• Clinics in Shoulder and Elbow
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• v.22 no.4
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• pp.173-182
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• 2019

Background: Patient reported outcome measures assess clinical progress from the patient's perspective. This study explored the relationship between shoulder outcome measures (The Disability of the Arm, Shoulder and Hand [DASH], American Shoulder and Elbow Surgeons Standard Shoulder Assessment score [ASES], and Constant score) by comparing the best possible scores obtained in an asymptomatic population compared to overall perception of health, as measured by the SF-36 outcome measure. Methods: Volunteers (age range, 20-69 years) with asymptomatic shoulders and no history of shoulder pain, injury, surgery, imaging, or pathology (bilaterally) were included. The DASH and ASES measures were completed by 111 volunteers (72 female, 39 male), of which 92 completed the Constant score (56 female, 36 male). The SF-36 was completed by all volunteers (level of evidence: IV case series). Results: The mean (${\bar{x}}$) score for ASES measure on the right shoulder was higher for the left-hand dominant side (${\bar{x}}=100.00$ vs. 95.02, p-value<0.001); no other significant differences. Better SF-36 scores were associated with better DASH scores. Our prediction models suggest that perception of overall health affects the DASH scores. Sex affected all three shoulder measures scores. Conclusions: Comparing scores of shoulder outcome measures to the highest possible score is not the most informative way to interpret patient progress. Variables such as health status, sex, and hand dominance need to be considered. Furthermore, it is possible to use these variables to predict scores of outcome measures, which facilitates the healthcare provider to deliver individualized care to their patients.

• Quality Improvement in Health Care
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• v.25 no.1
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• pp.11-28
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• 2019

Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

• Journal of Chest Surgery
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• v.27 no.5
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• pp.422-426
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• 1994

Recently, we experienced one case of multiple ribs fracture with large chest wall defects. This patient was treated with internal fixation of ribs by use of Judet`s struts and reconstruction of chest wall defects by use of Teflon mesh. Postoperative outcome was satisfactory result and its advantages were reduced duration of operation, prevention of pulmonary herniation and reduced risk of postoperative infection.

• The Journal of Information Systems
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• v.22 no.2
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• pp.105-129
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• 2013

Recently, since the interest with well-being has been getting higher than ever, people want reliable source of information related with health and medical treatment. Because of the characteristics of information related with medical care, there have been difficulties to find the information from books, television and internet surfing, for treating disease. Misinformation that can be obtained when considering dangerous situations or side effects, the role of the e-Health system is becoming more important. The objective of this study is an analysis of correlation and effect among patient's information need, e-Health system use and system outcome. To achieve the object of this study, e-Health system had been given to patients of breast cancer in Wisconsin and Detroit for 16 weeks. As a result, 282 sample was gathered and modified to meet purpose of the study. As a result, the information needs of patients due to the performance of the e-Health systems and shown to affect even the perception of patients' emotional and physical health and social support.

• Economic and Environmental Geology
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• v.39 no.6 s.181
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• pp.787-801
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• 2006

Focused in the characteristic of R&D on Geoscience and Mineral Resources as basic research area, we survey on methods of public works' economic impact analysis including cost-benefit analysis and resent technology evaluation methods and suggest apply-methods to conduct economic impact analysis on R&D of geoscience and mineral resources. To conduct economic impact analysis on the basic research area, it need to identification research's out-come not just output. In this perspective, we propose a method, Input-Output-Outcome Roadmapping to identify the outcome of R&D and show the relation of input, output, and outcome of R&D. Furthermore, noticing the different effects of R&D from public works, we directly evaluate the use-value of the academic theory or geological maps through Contingent Valuation Method(CVM) and others developed as evaluation methods on environmental goods. In indirect application methods, it can evaluate the partial of the pubic works' benefit with assuming R&D factors if R&D is a part of public works. If not, we evaluate the R&D's value as reductions of costs or additions of benefit with finding related public works.

• The Journal of the Korea Contents Association
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• v.10 no.7
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• pp.253-258
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• 2010

The image intensifier tube that is clinically used gets changed depending on its terms of use. As the brightness gets deteriorated and the performance gets decrease, the X-ray output needs to be increased to maintain the identical diagnosis outcome. As a consequence, the patients are exposed to the increased radiation. Since not many accurate studies have been made, this study measured the conversion factor and resolution depending on the use of the devices that were currently used in Korea. When comparison was made with a device with less than 1 year-use, the conversion factor of a device with 6 year-use got decreased up to 25% while its resolution was reduced from 3.4 lp/mm to 2.5 lp/mm. Such outcome highlights the necessary measures to be supplemented as the increased terms of use implied also the increased radiation exposure among the patients as well as difficulty to conduct an accurate exam.

• Journal of Korea Society of Industrial Information Systems
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• v.22 no.3
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• pp.95-107
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• 2017

This Study Categorized Service Quality of Banks into Interaction Quality, Physical Environment Quality, and Outcome Quality, and Proposed a Structural Model for Each Dimension of Service Quality on Customer Satisfaction, Persistence Intention and Cross-buying Intention, and Conducted an Empirical Analysis on the Customers who Use Banks. First, it was Confirmed that Three Dimensions of Service Quality Physical Environment Quality, Interaction Quality and Outcome Quality are One of the Sources that Form the Customer Satisfaction for Banks. Second, the Higher the Perceived Bank's Interactive Product Quality, Outcome Quality, and Physical Environment Quality Perceived by Customers Using Bank, it's Shown to have more Positive Effect on Customer Satisfaction, and the Effect Size was Shown in Order of Interaction Quality, Physical Environment Quality, and Outcome Quality. Third, Customer Satisfaction on Bank Services was Shown to have a Positive Effect on Relationship Intention and Cross-buying Intention. Finally, Based on the Results of this Analysis, the Implications of this Study and Future Research Directions were Presented.

• Journal of Korean Neurosurgical Society
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• v.56 no.1
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup1
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• pp.115-119
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• 2001

Objective : The cause and clinical outcome of cerebral hemorrhage in patients on maintenance hemodialysis have been poorly studied in korea. The purpose of this paper is to clarify the clincal features and the outcome of cerebral hemorrhage in patients on maintenance hemodialysis. Method : We analyzed clincal features and the outcome of cerebral hemorrhage in 14 patients on maintenance hemodialysis. Hematomas were reviewed and evaluated for location, size, and intraventricular extension by the one of the authors without any prior informations. The axial slice of CT film that the hematoma was appeared in maximal dimension was chosen for evaluations. Result : Hypertension was found in 71.4%(10 cases) and motality rate was 78.5%(11 cases). Basal ganglia hemorrhage was found in 50%(7 cases), subcortex in 28.5%(4 cases), pons in 14.2%(2 cases). Size of hematoma in patients on maintenance hemodialysis was significantly larger than that of hypertensive cerebral hemorrhage patients(p=0.0061). The 4 cases of basal ganglia hemorrhage without intraventricular hemorrhage and subarachnoid hemorrhage were good mental state at the onset of stroke because of small mass effect relative to the size of hematoma. The duration of hemodialysis treatment prior to strokes ranged from 1 to 107 months. Strokes developed within 6 hours of the previous hemodialysis are 5 cases. Average serum albumin concentration was 3.4g/dl. The use of heparin is less responsible for the development of cerebral hemorrhage in patients on maintenance hemodialysis Conclusion : Cerebral hemorrhage in patients on maintenance hemodialysis is more severe in terms of hematoma size and clinical outcome. Therefore, the prevention and treatment of cerebral hemorrhage in patients on maintenance hemodialysis should be more aggressive.

• Healthcare Informatics Research
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• v.24 no.4
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• pp.346-358
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• 2018

Objectives: The association between obstructive sleep apnea (OSA) and mortality or serious cardiovascular events over a long period of time is not clearly understood. The aim of this observational study was to estimate the clinical effectiveness of continuous positive airway pressure (CPAP) treatment on an outcome variable combining mortality, acute myocardial infarction (AMI), and cerebrovascular insult (CVI) during a follow-up period of 15.5 years ($186{\pm}58$ months). Methods: The data set consisted of 978 patients with an apnea-hypopnea index (AHI) ${\geq}5.0$. One-third had used CPAP treatment. For the first time, a data-driven causal Bayesian network (DDBN) and a hypothesis-driven causal Bayesian network (HDBN) were used to investigate the effectiveness of CPAP. Results: In the DDBN, coronary heart disease (CHD), congestive heart failure (CHF), and diuretic use were directly associated with the outcome variable. Sleep apnea parameters and CPAP treatment had no direct association with the outcome variable. In the HDBN, CPAP treatment showed an average improvement of 5.3 percentage points in the outcome. The greatest improvement was seen in patients aged ${\leq}55$ years. The effect of CPAP treatment was weaker in older patients (>55 years) and in patients with CHD. In CHF patients, CPAP treatment was associated with an increased risk of mortality, AMI, or CVI. Conclusions: The effectiveness of CPAP is modest in younger patients. Long-term effectiveness is limited in older patients and in patients with heart disease (CHD or CHF).