• Title/Summary/Keyword: cut-off score

Search Result 171, Processing Time 0.024 seconds

A Study on the Pressure Ulcers in Neurological Patients in Intensive Care Units (신경계 중환자의 욕창발생에 관한 연구)

  • Im, Mi-Ja;Park, Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
    • /
    • v.13 no.2
    • /
    • pp.190-199
    • /
    • 2006
  • Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

  • PDF

High-impact chronic pain: evaluation of risk factors and predictors

  • Ilteris Ahmet Senturk;Erman Senturk;Isil Ustun;Akin Gokcedag;Nilgun Pulur Yildirim;Nilufer Kale Icen
    • The Korean Journal of Pain
    • /
    • v.36 no.1
    • /
    • pp.84-97
    • /
    • 2023
  • Background: The concept of high-impact chronic pain (HICP) has been proposed for patients with chronic pain who have significant limitations in work, social life, and personal care. Recognition of HICP and being able to distinguish patients with HICP from other chronic pain patients who do not have life interference allows the necessary measures to be taken in order to restore the physical and emotional functioning of the affected persons. The aim was to reveal the risk factors and predictors associated with HICP. Methods: Patients with chronic pain without life interference (grade 1 and 2) and patients with HICP were compared. Significant data were evaluated with regression analysis to reveal the associated risk factors. Receiving operating characteristic (ROC) analysis was used to evaluate predictors and present cutoff scores. Results: One thousand and six patients completed the study. From pain related cognitive processes, fear of pain (odds ratio [OR], 0.92; 95% confidence interval [CI], 0.87-0.98; P = 0.007) and helplessness (OR, 1.06; 95% CI, 1.01-1.12; P = 0.018) were found to be risk factors associated with HICP. Predictors of HICP were evaluated by ROC analysis. The highest discrimination value was found for pain intensity (cut-off score > 6.5; 83.8% sensitive; 68.7% specific; area under the curve = 0.823; P < 0.001). Conclusions: This is the first study in our geography to evaluate HICP with measurement tools that evaluate all dimensions of pain. Moreover, it is the first study in the literature to evaluate predictors and cut-off scores using ROC analysis for HICP.

Validation of Adult Fall Assessment Scale Korean Version for Adult Patients in General Hospitals in Korea (한국형 낙상 위험 사정도구의 타당성 평가연구)

  • Choi, Eun Hee;Ko, Mi Suk;Lee, Shin Ae;Park, Jung Ha
    • Journal of Korean Clinical Nursing Research
    • /
    • v.26 no.2
    • /
    • pp.265-273
    • /
    • 2020
  • Purpose: The purpose of this study was to test the predictive validity of the Fall Assessment Scale-Korean version (FAS-K) and to find the most appropriate cutoff score to screen high-risk fall groups in adult patients in general hospitals in Korea. Methods: We performed a prospective evaluation study in medical and surgical ward patients at two major general hospitals in Seoul. Data were collected from Nov. 1, 2018 to Feb. 28, 2019, nurses performed 651 observation series. The researcher measured the fall risk assessment score by applying FAS-K, MFS (Morse Fall Scale), and JHFRAT (Johns Hopkins Hospital Fall Risk Assessment tool) to the patients twice a week between 10 am and 12 noon. Data were analyzed using Pearson's corelation coefficients, and the sensitivity, specificity, predictive value, and the area under the curve (AUC) of the three tools. Results: The FAS-K was positively correlated with the MFS (r=.70, p<.001) and the JHFRAT (r=.82, p<.001). According to the receiver operating characteristics (ROC) curve analysis of the FAS-K, sensitivity, specificity, and positive and negative prediction values were 85.3%, 49.4%, 8.5%, and 98.4%, respectively, when the FAS-K score was 4. Therefore, the cut-off score of the FAS-K to identify groups with high fall risk was 4. Conclusion: The FAS-K is a valid tool for measuring fall risk in adult inpatients. In addition, the FAS-K score, 4, can be used to identify high-risk fall groups and know specific points in time to provide active interventions to prevent falls.

Validation of Fall Risk Assessment Scales among Hospitalized Patients in South Korea using Retrospective Data Analysis (후향적 자료분석을 통한 낙상위험 사정도구의 타당도 비교: 종합병원 입원 환자를 중심으로)

  • Kang, Young Ok;Song, Rhayun
    • Korean Journal of Adult Nursing
    • /
    • v.27 no.1
    • /
    • pp.29-38
    • /
    • 2015
  • Purpose: The purpose of the study was to validate fall risk assessment scales among hospitalized adult patients in South Korea using the electronic medical records by comparing sensitivity, specificity, positive predictive values, and negative predictive values of Morse Fall Scale (MFS), Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS), and Johns Hopkins Hospital Fall Risk Assessment tool (JHFRAT). Methods: A total of 120 patients who experienced fall episodes during their hospitalization from June 2010 to December 2013 was categorized into the fall group. Another 120 patients, who didn't experience fall episodes with age, sex, clinical departments, and the type of wards matched with the fall group, were categorized to the comparison group. Data were analyzed for the comparisons of sensitivity, specificity, positive and negative predictive values, and the area under the curve of the three tools. Results: MFS at a cut-off score of 48 had .806 for ROC curves, 76.7% for sensitivity, 77.5% for specificity, 77.3% for positive predictive value, and 76.9% for negative predictive value, which were the highest values among the three fall assessment scales. Conclusion: The MFS with the highest score and the highest discrimination was evaluated to be suitable and reasonable for predicting falls of inpatients in med-surg units of university hospitals.

A Study on Sasang Constitutional Classification Methods based on ROC-curve using the personality score (성격점수를 이용한 ROC-curve 기반 사상체질 분류 방법에 대한 연구)

  • Kim, Ho-Seok;Jang, Eun-Su;Kim, Sang-Hyuk;Yoo, Jong-Hyang;Lee, Si-Woo
    • Korean Journal of Oriental Medicine
    • /
    • v.17 no.2
    • /
    • pp.107-113
    • /
    • 2011
  • Objectives : Sasang typology is extensively studied for the Sasang constitution diagnosis objectification with various data, for example, questionaires, reference materials, etc and analyzed with the several statistical methods. In this study, we used ROC-curve (Receiver Operating Characteristic curve) analysis to diagnose Sasang constitution, which is a kind of epidemiologic research methods and is away from traditional statistical methods. Methods : We collected personality questionnaire which consists of 15 items, from 24 oriental medical clinics. We analyzed the sensitivity and specificity using ROC curve method based on the score of personality questionnaire and also investigated classification accuracy and cut-off value of Sasang constitution. Results : The AUC (area under the ROC curve) value was 0.508 (p=.5511) for Taeeumin, 0.629 (p<.0001) for Soeumin and 0.604(p<.0001) for Soyangin, respectively. so the classification accuracy for Soeumin was highest Soeumin for over 30 points and Soyangin for below 28 points respectively. Conclusions : We suggest that Taeeumin is not classified easily in the ROC-curve analysis. We may classify Soeumin and Soyangin but the accuracy of Sasang constitutional diagnosis is still low.

Test-Retest Reliability of Brief KS-15 -Korean Sasang Constitutional Diagnostic Questionnaire- (단축형 사상체질 진단 설문지(KS-15)의 검사-재검사 신뢰도 연구)

  • Kim, Yunyoung;Jang, Eunsu
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.30 no.3
    • /
    • pp.177-183
    • /
    • 2016
  • The purpose of this study was to evaluate the reliabilities of questions and diagnostic value of the Korean Sasang Constitutional Diagnostic Questionnaire(KS-15). The young adults aged 20's participated in this study. The first survey was conducted in march, 2016, and the second one was conducted two weeks later. Three hundred and three questionnaires and the informed consent were obtained from all participants. The test-retest kappa analysis was used to identify the reliabilities of the questions and diagnostic value, and the significance level was .05. The number of subjects was 303 [87(28.7%)males and 216(71.3%)females]. The Cronbach's α were .630 in 6 characteristic questions. The test-retest reliabilities of questions were ranged from .469 to 734. The agreement rate of KS-15 between the first and second constitutional diagnostic value was 87.13%(Kappa=0.794). The higher Sasang constitutional probability score in first survey resulted in the higher agreement rate between first and second diagnostic value. KS-15 seems to be a reliable implement. Further studies for the reliability of the people of different ages and suitable cut off point in Sasang constitutional probability score are needed for the practical use of KS-15.

A Study on the Critical Failure Factors against B2B e-Marketplace Performance (B2B 중개기업의 성과 저해요인에 관한 연구)

  • Kwon, Suhn-Beom;Byun, Seong-Soo;Bae, Jun-Bum
    • Journal of Information Technology Services
    • /
    • v.4 no.1
    • /
    • pp.1-13
    • /
    • 2005
  • Many buying and selling companies have participated in B2B electronic commerce in order to boost sales and cut down purchase prices respectively. There are some studies on buying and selling companies performances of using B2B e-marketplaces which provide electronic B2B transaction services such as finding transaction partners, providing on-line transaction process like auctioneering, etc. This study investigates the critical failure factors against B2B e-marketplace in other words B2B market-maker or B2B intermediary. We proposed 4 hypotheses asserting that 4 critical failure factors make reverse effects on B2B intermediary performances. We adopt the Balanced Score Card (BSC) framework to evaluate B2B intermediary performance. Data were collected from 46 respondents of B2B intermediaries in Korea. Analyses showed that traditional off-line B2B practices like refunding to buyer or transactions without legal documents and low quality of product information and catalog are critical failure factors against B2B intermediary performance.

Cytoprotective action of Rubi Fructus by modulation of Reactive Oxygen Species, peroxynitrite and $Ca^{2+}$ (복분자(覆盆子)의 세포내 ROS, $ONOO^-$ 생성 및 $Ca^{2+}$ 증가 억제에 의한 혈관내피세포 보호작용)

  • Lee, Cheol-Woong;Jeong, Ji-Cheon
    • The Journal of Internal Korean Medicine
    • /
    • v.26 no.3
    • /
    • pp.615-625
    • /
    • 2005
  • Objectives : Poststroke depression is a frequent and specific entity that impaires the rehabilliation and functional recovery of patients with hemiplegia. The author evaluated the effect of Banhahubak-tang(Banxiahoupotang) in patients with poststroke depression. Methods : 38 patients suffering from poststroke depression(determined by Diagnostic and Statistical Manual of Mental Disorders, revised. 3rd edition. and Beck Depression Inventory[BDI] cutoff $point{\geqq}10$) in Kyunghee Oriental hospital were randomized into two groups; treatment group(n=19) and control group(n=19). The treatment group was prescribed with Banhahubak-tang(Banxiahoupotang) three times a day fur a week. Control troop was prescribed with other herbal medicines used for stroke Patients three times a day for a week. Patients were evaluated by use of BDI scale, Modified Barthel Index, Depression of Ki score, Yin syndrome score, and Yang syndrome score. Among 38 patients, 24 patients got BDI scores above 21, which is the cut-off score for depression in Korean. The same procedures and assessments described above were applied. Results : Treatment group did not significantly improve compared with control group. Results yielded only slight significance (P=0.086). Especially. patients with poststroke depression as yin syndrome improved more significantly on BDI than those classified as yang syndrome. When BDI cutoff point for depression was defined as being ${\geq}\;21$, treatment group did not significantly improve compared with control group(P=0.114). However, patients with poststroke depression classified as yin syndrome were also significantly improved on BDI than those classified as yang syndrome. Conclusions : This study suggests that Banhahubak-tang(Banxiahoupotang) is significantly effective in patients with poststroke depression classified as yin syndrome.

  • PDF

Validation of a Modified Early Warning Score to Predict ICU Transfer for Patients with Severe Sepsis or Septic Shock on General Wards (일반병동 내 중증 패혈증 또는 패혈성 쇼크 환자의 중환자실 전동 예측에 대한 수정조기경고점수(Modified Early Warning Score)의 타당성)

  • Lee, Ju Ry;Choi, Hye Ran
    • Journal of Korean Academy of Nursing
    • /
    • v.44 no.2
    • /
    • pp.219-227
    • /
    • 2014
  • Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

Diagnostic Role of Serum Free-to-Total Prostate Specific Antigen (PSA) Ratio in Prostate Cancer with Serum Total Concentration of PSA below 4 ng/mL

  • Chang, Chih-Chun;Lee, Yi-Chen;Tsai, Huang-Wen;Yii, Shyi-Chun;Yen, Tzung-Hai;Chu, Fang-Yeh
    • Asian Pacific Journal of Cancer Prevention
    • /
    • v.16 no.13
    • /
    • pp.5261-5264
    • /
    • 2015
  • Purpose: To examine the effectiveness of serum free-to-total prostate specific antigen ratio (%fPSA) for the detection of prostate cancer (PCa) in men with different serum total PSA (tPSA) categories. Materials and Methods: From January 2010 to December 2013, a total of 225 patients with lower urinary tract symptoms (LUTS) underwent tPSA and %fPSA measurements. Histological examination with calculation of Gleason score and whole body bone scans were performed in identified cases of PCa. Results: PCa was diagnosed in 44 (19.6%) patients and the remaining 181 patients had benign prostate disease. PCa was detected in 5 (23.8%), 13 (8.7%) and 26 (47.3%) cases with tPSA level ranges ${\leq}4ng/ml$, 4 to 10 ng/ml and >10 ng/ml, respectively. The average Gleason score was $7.2{\pm}0.2$. Some 6 (13.6%) out of 44 PCa patients had bone metastases. The sensitivity was 80% and specificity was 81.3% at the cut-off %fPSA of 15% in PCa patients with a tPSA level below 4 ng/mL. A lower %fPSA was associated with PCa patients with Gleason score ${\geq}7$ than those with Gleason score ${\leq}6$ ($11.7{\pm}0.98$ vs. $16.5{\pm}2.25%$, P=0.029). No obvious relation of %fPSA to the incidence of bone metastasis was apparent in this study. Conclusions: The clinical application of %fPSA could help to discriminate PCa from benign prostate disease in men with a tPSA concentration below 4 ng/mL.