• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.31-41
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• 2023

Purpose : This study was conducted to identify the common characteristics of older persons with sarcopenia and to explore the relationship between gait, balance, and stress using an integrated assessment tool. Methods : In this study, 95 people aged 65 years or older were screened using the sarcopenia diagnostic evaluation algorithm presented by the Asian Working Group for Sarcopenia in 2019. Skeletal muscle index, grip strength, and short physical performance battery were used as sarcopenia evaluation measurements. Based on the results of this evaluation, participants were grouped into the 'non-sarcopenia group' (41 participants) or the 'sarcopenia group' (54 participants). Participants underwent further assessment using an integrated evaluation tool capable of measuring gait, balance, and stress. Gait ability was evaluated using the timed up and go test, and balance ability was evaluated using the berg balance scale. And the stress of the last month was measured by modifying the stress index developed by a Korean researcher. Collected data were statistically analyzed using the independent t-test and Mann Whitney-U test. Results : The sarcopenia group and the non-sarcopenia group showed significant differences in all elements of the sarcopenia diagnostic evaluation. There were significant differences in all three integrated evaluation tools. For the evaluation of walking ability, the time measured in the timed up and go test was longer in the sarcopenia group, the berg balance scale score for the evaluation of balance ability was lower in the sarcopenia group, and the stress index was higher in the sarcopenia group. Conclusion : Through sarcopenia analysis using an integrated evaluation tool, it was confirmed that sarcopenia is closely related to decreased walking ability, poor balance, and increased stress. We recommend using this tool to reduce the risk of sarcopenia progression and stress exposure through the planning and implementation of an exercise program for sarcopenia prevention.

• 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.

• Korean Journal of Adult Nursing
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• v.27 no.5
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• pp.559-571
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• 2015

Purpose: This study is to determine the predictive validity of the St. Thomas Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY) for inpatients' fall risk. Methods: A literature search was performed to identify all studies published between 1946 and 2014 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases, using the following key words; 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Fourteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The predictive validity of STRATIFY was as follows; pooled sensitivity .75 (95% CI: 0.72~0.78), pooled specificity .69 (95% CI: 0.69~0.70) respectively. In addition, the pooled sensitivity in the study that targets only the over 65 years of age was .89 (95% CI: 0.85~0.93). Conclusion: The STRATIFY's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, STRATIFY is an appropriate tool to apply to hospitalized patients of the elderly at a potential risk of accidental fall in a hospital.

• Tuberculosis and Respiratory Diseases
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• v.87 no.1
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• pp.91-99
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• 2024

Background: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted. Methods: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE. Results: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test. Conclusion: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.48.1-48.11
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• 2020

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO₂) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO₂ values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I² statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO₂ values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.129-136
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• 2017

PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.63-73
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• 2021

Purpose : Selective functional movement assessment(SFMA) is a movement-based assessment tool designed for clinicians to diagnose and treat pain and functional physical problems. This concept is used for assistance in occupations related to movement, including clinical medical personnel, such as physical therapists, physical education instructors, and athlete coaches. Although this concept is widely used by clinicians, research and scientific proofs are relatively insufficient. This study aimed to review the literature on the understanding, reliability and effectiveness of SFMA, and to consider its role in the future of rehabilitation. Methods : In this review, a total of nine articles were selected according to the eligibility criteria of three major thesis topics. The main topics covered in the literature are reliability and effectiveness of clinical use of SFMA. To gather research articles, we searched official term 'Selective Functional Movement Assessment'. Among the searched 60 studies, nine were mentioned in this study that contained overlapping information and matched our desired topic. We reviewed four reliability analyses, four case reports, and one experimental study. Results : Reliability has an intermediate degree between high raters and within raters. The validity of the SFMA system is influenced by a combination of experience and logic; hence, further improvement is needed. Therefore, if the intervention was effective based on the diagnosis result, then biomechanical evidence is necessary to further support the claim. Conclusion : In future research, to use SFMA as a diagnostic tool with high accuracy, it is necessary to improve the reliability of the main problem through breakout, support for guidelines and validity and efficiency.

• Journal of Korean Academy of Nursing
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• v.27 no.1
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• pp.49-60
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• 1997

The purpose of this study was to determine the incidence of malnutrition among patients on admission to hospital, to monitor changes in their nutritional status during hospitalization, and to determine the factors which might affect changes in nutritional status. The subjects for the study were patients who were admitted to general medicine for more than one week. Patients suffering from cardiovascular. renal disease, or dehydration were excluded. Nutritional assessment of the patients was performed on admission and nutritional status was reassessed one week and two weeks after admission. The nutritional assessment tool consisted of subjective history taking and anthropometric measurements. Biochemical measurements were performed only on admission. For anthropometric assessment : patients' body weight, subcutaneous skinfolds thickness, % of body fat, body mass index, and lean body mass were measured using caliper or Bio impedance Analyzer. Factors which might influence current nutritional status, like dietary intake, anorexia, nausea, vomiting, diarrhea, sleep disturbance, and number of days of NPO for diagnostic examinations were analyzed. The results are as follows : 1. Of the 59 patients who were studied, 61% were male and 39% female. The nutritional status of all of the 59 subjects was reassessed one week after admission, but it was only done for 22 subjects at two weeks. 2. The anthropometric measurements. including weight body mass index, lean body mass, body fat. and skin fold thickness. were all significantly decreased at one week after admission compared to the values at admission. On the other hand, two weeks after admission, only body weight and abdominal skinfolds thickness were decreased. 3. The subjects reported anorexia for an average of two days, sleep disturbance for two days, and no food intake due to diagnostic test for one day. In the second week of hospitalization, almost none of the patients complained of gastrointestinal symptoms or sleep disturbance except anorexia. Food consumption which was measured based on rice intake was 60% of the food served during the first week of hospitalization, and 66% during the second week of hospitalization. 4. There was no correlation between the subjective nutritional assessment and anthropometric assessment. 5. There was no statistical significance in anthropometric measurements among the patients with various diseases whereas sleep disturbance and no food intake due to various diagnostic test was prominent in patients with gastrointestinal diseases.

• Child Health Nursing Research
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• v.22 no.4
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• pp.265-278
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• 2016

Purpose: The aim of this study was to conduct a systematic review and to describe the characteristics of child abuse screening instruments. Methods: Articles regarding the development of a child abuse screening instrument were investigated using the systematic review method. A literature search using the keywords "child and abuse or maltreatment and instrument or screening tool" in English, and "child," "abuse," and "instrument" in Korean, was conducted of material published in PubMed, PsycINFO, CINAHL, SCOPUS, ERIC, and RISS. Database and bibliographic searches, and quality appraisal using the Quality Assessment of Diagnostic Accuracy Studies tool that included systemic reviews, yielded 17 records. Results: Key elementary child abuse screening instruments were developed for physical, psychiatric, affective and sexual and child neglect assessment. The instruments' target populations were children at home and in institutions. The reviewed instruments had the advantage of diagnosing past, concurrent, and indirectly, potential child abuse. Conclusion: The results of this study demonstrate that child abuse screening instruments are available for screening and for assessment of abused children in various circumstances. This review of child abuse screening instruments offers evidence for the acceptable use of optimal psychometric tools for child abuse assessment and provides guidelines for child health nursing practice.