• 제목/요약/키워드: Screening risk assessment

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Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8595-8598
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    • 2016
  • Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

일 지역 여성의 유방암 위험요인과 유방암 조기검진 행위 분포 (Risk Factors and Early Screening Behavior for Breast Cancer in Rural Women)

  • 허혜경;박소미;김기연
    • 여성건강간호학회지
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    • 제11권1호
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    • pp.46-51
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    • 2005
  • Purpose: The aim of this study was to identify risk factors for breast cancer and early screening behavior in women in the community. Method: The participants were 125 women residing in W city. Data was collected using an instrument developed by the researchers. Analysis was done using descriptive statistics, and the $x^2$ test. Result: For risk based on the Gail Model, age (above 50 years) had a distribution of 24.8%, first degree family history, 4.9%, age at first full term pregnancy, 13.8%, and benign breast cancer history, 4.9%. For risk based on other common risk factors, menopause had a distribution of 20.7%, did not breast feed, 15.4%, history of HRT, 7.3%, meat preference, 35.0%, and history of smoking or drinking, 2.4% and 43.5%, respectively. There was a significant difference in BSE and mammography screening behavior ($x^2=22.5$, p<.00), but no difference in distribution of risk factors and screening behavior. Conclusion: For effective prevention of breast cancer, it is necessary to develop an instrument for risk assessment and, through assessment, select women at high risk. It is also necessary to provide education and appropriate recommendations on screening behavior.

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다양한 위해성평가 방법에 따라 도출한 오염토양 선별기준의 차이에 관한 연구 (I): 매체 간 이동현상 해석에 따른 차이 (Analysis on the Risk-Based Screening Levels Determined by Various Risk Assessment Tools (I): Variability from Different Analyses of Cross-Media Transfer Rates)

  • 정재웅;류혜림;남경필
    • 한국지하수토양환경학회지:지하수토양환경
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    • 제16권2호
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    • pp.12-29
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    • 2011
  • Risk-based screening levels (RBSLs) of some pollutants for residential adults were derived with risk assessment tools developed by United States Environmental Protection Agency (USEPA), American Society for Testing and Materials (ASTM), and Korea Ministry of Environment (KMOE) and compared each other. To make the comparison simple, ingestion of soil, dermal contact with soil, outdoor inhalation of vapors, indoor inhalation of vapors, and inhalation of soil particulates were chosen as exposure pathways. The results showed that the derived RBSLs varied for every exposure pathway. For direct exposure pathways (i.e., ingestion of soil and dermal contact with soil), the derived RBSLs varied mainly due to the different default values for exposure factors and toxicity data. When identical default values for the parameters were used, the same RBSLs could be derived regardless of the assessment tools used. For inhalation of vapors and inhalation of soil particulates, however, different analysis methods for cross-media transfer rates were used and different assumptions were established for each tool, identical RBSLs could not be obtained even if the same default values for exposure factors were used. Especially for inhalation of soil particulates pathway, screening level derived using KMOE approach (most conservative) was approximately 5000~10000 times lower than the screening level derived using ASTM approach (least conservative). Our results suggest that, when deriving RBSL using a specific tool, it is a prerequisite to technically review the analysis methods for cross-media transfer rates as well as to understand how the assessment tool derives the default values for exposure factors.

Compliance with Screening Recommendations According to Breast Cancer Risk Levels in Izmir, Turkey

  • Acikgoz, Ayla;Ergor, Gul
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1737-1742
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    • 2013
  • Early diagnosis has a major role in improving prognosis of breast cancer. The purpose of this study was to assess the risk status of women 35-69 years of age using risk assessment models and the prevalence of mammography in a community setting. The sample of this cross sectional study consisted of 227 women, 35-69 years of age residing in Izmir, a city located in western region of Turkey. A questionnaire was used to collect data and the Gail and Cuzick-Tyrer models were applied to assess the risk of breast cancer. In this study, 52.7% of women had mammography at least once, and 41.3% of the women over the age of 40 had mammography screening in the last two years. The five years risk for breast cancer was high in 15.8% of women according to the Gail model and ten years risk was high in 21.7% with the Cuzick-Tyrer model. In the present study, the breast cancer risk levels were assessed in a population setting for the first time in Turkey using breast cancer risk level assessment models. Being in 60-69 age group, having low education and not being in menopause were significant risk factors for not having mammography according to logistic regression analysis. Mammography utilization rate was low. Women must be educated about breast cancer screening methods and early diagnosis. The women in the high risk group should be informed on their risk status which may increase their attendance at breast cancer screening.

산업안전보건법 상 관리수준 검토를 위한 화학물질 유해성.위험성 평가대상 후보물질 선정에 관한 연구 (A Study on the Priority for the Hazard and Risk Evaluation of Chemicals (HREC) According to the Industrial Safety and Health Act (ISHA))

  • 양정선;임철홍;박상용
    • 한국산업보건학회지
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    • 제22권1호
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    • pp.73-81
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    • 2012
  • Object: The aim of this study is to suggest a list of priority chemicals for the Hazard & Risk Evaluation of Chemicals (HREC) controlled by the Industrial Safety and Health Act (ISHA). Method: Screening assessment was done for 642 chemicals whose exposure threshold limit values were set by the Ministry of Employment and Labor (MOEL). Hazard data were collected from Korea Occupational Safety & Health Agency (KOSHA) and/or other toxicity database. Exposure data were obtained from KOSHA internal database. The hazard and exposure scores of chemicals were listed by order of priority in accordance with GHS classification and exposure index data. Result: From the result of screening risk assessment for 642 chemicals, we extracted a list of 13 priority chemicals for HREC performed by the ISHA. A priority list of 27 chemicals which have carcinogen, mutagen and/or reproductive toxicity but not controlled by the ISHA was suggested for additional evaluation as "chemicals for special management".

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country

  • Shaimaa Sayed;Mortada H. F. El-Shabrawi ;Eman Abdelmonaem ;Nehal El Koofy;Sara Tarek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권4호
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    • pp.213-223
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    • 2023
  • Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

우리나라 농촌지역 노인들의 영양점검표(DETERMINE)를 통한 계절별 영양상태 판정의 신뢰도 분석 연구 (Reliability of Nutritional Screening Using DETERMINE Checklist for Elderly in Korean Rural Areas by Season)

  • 문현경;공정은
    • 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.

수정 RVS와 IRVS시스템의 비교분석을 통한 국내 고층건물 테러위험도 평가 (Risk Assessment of Tall Buildings in Korea by comparative study of Modified RVS and IRVS system)

  • 유영수;윤성원;주영규
    • 한국공간구조학회논문집
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    • 제12권4호
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    • pp.91-98
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    • 2012
  • As the occurrence rate of terror and hazard is increasing throughout the world, GSA, DoD, and FEMA are proceeding a study about mitigating the damage of terror. Korea is no more a safe place from the terrorist's threat, so we need to make measures against them. In this study we developed modified RVS System by revising some items to adjust the system to the domestic condition and conducted a risk assessment on several tall buildings in Korea. By using IRVS system which is developed by DHS, we also carried out the risk assessment. Comparing the results between RVS with IRVS, we performed terror risk evaluation of tall buildings. Through risk assessment of several tall buildings, we analyzed key factors of each scenarios and suggested the mean value of each items, so we would like to help the counter-terrorism in the design phase.

Evaluation of the efficacy of nutritional screening tools to predict malnutrition in the elderly at a geriatric care hospital

  • Baek, Myoung-Ha;Heo, Young-Ran
    • 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.

Significant Parameters for Assessing Soil Contaminant-Leaching to Groundwater and Determining Soil Sample Size in Field Survey

  • Jeong, Seung-Woo;An, Youn-Joo
    • Environmental Engineering Research
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    • 제13권2호
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    • pp.73-78
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    • 2008
  • For a given soil-contaminated site, a level of soil contamination is characterized and decisions on risk may be made from the risk assessment. The study evaluated critical design factors for the determination of sample size in the sampling design plan and the assessment of soil contaminant- leaching to groundwater. Two variables, the minimum relative detectable difference (T) and coefficient of variation (CV) were evaluated for the sample size determination. The minimum number of samples can be appropriately determined by CV under a T value greater than or equal to 0.2. Soil-contaminant leaching to groundwater was evaluated by using the Soil Screening Level equation of U.S. Environmental Protection Agency and the Risk Based Screening Level equation of American Society for Testing and Materials, with the same input parameters. The groundwater concentrations estimated from soil contaminant concentrations were significantly affected by the Darcy velocity of groundwater and the organic content of soil.