• Title/Summary/Keyword: Severity classification

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APACHE Ⅲ를 이용한 중환자 분류도구의 타당도 검증 (Patient Severity Classification in a Medical ICU using APACHE Ⅲ and Patient Severity Classification Tool)

  • 이경옥;신현주;박현애;정현명;이미혜;최은하;이정미;김유자;심윤경;박귀주
    • 대한간호학회지
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    • 제30권5호
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    • pp.1243-1253
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    • 2000
  • The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.

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한의 입원환자분류체계의 중증도 분류방안 연구 (A Study on the Severity Classification in the KDRG-KM (Korean Diagnosis-Related Groups - Korean Medicine))

  • 류지선;김동수;이병욱;김창훈;임병묵
    • 대한한의학회지
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    • 제38권3호
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    • pp.185-196
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    • 2017
  • Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

정면충돌에서 노인운전자의 중증도에 영향을 주는 요인 분석 (An Analysis of Factors Affecting Severity of Elderly Driver in Frontal Collision)

  • 전혁진
    • 한국화재소방학회논문지
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    • 제33권2호
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    • pp.139-144
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    • 2019
  • 노인인구의 증가로 노인운전자의 손상과 사망자도 증가하였다. 하지만 노인운전자의 손상과 중증도에 대한 연구는 활발히 이루어지지 않아 영향 요인을 파악하지 못하고 있다. 본 연구에서는 정면충돌에서의 노인운전자에 손상과 중증도에 영향을 미치는 요인을 찾아 중증도 분류에 추가적으로 활용하고자 하였다. Collision Deformation Classification Code를 통해 차량 파손 정도를 확인하였으며 간편손상척도(Abbreviated Injury Scale, AIS)로 손상부위와 정도를, 손상중증도점수(Injury Severity Score, ISS)로 환자의 중증도를 확인하였다. 중증외상환자의 발생률은 5이상의 차량 파손 정도를 가진 대상자에서 Odds ratio가 7.381로 나타났으며 선형회귀분석을 통한 중증도 요인 분석에서도 차량 파손 정도의 ${\beta}$값이 0.453으로 나타났다. 따라서 5이상의 차량 파손 정도는 노인운전자에서 중증도 분류에 추가적으로 활용될 수 있는 기준으로 제안될 수 있다.

IoT개념을 활용한 중증도 분류 시스템에 관한 연구 (Research of IoT concept implemented severity classification system)

  • Kim, Seungyong;Kim, Gyeongyong;Hwang, Incheol;Kim, Dongsik
    • 한국재난정보학회 논문집
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    • 제14권1호
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    • pp.28-35
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    • 2018
  • 본 연구에서는 재난현장 또는 일상에서 발생할 수 있는 다수사상자의 중증도 분류를 신속하고 정확하게 수행하기 위한 시스템을 설계하여 구현하였으며, 중증도 분류 알고리즘의 정확도뿐만 아니라 사용자 편의성 등 현장의 요구사항을 적극 반영하였다. 개발된 e-Triage System은 IoT개념을 활용하여 다양한 중증도 분류 알고리즘을 적용하였으며, 기존의 중증도 분류표의 단점을 극복하기 위하여 NFC 모듈 등 전자적 요소를 반영한 e-Triage Tag를 구현하였다. 앱으로 구현된 중증도 분류 알고리즘을 사용하여 신속하고 정확한 환자의 평가가 가능함을 입증하였고, 시인성을 위해 전자 중증도 분류 결과를 4가지 LED램프로 표출하였으며, 2차 분류를 통해 RTS 점수를 FND(Flexible Numeric Display)로 표출하였다.

중증도 분류에 따른 진료비 차이: 간질환을 중심으로 (Differences of Medical Costs by Classifications of Severity in Patients of Liver Diseases)

  • 신동교;이천균;이상규;강중구;선영규;박은철
    • 보건행정학회지
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    • 제23권1호
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    • pp.35-43
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    • 2013
  • Background: Diagnosis procedure combination (DPC) has recently been introduced in Korea as a demonstration project and it has aimed the improvement of accuracy in bundled payment instead of Diagnosis related group (DRG). The purpose of this study is to investigate that the model of end-stage liver disease (MELD) score as the severity classification of liver diseases is adequate for improving reimbursement of DPC. Methods: The subjects of this study were 329 patients of liver disease (Korean DRG ver. 3.2 H603) who had discharged from National Health Insurance Corporation Ilsan Hospital which is target hospital of DPC demonstration project, between January 1, 2007 and July 31, 2010. We tested the cost differences by severity classifications which were DRG severity classification and clinical severity classification-MELD score. We used a multiple regression model to find the impacts of severity on total medical cost controlling for demographic factor and characteristics of medical services. The within group homogeneity of cost were measured by calculating the coefficient of variation and extremal quotient. Results: This study investigates the relationship between medical costs and other variables especially severity classifications of liver disease. Length of stay has strong effect on medical costs and other characteristics of patients or episode also effect on medical costs. MELD score for severity classification explained the variation of costs more than DRG severity classification. Conclusion: The accuracy of DRG based payment might be improved by using various clinical data collected by clinical situations but it should have objectivity with considering availability. Adequate compensation for severity should be considered mainly in DRG based payment. Disease specific severity classification would be an alternative like MELD score for liver diseases.

Feature Extraction of Non-proliferative Diabetic Retinopathy Using Faster R-CNN and Automatic Severity Classification System Using Random Forest Method

  • Jung, Younghoon;Kim, Daewon
    • Journal of Information Processing Systems
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    • 제18권5호
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    • pp.599-613
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    • 2022
  • Non-proliferative diabetic retinopathy is a representative complication of diabetic patients and is known to be a major cause of impaired vision and blindness. There has been ongoing research on automatic detection of diabetic retinopathy, however, there is also a growing need for research on an automatic severity classification system. This study proposes an automatic detection system for pathological symptoms of diabetic retinopathy such as microaneurysms, retinal hemorrhage, and hard exudate by applying the Faster R-CNN technique. An automatic severity classification system was devised by training and testing a Random Forest classifier based on the data obtained through preprocessing of detected features. An experiment of classifying 228 test fundus images with the proposed classification system showed 97.8% accuracy.

Detection of Stator Winding Inter-Turn Short Circuit Faults in Permanent Magnet Synchronous Motors and Automatic Classification of Fault Severity via a Pattern Recognition System

  • CIRA, Ferhat;ARKAN, Muslum;GUMUS, Bilal
    • Journal of Electrical Engineering and Technology
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    • 제11권2호
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    • pp.416-424
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    • 2016
  • In this study, automatic detection of stator winding inter-turn short circuit fault (SWISCFs) in surface-mounted permanent magnet synchronous motors (SPMSMs) and automatic classification of fault severity via a pattern recognition system (PRS) are presented. In the case of a stator short circuit fault, performance losses become an important issue for SPMSMs. To detect stator winding short circuit faults automatically and to estimate the severity of the fault, an artificial neural network (ANN)-based PRS was used. It was found that the amplitude of the third harmonic of the current was the most distinctive characteristic for detecting the short circuit fault ratio of the SPMSM. To validate the proposed method, both simulation results and experimental results are presented.

확률밀도함수와 KOMPSAT-3A를 활용한 산불피해강도 분류 (Forest Fire Severity Classification Using Probability Density Function and KOMPSAT-3A)

  • 이승민;정종철
    • 대한원격탐사학회지
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    • 제35권6_4호
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    • pp.1341-1350
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    • 2019
  • 본 연구는 산불 전후 KOMPSAT-3A 영상을 사용하여 산불피해지역을 분석하는 것을 목적으로 한다. KOMPSAT 시리즈 중 KOMPSAT-3A는 적외선 및 고해상도의 멀티 스펙트럼 밴드를 가진 VHR위성이다. 하지만, KOMPSAT-3A를 활용하여 산불피해강도를 분류하는 연구는 부족한 실정이다. 따라서 본 연구에서는 KOMPSAT-3A의 산불 피해강도를 분류하기 위한 새로운 알고리즘을 제시하는 것을 목표로 한다. 또한, 본 연구에서는 산불 피해지역에 대한 참조자료로 Sentinel-2로 생성한 dNBR을 사용하였다. 본 연구의 연구 지역은 2019년 4월 4일 강릉에서 발생한 산불 피해지역으로 선정하였다. 본 연구에서는 산불피해구간을 산정하기 위한 알고리즘으로 오픈 소스 통계 프로그램인 R software의 확률분포함수를 사용하였다. KOMPSAT-3A에서 산불 피해지역은 산불 전, 후 NDVI의 변화에 따라 생성되었다. 산불피해강도는 분포 함수의 표준 편차를 사용하여 각 등급 크기를 산정하였다. 총 5개 구간에 따른 산불 피해 강도가 효과적으로 분류되었다.

ICD-10을 이용한 ICISS의 타당도 평가 (Validation of the International Classification of Diseases 10th Edition Based Injury Severity Score(ICISS))

  • 정구영;김창엽;김용익;신영수;김윤
    • Journal of Preventive Medicine and Public Health
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    • 제32권4호
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    • pp.538-545
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    • 1999
  • Objective : To compare the predictive power of International Classification of Diseases 10th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with Trauma and Injury Severity Score(TRISS) and International Classification of Diseases 9th Edition Clinical Modification(ICD-9CM) based ICISS in the injury severity measure. Methods : ICD-10 version of Survival Risk Ratios(SRRs) was derived from 47,750 trauma patients from 35 Emergency Centers for 1 year. The predictive power of TRISS, the ICD-9CM based ICISS and ICD-10 based ICISS were compared in a group of 367 severely injured patients admitted to two university hospitals. The predictive power was compared by using the measures of discrimination(disparity, sensitivity, specificity, misclassification rates, and ROC curve analysis) and calibration(Hosmer-Lemeshow goodness-of-fit statistics), all calculated by logistic regression procedure. Results : ICD-10 based ICISS showed a lower performance than TRISS and ICD-9CM based ICISS. When age and Revised Trauma Score(RTS) were incorporated into the survival probability model, however, ICD-10 based ICISS full model showed a similar predictive power compared with TRISS and ICD-9CM based ICISS full model. ICD-10 based ICISS had some disadvantages in predicting outcomes among patients with intracranial injuries. However, such weakness was largely compensated by incorporating age and RTS in the model. Conclusions : The ICISS methodology can be extended to ICD-10 horizon as a standard injury severity measure in the place of TRISS, especially when age and RTS were incorporated in the model. In patients with intracranial injuries, the predictive power of ICD-10 based ICISS was relatively low because of differences in the classifying system between ICD-10 and ICD-9CM.

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만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성 (The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients)

  • 신상열;윤재호;김순종;유광하
    • Tuberculosis and Respiratory Diseases
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    • 제58권5호
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    • pp.507-514
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    • 2005
  • 연구배경 : COPD환자에서 질환의 중증도, 치료 반응정도, 급성악화등을 평가하는데 $FEV_1$과 PEFR이 중요한 측정지표로 사용되고 있다. 하지만 COPD환자에서 PEFR과 $FEV_1$의 일치성에 대해서는 잘 알려져 있지 않아 PEFR 측정이 중증도 분류 검사로 사용이 가능한지는 모르는 상태이다. 방 법 : 2003년 9월부터 2004년 8월까지 건국대학교 병원호흡기 내과 외래에서 진료받은 COPD환자 125명을 대상으로 $FEV_1$과 PEFR을 측정하여 그 결과를 통계, 분석하였다. 결 과 : $FEV_1$ 예측치의 평균은 $56.98{\pm}18.21$이었고 PEFR 예측치의 평균은 $70{\pm}27.60$로 PEFR 예측치가 $FEV_1$ 예측치보다 13%정도 높게 측정 되었다. 두 검사 사이에는 유의한 상관관계가 있었다. COPD환자들의 나이와 PEFR 과는 유의한 상관관계가 없었다. 주관적 증상인 호흡 곤란과 PEFR 과는 유의한 상관관계가 있었다. 결 론 : COPD 환자들에서 PEFR 을 이용한 중증도 분류시 $FEV_1$에 비해 경한 쪽으로 분류되는 성향이 있으므로 증상이 심한 경우 중증도 분류 해석에 주의를 요해야 하겠다. COPD 환자들에서 중증도 분류가 확정된 경우 추적 관찰은 PEFR 값으로 $FEV_1$을 대체하는 것이 가능할 것으로 생각된다.