분석을 통해 유의한 위험요인 5개를 확인하였다. 8개 문항과 5개 문항으로 구성된 도구를 이용하여 실제 낙상을 경험한 군과 비낙상군을 비교하여 민감도, 특이도, 양성예측도, 음성예측도를 확인하였다. 결과 로지스틱 회귀분석 결과 입원 환아의 낙상 발생 위험의 유의한 예측 요인은 다음의 5가지였다. 연령은 3세 미만인 경우 3.00배, 뇌신경질환 진단이 있는 경우 2.41배, 활동 및 기능은 도움이 필요한 경우 3.18배, 신체발달은 정상인 경우에 7.09배, 위험약품 처방 수가 3개 이상인 경우 3.475배로 낙상위험이 높은 것으로 나타났다. 8개 문항의 경우 12점 이상을 고위험으로 보았을 때 민감도는 76.6%, 특이도는 30.3%였으며, 5개 문항의 경우 7점 이상을 고위험으로 보았을 때 민감도는 93.6%, 특이도는 16.2%로 나타났다. 결론 입원환아의 낙상위험예측도구로서 8개 문항과 5개 문항의 도구 모두 민감도는 높으나 특이도는 낮은 제한점을 갖고 있다. 그러나 낙상위험을 예방하기 위한 목적으로 사용됨을 감안하면 특이도는 낮지만 민감도가 높으므로 임상현장에서 사용 가능할 것으로 판단된다.

• Environmental Engineering Research
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• 제18권4호
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• pp.241-246
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• 2013

For effective and efficient environmental management, developed countries, such as the Netherlands, UK, Australia, Canada, and United States apply ecological risk assessment, and they have an autonomous risk assessment methodology to protect native receptors. In this study, soil ecological protective concentration (EPC) of cadmium in Korea was derived using Korean ecological risk assessment methodology. The soil EPC of cadmium was calculated using probabilistic ecological risk assessment based on species sensitivity distribution. The soil EPC was calculated according to land use for residential/agricultural and industrial/commercial purposes. The chronic soil EPCs for residential/agricultural and industrial/commercial lands were derived to be 1.58 and 9.60 mg/kg, respectively. These values were similar to soil EPC of European Commission, the Netherlands, UK, and Canada. However, these values were lower than the established Korean soil standard, because the current soil standard was based on human risk. Therefore, the impact on an ecosystem when establishing environmental standard should be considered.