• Sleep Medicine and Psychophysiology
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• v.8 no.1
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• pp.37-44
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• 2001

Background: Sleep disorders are prevalent in the general population and in medical practice. Three diagnostic classifications for sleep disorders have been developed recently: The International Classification of Sleep Disorders (ICSD), The Diagnostic and Statistical Manual, 4th edition (DSM-IV) and The International Classification of Diseases, 10th edition (ICD-10). Few data have yet been published regarding how the diagnostic systems are related to each other. To address these issues, we evaluated the frequency of sleep disorder diagnoses by DSM-IV and ICSD and compared the DSM-IV with the ICSD diagnoses. Method: Two interviewers assessed 284 inpatients who had been referred for sleep problems in general units of Anam Hospital, holding an unstructured clinical interview with each patient and assigning clinical diagnoses using ICSD and DSM-IV classifications. Results: The most frequent DSM-IV primary diagnoses were "insomnia related to another mental disorder (61.1% of cases)" and "delirium due to general medical condition (26.8%)". "Sleep disorder associated with neurologic disorder (38.4% of cases)" was the most frequent ICSD primary diagnosis, followed by "sleep disorder associated with mental disorder (33.1%)". In comparing the DSM-IV diagnoses with the ICSD diagnoses, sleep disorder unrelated with general medical condition or another mental disorder in DSM-IV categories corresponded with these in ICSD categories. But DSM-IV "primary insomnia" fell into two major categories of ICSD, "psychophysiologic insomni" and "inadequate sleep hygiene". Of 269 subjects, 62 diagnosed with DSM-IV sleep disorder related to general medical condition or another mental disorder disagreed with ICSD diagnoses, which were sleep disorders not associated with general medical condition or mental disorder, i. e., "inadequate sleep hygiene", "environmental sleep disorder", "adjustment sleep disorder" and "insufficient sleep disorder". Conclusion: In this study, we found not only a similar pattern between DSM-IV and ICSD diagnoses but also disagreements, which should not be overlooked by clinicians and resulted from various degrees of understanding of the pathophysiology of the sleep disorders among clinicians. Non-diagnosis or mis-diagnosis leas to inappropriate treatment, therefore the clinicians' understanding of the classification and pathophysiology of sleep disorders is important.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.5
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• pp.47-60
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• 1998

This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.

• Journal of the Korean Operations Research and Management Science Society
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• v.16 no.1
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• pp.35-44
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• 1991

An expert system that diagnoses the malfunction of local area network is developed. The system detects specific devices in the network as the source of thd deta disconnection. These soures are sct to goals in the knowledge base and rules are constructed by uncluding all possible occurrences un thd connection of therminals and host computers. An approach via OR graph is employed for thd systematic rule generation. The system is implemented in a shell and illustrative inference processes are presented.

• Journal of Korean Academy of Nursing
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• v.35 no.6
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• pp.979-990
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• 2005

Purpose: The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions. Method: The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004. Results: Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain $(28.4\%)$, Impaired physical mobility $(15.6\%)$, Impaired walking $(8.7\%)$, Chronic pain $(5.5\%)$ and Risk for disuse syndrome $(5.0\%)$. The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(95.2\%)$, Comfort level $(35.5\%)$ and Pain level $(17.7\%)$. The nursing interventions of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management $(71.0\%)$, Splinting $(24.2\%)$ and Analgesic administration $(17.7\%)$. In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention. Conclusion: It is expected that this program will help nurses perform their nursing processes more efficiently.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2001.01a
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• pp.378-382
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• 2001

The purpose of this study was to develop an expert system supporting the diagnosis of diffuse interstitial lung disease by high resolution computed tomography. CLIPS(C language integrated production system) with rule-based reasoning was used to develop the system. Development of expert system had three stages knowledge acquisition, knowledge representation, and reasoning. Knowledge was obtained and integrated, from tables and figure legends of a representative textbook in the domain of this expert system, High-Resolution CT of the Lung, by Webb WR, Mueller NL, and Naidich DP. The acquired knowledge was analyzed to form a knowledge base. Overlapping knowledge was eliminated, similar pieces of knowledge were combined and professional terms were defined. The most important knowledge of findings was then selected for each disease. After groupings of combined findings were made, disease groups were analyzed sequentially to determine final diagnoses. The system was based upon the input of 69 diseases, 185 findings, 73 conditions, 387 status, and 62 rules. The system was set up to determine the diagnoses of diseases from the combination of findings using forward reasoning. In an empirical trial, the system was applied to support the diagnosis of 40 cases of diffuse interstitial lung diseases. The performance of two doctors with support of the system was compared to that of another two doctors without support of the system. The two doctors with the support of the system made more accurate diagnoses than the doctors without the support of the system. The system is believed to be useful for the diagnosis of rare diseases and for cases with many possible differential diagnoses. In conclusion, an expert system supporting the high resolution computed tomographic diagnosis of diffuse interstitial lung disease was developed and the system is thought to be useful for medical practice.

• Quality Improvement in Health Care
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• v.15 no.1
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• pp.123-133
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• 2009

Background : The principal diagnosis has been used in many different fields such as hospital statistics, medical research, insurance claim, national health statistics and so on. Some principal diagnoses have a relatively low level of reliability in the medium-sized hospitals. The purpose of this study is to identify the reliability level of principal diagnoses and to suggest ways to improve reliability of the principal diagnosis. Method : Data were collected from a medium-sized hospital located in Pusan. The discharge summaries on 323 patients who were discharged in January, 2008 and the outpatient summaries on 251 patients who visited the hospital on March 28, 2008 were collected, and descriptive analysis was performed using SPSS version 12.0K. Result : The findings are the followings: (1) the diagnostic consistency rate between medical records and doctors' was 92.0%; (2) the diagnostic consistency rate between medical records and insurance claims was 86.1%; (3) the diagnostic consistency rate between doctors' diagnoses and insurance claims was 80.2%. The evidence seems to indicate that some principal diagnoses have reliability problems in the medium-sized hospitals. Conclusion : The results of this study suggest the followings: (1) employees should be trained and supervision of hospital activities are needed; (2) network systems should be constructed for each department; (3) professions need to be fostered (4) doctors' awareness of medical records should be changed.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.4
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• pp.1583-1588
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• 2012

Fine needle aspiration (FNA) cytology is well accepted as a safe, reliable, minimal invasive and cost-effective method for diagnosis of salivary gland lesions. This study evaluated the accuracy and diagnostic performance of FNA cytology in Thailand. A consecutive series of 290 samples from 246 patients during January 2001-December 2009 were evaluated from the archive of the Anatomical Pathology Department of our institution and 133 specimens were verified by histopathologic diagnoses, obtained with material from surgical excision or biopsy. Cytologic diagnoses classified as unsatisfactory, benign, suspicious for malignancy and malignant were compared with the histopathological findings. Among the 133 satisfactory specimens, the anatomic sites were 70 (52.6%) parotid glands and 63 (47.4 %) submandibular glands. FNA cytological diagnoses showed benign lesions in 119 cases (89.5 %), suspicious for malignancy in 3 cases (2.2 %) and malignant in 11 cases (8.3%). From the subsequent histopathologic diagnoses, 3/133 cases of benign cytology turned out to be malignant lesions, the false negative rate being 2.2 % and 1/133 case of malignant cytology turned out to be a benign lesion, giving a false positive rate was 0.8%. The overall accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 97.0% (95% CI, 70.6%-99.4%), 81.3% (95% CI, 54.4%-96.0%), 99.1% (95% CI, 95.4%-100%), 92.9% (95% CI, 66.1%-99.8), 97.5% (95% CI, 92.8%-99.5%), respectively. This study indicated that FNA cytology of salivary gland is a reliable and highly accurate diagnostic method for diagnosis of salivary gland lesions. It not only provides preoperative diagnosis for therapeutic management but also can prevent unnecessary surgery.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3489-3494
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• 2016

Background: A major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the coverage. Objective: We determined the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus samples collected by physicians (Physician sampling). Materials and Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician sampling using a Cervex brush. The women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from these two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study, ranging from 22 to 65 years age. There was a significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). Using the cytological smears taken by physicians as the gold standard, the sensitivity of self-sampling was 71.9% (95% CI:70.9-72.8), the specificity was 86.6% (95% CI:85.7-87.5), the positive predictive value was 74.2% (95% CI:73.3-75.1) and the negative predictive value was 85.1% (95% CI: 84.2-86.0). Self-sampling smears (22.9%) allowed detection of micro-organisms better than physicians samples (18.5%). Conclusions: This study shows that samples taken by women themselves (self-sampling) and physicians have good diagnostic agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

• The Journal of Society for e-Business Studies
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• v.22 no.4
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• pp.53-69
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• 2017

This study focuses on analyzing no-shows associated with patients' clinical characteristics described by diagnoses in their medical data. A dataset of 7,055 patient-records from a Veterans hospital in the United States was used to test if there is difference on no-shows along with each patient's diagnosed diseases and the number of diagnoses. Patients with mental diseases such as drug dependence abuse and major depression, and chronic diseases such as hypertension are more likely to no-show. In comparisons with the number of diagnoses, the no-show decreases as the number of diagnoses increases up to four and doesn't change significantly afterwards. We provide managerial insights on clinical operations problems from statistical analysis. We believe that our results can be used to develop appropriate solutions on no-shows in clinics.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.7 no.6
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• pp.1004-1011
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• 2006

In this study, we have performed a systematic case study on troubles and diagnoses of passenger car's engine based on OBD. We have acquired 1,242 data in order to analysis accurate troubles' causes and apposite diagnoses. 128 data of them are got using OBD apparatus, and the rest of them are collected on related website. As results, distribution on trouble cases shows bad idling(32%), poor acceleration(21%), stop in running(19%), faulty start(11%), inferior fuel economy(9%), and insufficient power(8%) in order of magnitude. And in the systematic cases, it is not difficult to detect troubles in a single part. But we know that special apparatus such as multichannel scanner is needed in complicated troubles. Furthermore we think that the survey is continued in various ways for more systematic case study on troubles and diagnoses.