• Title/Summary/Keyword: diagnostic coverage

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A Review of the Medical Nutrition Therapy (MNT) of the U.S. Medicare System (미국 임상영양치료(MNT)의 법제화 과정 및 수가 체계)

  • 박은철;김현아;이해영;이영은;양일선
    • Korean Journal of Community Nutrition
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    • v.7 no.6
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    • pp.852-862
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    • 2002
  • The purposes of this study were 1) to review the Medical Nutrition Therapy (MNT) Act of the United States, 2) to introduce the efforts of the American Dietetic Association (ADA) to expand the Medicare coverage for MNT and 3) to provide information about the reimbursement under Medicare Part B for the cost of MNT. The MNT Act defined MNT services as “the nutritional diagnostic, therapeutic, and counseling services provided by a Registered Dietitian or nutritional professional for the purpose of managing diabetes or renal diseases”. Also, the MNT Act defined “conditions for coverage of MNT”, “limitations on coverage of MNT”, and “qualifications of MNT service provider”. To expand the coverage of Medicare to include MNT, the ADA realized the need for development of a protocol for MNT, as well as studies to evaluate the effectiveness and cost-effectiveness of the MNT protocol developed. Therefore, the ADA supported the studies to develop a strong database of scientific investigations of nutritional services. Furthermore, the ADA needed credible data that could be used by Policy makers, so the ADA contracted with the Lewin Group to if out the study to gather the additional data needed to strengthen the ADA's position. In the report of the Lewin Group, which was entitled, “The Cost of Covering Medical Nutrition Therapy under Medicare : 1998 through 2004”, it was concluded, that if coverage for MNT in the Part B portion of Medicare had begun in 1998, by 2004, approximately $ 2.3 billion would have been saved through reduced hospital spending under Part A of Medicare ($ 1.2 billion) and reduced physician visits under Part B ($ 1.1 billion) Effective January 1 2002, the US Congress extended Medicare coverage to include MNT to beneficiaries with diabetes or renal diseases. The Centers for Medicare and Medicaid Services (CMS) established the duration and frequency for the MNT based on published reports or generally accepted protocols (for example, protocols suggested by the ADA). The number of hours covered by Medicare is 3 hours for the initial MNT and 2 hours for a follow-up MM. In 2002, a Medicare coverage policy was made to define the Physician's Current Procedural Terminology (CPT) codes 97802, 97803, and 97804 for MNT.

Clinicopathologic Characteristics of Male Breast Cancer: A Report of 21 Cases in Radiotherapy Center of Hamedan, Iran

  • Sedighi, Abdolazim;Hamed, Ehsan Akbari;Mohammadian, Kamal;Behnood, Sepideh;Kalaghchi, Bita
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7381-7383
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    • 2013
  • Background: Male breast cancer accounts for less than 1% of all cancer in men and only around 1% of all diagnosed breast cancer. Despite a significant raise in the last 25 years, it still remains a rare disease. Materials and Methods: We conducted a retrospective study from 2004-2011 with 21 male breast cancer patients. We aimed to analyze the epidemiologic data (age, personal and family history), tumor characteristics (size, histological type, location, TNM stage, receptors), surgery, adjuvant chemotherapy and radiation therapy, hormonal therapy and survival (relapse, follow up, death) who reffered to our center with breast cancer. Results: The median age was $49.2{\pm}14.2$ years (range 30-83 years). A family history of breast cancer was noted in four cases. The main clinical complaint was a retroareolar mass in 85.7%of patients (n=18). Histologically, 85.7% (n=18)were invasive ductal carcinoma and 4.7% (n=1) had ductal carcinoma in situ and 9.4% (n=2) had mixed histology including invasive medullary and ductal carcinoma. Hormonal therapy was delivered to 16 cases (76.1%) due to ER or PR positivity. During median follow up of 30 months (3-84 month), distant metastases were evident in 4 cases (19%). During the follow-up period, only one patient died due to metastatic disease. The mean time to recurrence detection was 30 months. Conclusions: The percentage of cases of male breast cancer is very low compared to breast cancer in females, explaining why very few investigations have been conducted in Iran. Limited coverage in the literature make gender-specific findings difficult so future research of this entity involving multi-institutional cooperation and longer follow up is essential to provide new insights about the biological and clinical factors of this rare cancer.

Cancer Registration in Basrah-Southern Iraq: Validation by Household Survey

  • Hussain, Riyadh Abdul-Ameer;Habib, Omran S
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.197-200
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    • 2016
  • On an international scale, the burden of cancer in absolute numbers continues to increase, mainly due to aging of population in many countries, the overall growth of the world population, changing lifestyle with increasing cancer-causing behavior, like cigarette smoking, changing dietary habits and sedentary life. Cancer is the second-leading cause of death and disability in the world, after only heart disease. Recently, increasing incidence and mortality of cancer have also become evident in the developing world. In Iraq and particularly in Basrah in the southern part of the country, the burden has definitely increased and deserves extensive research. The present paper is part of an extensive household survey carried out in Basrah in 2013. Among the objectives was to validate official cancer registration in the governorate. The cross-sectional survey had a retrospective component to inquire about the incidence of cancer and cancer-related deaths during the three years preceding the date of inquiry (2010-2012). A convenient sample of 6,999 households with 40,688 inhabitants using multistage cluster sampling was surveyed involving all urban and rural areas of Basrah. The official cancer registration activities in Basrah seemed to have attained a high level of registration coverage (70-80%) but the gap, represented by missed cases, is still high enough to criticize the system. Most of the missing cases were either not notified by treating facilities or they were diagnosed and treated outside Basrah. Using a set of parameters, the pattern of cancer was consistent based on data of the household survey and data of the cancer registry but a gap still existed in the coverage of incident cancer and mortality by cancer registration. Integrated serious steps are required to contain the risk of cancer and its burden on the patient through improving the registration process, improving early detection, diagnostic and management capabilities and encouraging scientific research to explore the hidden risk factors and possible causes of low registration coverage. Periodic household surveys seemed feasible and essential to support routine registration.

Analyzed the Computed Tomography Dose Index (CTDI) to the Pediatric Brain CT by Reason of the Observation for the Exposure Dose: Base on a Hospital (소아 두부 전산화단층촬영 선량지표 분석을 통한 피폭선량 모니터링: 일개병원 사례 중심으로)

  • Lee, Jae-Seung;Kim, Hyun-Jin;Im, In-Chul
    • The Journal of the Korea Contents Association
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    • v.15 no.6
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    • pp.290-296
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    • 2015
  • The purpose of this study was to derive the proposals and to suggest the exposure dose reduction scheme on pediatric head CT scan by analyzing and comparing CT dose index (CTDI) and the national diagnostic reference levels. From January 2014 to December, 231 children under 10years who were requested a pediatric head CT scan with head injury were examined. Research methods were to research and analyze the general characteristics kVp, mA test coverage $CTDI_{vol}$ and DLP referring to dose reports and electronic medical record (EMR). As a result, 7.4%(17 patients) of the total subjects in $CTDI_{vol}$ showed a national diagnostic reference levels exceeding. For DLP 41.6%(96 patients) in excess was relatively higher than $CTDI_{vol}$. DLP was exceeded more than about 60% that is higher than the CT dose index presented by Korea Food & Drug Administration. it is cause of high DLP that scan range increased more than about 30% wider than the standard test coverage presented in Health Insurance Review & Assessment Service. In conclusion, it is able to significantly lower the dose if it is complied with checking the baseline scan range of pediatric head CT scan and appropriately adjusting the protocol.

Selection of radiation treatment plan technique at breast cancer operating technique (유방암 수술기법에 따른 방사선치료계획 기법의 선택)

  • Kim, Jeong-Ho;Bae, Seok-Hwan;Kim, Ki-Jin;Yoo, Se-Jong
    • Journal of the Korea Safety Management & Science
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    • v.17 no.1
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    • pp.125-130
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    • 2015
  • Techniques, using physical wedge filter and using dynamic wedge filter and FIF(Field in Field) and ISCT(Irregular Surface Compensating Technique), have been developed according to progress of radiation therapy of breast cancer. Measurement of dose was done to judge the usefulness of technique using three cases, non tissue loss after breast conserving operating and tissue loss after breast conserving operating and mastectomy. Dose indexes of breast tissue, CI (Conformity Index), HI (Homogeneity Index) and QOC (Quality of Coverage), dose index of skin, or dose indexes of lung, volume of 50 percent dose and 20 percent dose were estimated and compared. Using dynamic wedge filter is useful plan at non tissue loss allowing for high dose of lung. FIF and ISCT are useful plan at tissue loss. ISCT is useful plan at mastectomy. Henceforth, we need to apply to valid plan and body type and thorax size.

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.

Application of MRI in dentistry: Radiation free image (치과 임상에서 MRI의 활용)

  • Jeon, Kug Jin
    • The Journal of the Korean dental association
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    • v.57 no.11
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    • pp.700-707
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    • 2019
  • On account of the dentistry mainly deals with hard tissues such as teeth and bones, CBCT and CT are common imaging modality in clinics. Recently, insurance coverage of MRI has been extended to head and neck region. In addition, unlike CBCT or CT, ionizing radiation is not used, the demand for MRI is gradually increasing in dentistry. Even though, many dentists still think that MRI is a difficult diagnostic tool and they are not confident when to use it. Therefore, the objective of this manuscript is to help the dental clinicians to access easily on MRI by introducing the overview, application and precautions of this imaging tool.

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Stereoelectroencephalography in Pediatric Epilepsy Surgery

  • Tomlinson, Samuel B.;Buch, Vivek P.;Armstrong, Dallas;Kennedy, Benjamin C.
    • Journal of Korean Neurosurgical Society
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    • v.62 no.3
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    • pp.302-312
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    • 2019
  • Stereoelectroencephalography (SEEG) is an invasive technique used during the surgical management of medically refractory epilepsy. The utility of SEEG rests in its ability to survey the three-dimensional organization of the epileptogenic zone as well as nearby eloquent cortices. Once concentrated to specialized centers in Europe and Canada, the SEEG methodology has gained worldwide popularity due to its favorable morbidity profile, superior coverage of deep structures, and ability to perform multi-lobar explorations without the need for craniotomy. This rapid shift in practice represents both a challenge and an opportunity for pediatric neurosurgeons familiar with the subdural grid approach. The purpose of this review is to discuss the indications, technique, and safety of long-term SEEG monitoring in children. In addition to reviewing the conceptual and technical points of the diagnostic evaluation, attention will also be given to SEEG-based interventions (e.g., radiofrequency thermo-coagulation).

A Review of Organ Dose Calculation Tools for Patients Undergoing Computed Tomography Scans

  • Lee, Choonsik
    • Journal of Radiation Protection and Research
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    • v.46 no.4
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    • pp.151-159
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    • 2021
  • Background: Computed tomography (CT) is one of the crucial diagnostic tools in modern medicine. However, careful monitoring of radiation dose for CT patients is essential since the procedure involves ionizing radiation, a known carcinogen. Materials and Methods: The most desirable CT dose descriptor for risk analysis is the organ absorbed dose. A variety of CT organ dose calculators currently available were reviewed in this article. Results and Discussion: Key common elements included in CT dose calculators were discussed and compared, such as computational human phantoms, CT scanner models, organ dose database, effective dose calculation methods, tube current modulation modeling, and user interface platforms. Conclusion: It is envisioned that more research needs to be conducted to more accurately map CT coverage on computational human phantoms, to automatically segment organs and tissues for patient-specific dose calculations, and to accurately estimate radiation dose in the cone beam computed tomography process during image-guided radiation therapy.

Nanopore Metagenomics Sequencing for Rapid Diagnosis and Characterization of Lily Viruses

  • Lee, Hyo-Jeong;Cho, In-Sook;Jeong, Rae-Dong
    • The Plant Pathology Journal
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    • v.38 no.5
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    • pp.503-512
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    • 2022
  • Lilies (Lilium spp.) are one of the most important ornamental flower crops grown in Korea. Most viral diseases in lilies are transmitted by infected bulbs, which cause serious economic losses due to reduced yields. Various diagnostic techniques and high-throughput sequencing methods have been used to detect lily viruses. According to Oxford Nanopore Technologies (ONT), MinION is a compact and portable sequencing device. In this study, three plant viruses, lily mottle, lily symptomless, and plantago asiatica mosaic virus, were detected in lily samples using the ONT platform. As a result of genome assembly of reads obtained through ONT, 100% coverage and 90.3-93.4% identity were obtained. Thus, we show that the ONT platform is a promising tool for the diagnosis and characterization of viruses that infect crops.