• Title/Summary/Keyword: diagnostic assessment

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The Impact of Diagnostic Imaging Fee Changes to Medical Provider Behavior: Focused on the Number of Exams of Computed Tomograph (영상진단 수가 변화가 의료공급자 진료행태에 미치는 영향: 전산화단층영상진단 검사건수를 중심으로)

  • Cho, Su-Jin;Kim, Donghwan;Yun, Eun-Ji
    • Health Policy and Management
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    • v.28 no.2
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    • pp.138-144
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    • 2018
  • Background: Diagnostic imaging fee had been reduced in May 2011, but it was recovered after 6 months because of strong opposition of medical providers. This study aimed to analyze the behavior of medical providers according to fee changes. Methods: The National Health Insurance claims data between November 2010 and December 2012 were used. The number of exams per computed tomography was analyzed to verify that the fee changes increased or decreased the number of exams. Multivariate regression model were applied. Results: The monthly number of exams increased by 92.5% after fee reduction, so the diagnostic imaging spending were remained before it. But medical provider decreased the number of exams after fee return. After adjusting characteristic of hospitals, fee reduction increased the monthly number of exams by 48.0% in a regression model. Regardless type of hospitals and severity of disease, the monthly number of exams increased during period of fee reduction. The number of exams in large-scaled hospitals (tertiary and general hospital) were increased more than those of small-scaled hospitals. Conclusion: Fee-reduction increased unnecessary diagnostic exams under the fee-for-service system. It is needed to define appropriate exam and change reimbursement system on the basis of guideline.

Development and validation of heuristics for usability improvements on web-based diagnostic assessment management system for primary-middle schoolers (초·중학생 대상 웹기반 진단평가관리시스템 사용성 개선을 위한 휴리스틱스 개발 및 검증)

  • Cha, Hyunjin;Hwang, YunJa
    • Journal of The Korean Association of Information Education
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    • v.21 no.6
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    • pp.675-690
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    • 2017
  • Preparing the 4th industrial revolution age, a diagnostic assessment management system which can collect nationwide data has been implemented and utilized for the development of the evidence-based educational policy. This study aims to develop heuristics to help to improve usability of such systems, which are utilized by primary and middle school community including teachers and students in the nationwide. To achieve the objective, previous studies related to the development of heuristics in the educational contexts as well as basic heuristics from Nielsen were reviewed, and usability problems of the web-based diagnostic-supplement system being currently utilized, as a sample system, were analyzed. Then, the first version of heuristics was developed. The developed heuristics were validated and revised through 2 rounds of the delphi methods with 15 experts. This study has an implication with preparing foundations on improving usability of such diagnostic assessment management system utilized by school community at the nationwide in educational contexts.

Clinical Application of $^{18}F-FDG$ PET in Neuroblastoma (신경모세포종에서 $^{18}F-FDG$ PET의 임상 이용)

  • Paeng, Jin-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.134-136
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    • 2008
  • Neuroblastoma is the most common extracranial solid tumor in children. In diagnostic assessment of neuroblastoma, $^{18}F-FDG$ PET has been reported to have high diagnostic performance, especially, very high sensitivity in staging, restaging, and assessment of therapeutic efficacy. In comparison with conventional diagnostic imaging modalities including a, bone scan, and MIBG scan, $^{18}F-FDG$ PET showed better diagnostic performance. According to clinical research data hitherto, $^{18}F-FDG$ PET is expected to be an effective diagnostic tool in the management of neuroblastoma.

Quantitative gated myocardial perfusion SPECT (정량적 게이트 심근관류 SPECT)

  • Ahn, Byeong-Cheol
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.4
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    • pp.207-218
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    • 2003
  • Myocardial perfusion imaging has been increasingly used to provide prognostic data and guidance on the choice of appropriate management of patients with known or suspected coronary artery disease. The electrocardiogram gated myocardial SPECT program is corning into wide use with an advent of $^{99m}Tc-labeled$ tracers and an improvement of SPECT machines. The gated technique permits measurement of important cardiac prognostic indicators without any further discomforts or radiation burden in patients underwent standard myocardial perfusion SPECT. In addition, gated study significantly improves diagnostic yield by reducing the number of borderline interpretations and could find myocardial stunning and viable myocardium. Gated single photon emission computed tomography (SPECT) imaging allows the automated calculation of end-diastolic volume, end-systolic volume, ejection fraction, myocardial mass and the assessment of regional wall motion and thickening, and it have dramatically improved assessment of coronary artery disease in routine nuclear practice. This allows the simultaneous assessment of both perfusion and function within the same acquisition, and serves as a cost-effective technique for providing more diagnostic data with fewer diagnostic tests. Because the diagnostic and prognostic power derived from knowledge of left ventricular function can be added to that provided by assessing myocardial perfusion, gated SPECT imaging has rapidly gained widespread acceptance and is now used on a routine clinical basis in a growing number of laboratories, including South Korea. The gated SPECT technique for measurement of left ventricular parameters has been validated against a variety of well established techniques. In this work, overview of gated myocardial perfusion SPECT focus on functional parameters is presented.

An Investigation of a Country-Level Diagnostic Assessment Model for the TIMSS (국제 수학·과학 성취도 추이 연구 분석을 위한 국가 수준 진단평가 모형 탐색)

  • Park, Chanho
    • Korean Journal of Comparative Education
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    • v.28 no.5
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    • pp.1-19
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    • 2018
  • The purpose of educational assessments such as the Trends in International Mathematics and Science Study (TIMSS) is to compare groups such as countries. When the unit of measurement is above the student level, group-level diagnostic assessment based on multilevel item response theory (ML-IRT) can be considered just as cognitive diagnosis models are developed from item response theory. This study suggests an ML-IRT-based group-level diagnostic assessment model by modifying an item feature model by Park and bolt (2008). The model is illustrated on the recently released TIMSS 2015 Grade 8 mathematics assessment. The results provide skill profiles for the studied countries and the nine cognitive attributes; that is, the attribute effects can be compared across the countries and also across the attributes. By controlling unexplained variance, the suggested model may provide more reliable and more informative group-level comparisons. The results are interpreted using an example. Limitations and directions for future research are also discussed.

Health Insurance Benefit Criteria and Quality Assurance Policies of Diagnostic Ultrasound Services in Other Countries (주요국의 초음파검사 시행현황과 질 확보방안)

  • Chung, Seol Hee;Lee, Hye Jin;Kim, Han Sang;Oh, Ju-Yeon
    • Health Policy and Management
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    • v.24 no.2
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    • pp.109-119
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    • 2014
  • In accordance with the government's plan to expand the national health insurance (NHI) coverage for severe diseases such as cancer, heart disease, cerebrovascular disease, and rare and incurable disease, the diagnostic ultrasound services have been covered by NHI from October 1, 2013. The quality is very important factor in providing diagnostic services because they influence on the diagnosis, treatment, and outcome of diseases. In particular, equipments and health care providers plays an important role in providing qualitative services. The purpose of this paper is to examine the major feature of ultrasound services covered by health security system and to review quality assurance policies in other countries such as Australia, Japan, the USA, and Canada. In addition, we assessed the implication of those policies. We especially put emphasis on the types and qualifications of healthcare professionals and measures to manage equipments. All countries have reviewed on policies to promote the quality such as educational requirements of professionals or restrictions on the duration of equipment usage. Various measures should be implemented to assure the qualitative ultrasound service.

Development of Global Insulation Assessment System for Medium Voltage power Cable System (배전용 전력케이블 시스템 포괄진단 설비 개발)

  • 이동영
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.17 no.2
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    • pp.66-72
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    • 2003
  • The global assessment system for medium voltage power cable systems has been developed The minimum purpose of diagnostic activity is the economic discrimination and maintenance of bad cables which is likely to cause cable system failure. I have adapted the Aging Time Constant Method to construct the power cable assessment system for the diagnostic purpose. From the field application test and breakdown test results, it could be concluded that the diagnostic system was successful art convenient for the discrimination and maintenance of the bad cables, which is likely to fail sooner or later, economically.

Educational Needs Based on Analysis of Importance, Frequency and Difficulty of ICU Nursing Practice for ICU Nurses (중환자실 간호실무의 중요도, 수행 빈도 및 난이도 분석을 통한 중환자실 간호사의 교육요구도)

  • Kim, Keum-Soon;Kim, Jin-A;Park, Young-Rye
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.373-382
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    • 2011
  • Purpose: The purpose of this study was to assess the educational needs of ICU nurses based on an analysis of importance, frequency, and difficulty for ICU nursing practice. Method: A cross-sectional survey was conducted using a questionnaire with 80 questions in 14 ICU nursing categories. Data were collected from August to October 2009. A total of 295 ICU nurses from five hospitals who had minimum of one year clinical experience participated. Data were analyzed with using descriptive statistics. Results: For importance, emergency care had the highest score, followed by physical assessment, communication, cardiovascular care, and ICU basic nursing. Regarding the frequency, physical assessment had the highest score, followed by communication, medication, ICU basic nursing, and respiratory care. Cardiovascular care was the most difficult task, followed by neurological care, emergency care, other ICU related nursing care, diagnostic test, and communication. Conclusion: The findings indicate a high educational need in the areas of communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care. Thus the development of educational programs on communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care are needed for ICU nurses.

Meta-analysis of the Diagnostic Test Accuracy of Pediatric Inpatient Fall Risk Assessment Scales

  • Kim, Eun Joo;Lim, Ji Young;Kim, Geun Myun;Lee, Mi Kyung
    • Child Health Nursing Research
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    • v.25 no.1
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    • pp.56-64
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    • 2019
  • Purpose: This study was conducted to obtain data for the development of an effective fall risk assessment tool for pediatric inpatients through a systematic review and meta-analysis of the diagnostic test accuracy of existing scales. Methods: A literature search using Medline, Science Direct, CINAHL, EMBASE, and the Cochrane Library was performed between March 1 and 31, 2018. Of 890 identified papers, 10 were selected for review. Nine were used in the meta-analysis. Stata version 14.0 was used to create forest plots of sensitivity and specificity. A summary receiver operating characteristic curve was used to compare all diagnostic test accuracies. Results: Four studies used the Humpty Dumpty Falls Scale. The most common items included the patient's diagnoses, use of sedative medications, and mobility. The pooled sensitivity and specificity of the nine studies were .79 and .36, respectively. Conclusion: Considering the low specificity of the pediatric fall risk assessment scales currently available, there is a need to subdivide scoring categories and to minimize items that are evaluated using nurses' subjective judgment alone. Fall risk assessment scales should be incorporated into the electronic medical record system and an automated scoring system should be developed.

Diagnostic accuracy of imaging examinations for peri-implant bone defects around titanium and zirconium dioxide implants: A systematic review and meta-analysis

  • Chagas, Mariana Murai;Kobayashi-Velasco, Solange;Gimenez, Thais;Cavalcanti, Marcelo Gusmao Paraiso
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.363-372
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    • 2021
  • Purpose: This systematic review and meta-analysis assessed the diagnostic accuracy of imaging examinations for the detection of peri-implant bone defects and compared the diagnostic accuracy between titanium (Ti) and zirconium dioxide (ZrO2) implants. Materials and Methods: Six online databases were searched, and studies were selected based on eligibility criteria. The studies included in the systematic review underwent bias and applicability assessment using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool and a random-effect meta-analysis. Summary receiver operating characteristic (sROC) curves were constructed to compare the effect of methodological differences in relation to the variables of each group. Results: The search strategy yielded 719 articles. Titles and abstracts were read and 61 studies were selected for full-text reading. Among them, 24 studies were included in this systematic review. Most included studies had a low risk of bias (QUADAS-2). Cone-beam computed tomography (CBCT) presented sufficient data for quantitative analysis in ZrO2 and Ti implants. The meta-analysis revealed high levels of inconsistency in the latter group. Regarding sROC curves, the area under the curve (AUC) was larger for the overall Ti group (AUC=0.79) than for the overall ZrO2 group (AUC=0.69), but without a statistically significant difference between them. In Ti implants, the AUCs for dehiscence defects(0.73) and fenestration defects(0.87) showed a statistically significant difference. Conclusion: The diagnostic accuracy of CBCT imaging in the assessment of peri-implant bone defects was similar between Ti and ZrO2 implants, and fenestration was more accurately diagnosed than dehiscence in Ti implants.