• Title/Summary/Keyword: cut-off score

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A Longitudinal Validation Study of the Korean Version of PCL-5(Post-traumatic Stress Disorder Checklist for DSM-5) (PCL-5(DSM-5 기준 외상 후 스트레스 장애 체크리스트) 한국판 종단 타당화 연구)

  • Lee, DongHun;Lee, DeokHee;Kim, SungHyun;Jung, DaSong
    • Korean Journal of Culture and Social Issue
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    • v.28 no.2
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    • pp.187-217
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    • 2022
  • The aim of this study is to examine the psychometric properties of the Korean version of the Post-traumatic Stress Disorder Checklist for DSM-5(PCL-5). For this purpose, online surveys were conducted for two times with a one year interval using the data from 1,077 Korean adults at time 1, and 563 Korean adults at time 2. First, from the result of the confirmatory factor analysis, comparing the model fit of the 1, 4, 6, and 7-factor model, the 4, 6, and 7-factor model showed a acceptable fit, and the best fit was seen in the order of the 7, 6, 4-factor model. Second, the internal consistency, omega coefficient, construct validity, average variance extracted, and test-retest reliability results were all satisfactory.. Third, a correlation analysis with the K-PC-PTSD-5 and the sub-factors of BSI-18 was conducted to check the validity of the Korean Version of PCL-5. As a result, a positive correlation was seen with both K-PC-PTSD-5 and BSI-18. Fourth, a hierarchical multiple regression was performed to examine whether the Korean Version of PCL-5 predicts future PTSD, depression, anxiety, and somatization. As a result, the Korean Version of PCL-5 measured at time 1 significantly predicted PTSD, depression, anxiety, and somatization symptoms at time 2. Fifth, by analyzing the ROC curve, the discriminant power of PCL-5 for screening PTSD symptom groups was confirmed, and the best cut-off score was suggested. As a result of the longitudinal validation of Korean version of PCL-5, it was found that this scale is a reliable and valid measure for Korean adults. By looking into the predictive validity of the scale, it was found that the Korean version of PCL-5 can predict not only PTSD symptoms but also PTSD-related symptoms such as depression, anxiety, and somatization. Also, this study differs from previous validation studies measuring PTSD symptoms in that it suggested a cut-off score to help differentiate PTSD symptom groups.

Comparison Among the Four Examination Methods for Dry Eye (OQAS test, TBUT, Schirmer Test, McMonnies test) (4가지 건성안 분석방법(OQAS test, TBUT, Schirmer test, McMonnies test)의 비교)

  • Park, Chang Won;Kim, Hyojin
    • Journal of Korean Ophthalmic Optics Society
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    • v.20 no.4
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    • pp.519-526
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    • 2015
  • Purpose: To evaluate the changes of OSI value according to tear-film instability measured serially by OQAS(Optical Quality Analysis System, Visiometrics, Spain) every seconds. The presented study analyzed the relationship of the OQAS parameter with the results of the tear-film break-up time, Schirmer test, and the McMonies score. Methods: 147 eyes of 82 subjects were randomly selected from university students (age: $21.51{\pm}3.97$, male 45, female 37). Subjects were measured tear-film break-up time, Schirmer test, McMonies score and once every second for 15 seconds after blinking by continuous measurements from OQAS system. Results: The normal eye groups presented OSI values of $2.13{\pm}1.16$ while the dry eye groups had OSI values of $3.76{\pm}1.42$. Therefore, a significant difference between the normal eye group and dry eye group was discovered (p<0.05). In addition, the OSI value of all subjects increased over time. The OSI value, which was measured every second after blinking occurred, significantly increased between 6 seconds and 7 seconds after the start of the measurement (p<0.05). OSI cut off of 30% (sec.) showed a greater correlation; TBUT (r = 0.855, p = 0.000), McMonies test (r = -0.351, p = 0.003), Schirmer (r = 0.316, p = 0.012). Conclusions: Continuous measurement of OQAS showed a high correlation with the value of the existing dry eye tests. Therefore, Analysis of OSI values by utilization of OQAS could be useful in objectively evaluation of tear film in patients.

Reliability and Validity of the Korean Version of the Short Michigan Alcoholism Screening Test for Fathers and Mothers (부모의 음주문제를 선별하는 도구의 신뢰도 및 타당도 분석 -한국어판 Short Michigan Alcoholism Screening Test for Fathers and Mothers의 평가-)

  • Kim, Yong-Seok
    • Korean Journal of Social Welfare
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    • v.56 no.3
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    • pp.37-59
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    • 2004
  • Short Michigan Alcoholism Screening Test for Fathers(F-SMAST) and Mothers(M-SMAST) is to measure the presence of an alcohol use disorder in one's father and/or mother. The purpose of this study is to evaluate the Korean version of the F-SMAST and M-SMAST. A total of 241 college students, who resided in Seoul and two other cities, participated in this study. The internal consistency of the Korean version of the F-SMAST and M-SMAST was assessed using alpha coefficient. The alpha coefficient of both the F-SMAST and the M-SMAST was 0.82. Standard Errors of Measurement(SEM) were also computed. SEMs of the F-SMAST and the M-SMAST were quite low. With a cut-off score of 3, the F-SMAST correctly identified 91 percent of respondents who were presumed to be children of alcoholics and correctly identified 81 percent of respondents who were presumed not to be children of alcoholics. Sensitivity and specificity of the M-SMAST with a cut-off score of 1 are 0.33 and 0.81, respectively. Several variables were examined in relation to the F-SMAST and the M-SMAST to examine convergent and discriminant validity. It was found that the F-SMAST and the M-SMAST were significantly correlated with most of convergent variables(average amount of drinking per day, AUDIT, distress) and had not statistically significant relationships with discriminant variables(demographic variables). This study suggests that the Korean version of the F-SMAST and the M-SMAST be repeatedly assessed across different sample in order to confirm the findings of this study.

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The usefulness of newly developed R2CHA2DS2-VASc score and comparison with CHADS2 and CHA2DS2-VASc scores in atrial fibrillation patients (심방세동 환자에서 새로 개발된 R2CHA2DS2-VASc score 유용성 및 CHADS2, CHA2DS2-VASc scores와의 비교연구)

  • Kwak, Jae-Hoon;Yeo, Se-Hwan;Kim, Yeo-Un;Lee, Jin-Suk;Kim, Byong-Kyu;Chung, Jin-Wook;Bae, Jun-Ho;Nah, Deuk-Young;Lee, Kwan
    • Journal of Yeungnam Medical Science
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    • v.33 no.1
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    • pp.8-12
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    • 2016
  • Background: The decision to administer oral anticoagulation therapy depends on accurate assessment of stroke risk in patients with atrial fibrillation (AF). Various stroke risk stratification schemes have been developed to help inform clinical decision making. The CHADS2 and CHA2DS2-VASc scores have been used in estimating the risk of stroke in patients with AF. Recently R2CHA2DS2-VASc score was developed. The objective of the current study is to validate the usefulness of the R2CHA2DS2-VASc score and to compare the accuracy of the CHADS2, CHA2DS2-VASc, and R2CHA2DS2-VASc scores in predicting a patient's risk of stroke. Methods: Based on medical records, we conducted a retrospective study of patients hospitalized with AF from March 2011 to July 2013. A total of 448 AF patients were included in this study. The receiver operating characteristic (ROC) curve analysis in MedCalc was used for comparison with respective diagnostic values. Results: The patient characteristics showed male predominance (60.9%). Among the 448 AF patients, 131 (29.2%) patients had strokes during the study. A R2CHA2DS2-VASc score of more than 5 is the optimal cut-off value for prediction of stroke. A risk score of three, the area under the ROC curve (AUC) of R2CHA2DS2-VASc score (AUC 0.631; 95% confidence interval, 0.585-0.679) was the highest. A significant difference was observed between AUC for R2CHA2DS2-VASc, CHADS2, and CHA2DS2-VASc scores, but no meaningful difference between CHADS2 and CHA2DS2-VASc scores. Conclusion: We determined the usefulness of the R2CHA2DS2-VASc score, which showed better association with stroke than the CHADS2 and CHA2DS2-VASc scores.

Predictive Value of IHC4 Score for Pathological Response to Neoadjuvant Chemotherapy in Hormone Receptor-Positive Breast Cancer

  • Elsamany, Shereef;Elmorsy, Soha;Alzahrani, Abdullah;Rasmy, Ayman;Abozeed, Waleed N;Mohammed, Amrallah A;Sherisher, Mohamed A;Abbas, Mohammed M;Mashhour, Miral
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7975-7979
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    • 2015
  • Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a lower IHC4 score was associated with an increased probability of pCR (low; 52.9% vs. High; 21.6%, OR=4.1, 95% CI=1.28-13.16, p=0.018) and a lower pathological stage (OR=3.9, 95% CI=1.34-11.33, p=0.012). When the IHC4 score was treated as a continuous variable, a lower score was again associated with an increased probability of pCR (OR=1.010, 95% CI=1.001-1.018, p=0.025) and lower pathological stage (OR=1.009, 95% CI=1.002-1.017, P=0.008). Lower clinical stage was associated with a better pCR rate that was of borderline significance (P=0.056). When clinical stage and IHC4 score were incorporated together in a logistic model, the likelihood ratio test gave a P-value of 0.004 after removal of the IHC4 score and 0.011 after removal of the stage, indicating a more significant predictive value of the IHC4 score for pCR. Conclusions: This study suggests that the IHC4 score can predict pathological response to neoadjuvant chemotherapy in HR-positive BC patients. This finding now needs to be validated in a larger cohort of patients.

Respiratory Severity Score as a Predictive Factor for the Mortality of Congenital Diaphragmatic Hernia

  • Ahn, Ja-Hye;Jung, Young Hwa;Shin, Seung Han;Kim, Hyun-Young;Kim, Ee-Kyung;Kim, Han-Suk
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.102-108
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    • 2018
  • Purpose: Congenital diaphragmatic hernia (CDH) is rare but potentially fatal. The overall outcome is highly variable. This study aimed to identify a simple and dynamic parameter that helps predict the mortality of CDH patients in real time, without invasive tests. Methods: We conducted a retrospective chart review of 59 CDH cases. Maternal and fetal information included the gestational age at diagnosis, site of defect, presence of liver herniation, and lung-to-head ratio (LHR) at 20 to 29 weeks of gestational age. Information regarding postnatal treatment, including the number of days until surgery, the need for inhaled nitric oxide (iNO), the need for extracorporeal membrane oxygenation (ECMO), and survival, was collected. The highest respiratory severity score (RSS) within 24 hours after birth was also calculated. Results: Statistical analysis showed that a younger gestational age at the initial diagnosis (P<0.001), a lower LHR (P=0.001), and the presence of liver herniation (P=0.003) were prenatal risk factors for CDH mortality. The RSS and use of iNO and ECMO were significant factors affecting survival. In the multivariate analysis, the only remaining significant risk factor was the highest preoperative RSS within 24 hours after birth (P=0.002). The area under the receiver operating characteristic curve was 0.9375, with a sensitivity of 91.67% and specificity of 83.87% at the RSS cut-off value of 5.2. The positive and negative predictive values were 82.14% and 92.86%, respectively. Conclusion: Using the RSS as a prognostic predictor with simple calculations will help clinicians plan CDH management.

Aortic Valve Replacement for Aortic Stenosis in Elderly Patients (75 Years or Older)

  • Sohn, Bongyeon;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Kim, Ki-Bong
    • Journal of Chest Surgery
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    • v.51 no.5
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    • pp.322-327
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    • 2018
  • Background: This study evaluated the early and long-term outcomes of surgical aortic valve replacement (AVR) in elderly patients in the era of transcatheter aortic valve implantation. Methods: Between 2001 and 2018, 94 patients aged ${\geq}75years$ underwent isolated AVR with stented bioprosthetic valves for aortic valve stenosis (AS). The main etiologies of AS were degenerative (n=63) and bicuspid (n=21). The median follow-up duration was 40.7 months (range, 0.6-174 months). Results: Operative mortality occurred in 2 patients (2.1%) and paravalvular leak occurred in 1 patient. No patients required permanent pacemaker insertion after surgery. Late death occurred in 11 patients. The overall survival rates at 5 and 10 years were 87.2% and 65.1%, respectively. The rates of freedom from valve-related events at 5 and 10 years were 94.5% and 88.6%, respectively. The Society of Thoracic Surgeons (STS) score (p=0.013) and chronic kidney disease (p=0.030) were significant factors affecting long-term survival. The minimal p-value approach demonstrated that an STS score of 3.5% was the most suitable cut-off value for predicting long-term survival. Conclusion: Surgical AVR for elderly AS patients may be feasible in terms of early mortality and postoperative complications, particularly paravalvular leak and permanent pacemaker insertion. The STS score and chronic kidney disease were associated with long-term outcomes after AVR in the elderly.

Optimal Threshold from ROC and CAP Curves (ROC와 CAP 곡선에서의 최적 분류점)

  • Hong, Chong-Sun;Choi, Jin-Soo
    • The Korean Journal of Applied Statistics
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    • v.22 no.5
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    • pp.911-921
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    • 2009
  • Receiver Operating Characteristic(ROC) and Cumulative Accuracy Profile(CAP) curves are two methods used to assess the discriminatory power of different credit-rating approaches. The points of optimal classification accuracy on an ROC curve and of maximal profit on a CAP curve can be found by using iso-performance tangent lines, which are based on the standard notion of accuracy. In this paper, we offer an alternative accuracy measure called the true rate. Using this rate, one can obtain alternative optimal threshold points on both ROC and CAP curves. For most real populations of borrowers, the number of the defaults is much less than that of the non-defaults, and in such cases the true rate may be more efficient than the accuracy rate in terms of cost functions. Moreover, it is shown that both alternative scores of optimal classification accuracy and maximal profit are the identical, and this single score coincides with the score corresponding to Kolmogorov-Smirnov statistic used to test the homogeneous distribution functions of the defaults and non-defaults.

Breast Cancer Awareness at the Community Level among Women in Delhi, India

  • Dey, Subhojit;Mishra, Arti;Govil, Jyotsna;Dhillon, Preet K
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5243-5251
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    • 2015
  • Background: To assess women's awareness from diverse sections of society in Delhi regarding various aspects of breast cancer (BC) - perceptions, signs and symptoms, risk factors, prevention, screening and treatment. Materials and Methods: Community-level survey was undertaken in association with the Indian Cancer Society (ICS), Delhi during May 2013-March 2014. Women attending BC awareness workshops by ICS were given self-administered questionnaires before the workshop in the local language to assess BC literacy. Information provided by 2017 women was converted into awareness scores (aware=1) for analysis using SPSS. Awareness scores were dichotomized with median score=19 as cut off, create more aware and less aware categories. Bivariate and multivariate analysis provided P-values, odds ratios (ORs) and 95% confidence intervals (CIs). Results: Broadly, 53.4% women were aware about various aspects of BC. Notably, 49.1% women believed that BC was incurable and 73.9% women believed pain to be an initial BC symptom. Only 34.9% women performed breast self-examination (BSE) and 6.9% women had undergone clinical breast-examination/mammography. 40.5% women had higher awareness (awareness score > median score of 19), which was associated with education [graduates (OR=2.31; 95%CI=1.78, 3.16), post-graduates (OR=7.06; 95%CI=4.14, 12.05) compared to ${\leq}$ high school] and socio-economic status (SES) [low-middle (OR=4.20; 95%CI=2.72, 6.49), middle (OR=6.00; 95%CI=3.82, 9.42) and upper (OR=6.97; 95%CI=4.10, 11.84) compared to low SES]. Conclusions: BC awareness of women in Delhi was suboptimal and was associated with low SES and education. Awareness must be drastically increased via community outreach and use of media as a first step in the fight against BC.

Influence of Clinical and Demographical Variables on Depression, Instrumental Activities of Daily Living, and Cognitive Function in Patients with Parkinson's Disease (파킨슨병 환자의 인구학적.임상적 특성에 따른 우울, 일상생활 수행능력 및 인지기능)

  • Sohng, Kyeong-Yae;Choi, Dong-Won;Park, Hea-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.249-256
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    • 2006
  • Purpose: To investigate the influence of clinical and demographical variables on depression, instrumental activities of daily living (IADL), and cognitive function in patients with Parkinson's disease. Method: Using a structured questionnaire data were collected from 100 participants registered in the neurology department of C university hospital. Duration and stage of disease, fall history, vision impairment, duration and quality of sleep, orthostatic hypotension, ambulation impairment, and use of walking aid were included in clinical variables. Depression, IADL, and cognitive function were assessed using Kee's GDSSF-K, Cho's scale, and K-MMSE. Collected data were analyzed using the SAS program. Results: The depression score for the participants was 7.78, higher than cut-off score(5). Participants who were male, living with spouse, above high school education, high economic status, with no vision impairment, and no ambulation impairment revealed high cognitive scores. Average IADL score were significantly higher for participants who were male, who had high economic status, low stage of disease, and no ambulation impairment. Depression IADL & cognitive function scores were significantly different according to ambulation impairment. Scores for ADL and cognitive function were positively correlated. Conclusion: It is recommended that make programs for patients with Parkinson's disease, clinical and demographic variables should be considered according to their individual needs.

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