• Quality Improvement in Health Care
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• v.24 no.2
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• pp.15-25
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• 2018

Purpose: To compare the Appropriateness of abdominal CT to abdominal radiography as an imaging modality in terms of the diagnostic value, medical costs and decision making times for patients presented to the emergency department with nontraumatic abdominal pain. Methods: This study used the records of 530 cases presented to the emergency department(ED) with nontraumatic abdominal pain from February to March 2012. Imaging modalities were categorized into abdominal radiography and CT (radiography first or CT first) or radiography alone or CT alone. The diagnostic value, total medical costs and effect on decision making time of the each imaging modalities were compared. Especially, in retrospective review, to evaluate the predictability of the abdominal radiography, alit was assumed that all the 530 cases performed that exam as initial imaging. Results: Among 530 cases, 255 cases underwent abdominal radiography only, 28 cases underwent abdominal CT only and the remnant 247 cases underwent abdominal CT with plain abdominal radiography. The diagnostic value was higher in the cases with abdominal CT (268/275, 97.5%) than in the cases with plain abdominal radiography (19/255, 7.5%).The number of cases predicted by abdominal radiography only as initial imaging were 39/530 (7.4%). In cases where the patients performed the abdominal CT as the first imaging modality thereby omitting the abdominal radiography, the total diagnostic imaging fee was lower than in cases with plain abdominal radiography first followed by the abdominal CT (277,140 vs. 284,226(mean, Korean Won)). Although diagnostic value of the plain abdominal radiography as first imaging modality was lower than the abdominal CT, Decision making time, average duration of hospital stay was longer and the total medical costs was higher than abdominal CT. Conclusion: As an imaging modality in the ED for patients with acute nontraumatic abdominal pain, plain abdominal radiography is an avoidable procedure when viewed in terms of the diagnostic value and total medical costs and decision making times comparing with abdominal CT.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8605-8611
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• 2016

The reliability of using diagnostic binary ratios of particulate carcinogenic polycyclic aromatic hydrocarbons (PAHs) as chemical tracers for source characterisation was assessed by collecting PM10 samples from various air quality observatory sites in Thailand. The major objectives of this research were to evaluate the effects of day and night on the alterations of six different PAH diagnostic binary ratios: An/(An + Phe), Fluo/(Fluo + Pyr), B[a]A/(B[a]A + Chry), B[a]P/(B[a]P + B[e]P), Ind/(Ind + B[g,h,i]P), and B[k]F/Ind, and to investigate the impacts of site-specific conditions on the alterations of PAH diagnostic binary ratios by applying the concept of the coefficient of divergence (COD). No significant differences between day and night were found for any of the diagnostic binary ratios of PAHs, which indicates that the photodecomposition process is of minor importance in terms of PAH reduction. Interestingly, comparatively high values of COD for An/(An + Phe) in PM10 collected from sites with heavy traffic and in residential zones underline the influence of heterogeneous reactions triggered by oxidising gaseous species from vehicular exhausts. Therefore, special attention must be paid when interpreting the data of these diagnostic binary ratios, particularly for cases of low-molecular-weight PAHs.

• Journal of Korean Society for Quality Management
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• v.21 no.1
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• pp.55-64
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• 1993

This article is concerned with procedures for detecting one or more outliers or influential observations in a linear regression model. A test procedure, based on recursive residuals is proposed and developed The power of the test procedure to identify one or more outliers is investigated through simulation, and its relevance to the number and configuration of the outlier.

• Korean Management Science Review
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• v.26 no.1
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• pp.137-159
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• 2009

An organizational performance measurement practice is a function of performance measurement system and performance management system they are currently employing, and its quality is determined by evaluating the followings in a comprehensive manner: first, if they are measuring right things; second, if they are measuring in a right way; third, if they are actively facilitating a process of data collection, structuring, analysis, interpretation, and dissemination; and fourth, if they are using performance measurement results for the primary purposes of performance measurement. This study proposes a diagnostic framework for evaluating the performance measurement practices of public broadcasting which include the qualities of performance measurement and performance management, and develop a structured questionnaire for that purpose. The framework proposed in this study does not serve only as a useful tool for public broadcasting to revise their respective performance measures and performance measurement systems, but it also make their respective performance measurement practices a strategic management tool as well as an operational management one.

• Korean Journal of Digital Imaging in Medicine
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• v.16 no.2
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• pp.25-29
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• 2014

The full-field digital mammography (FFDM), which has been known as a digital breast imaging system, carries out more outstanding performance than the screen-film mammography in overall image quality, skin & nipple, description of pectoral muscle and expression of micro-calcification. Thus, in this thesis, I perform experiments for both the enhancement of image quality and accurate estimation of the result in question, when detecting the very tiny-sized lesions in mammography. The image of digital breast X-rays is the important diagnostic tool for detecting early breast cancer and micro calcification lesion. The experiment of how much compression rate has an effect on the result of diagnosis in the case of microcalcification lesion, with JPEG2000 40:1 compression and over 50% enlargement led to obscure or definitely unacceptable diagnostic results is performed. And in another study of assessment of PSNR degree. I recognized the importance of standardized management system in mammography, where not to mention the accurate reading of the image has the most crucial role in diagnosis

• Journal of Korean Society of Industrial and Systems Engineering
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• v.42 no.3
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• pp.25-38
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• 2019

This study is to develop a diagnostic model for the effective introduction of smart factories in the manufacturing industry, to diagnose SMEs that have difficulties in building their own smart factory compared to large enterprise, to identify the current level and to present directions for implementation. IT, AT, and OT experts diagnosed 18 SMEs using the "Smart Factory Capacity Diagnosis Tool" developed for smart factory level assessment of companies. They analyzed the results and assessed the level by smart factory diagnosis categories. Companies' smart factory diagnostic mean score is 322 out of 1000 points, between 1 level (check) and 2 level (monitoring). According to diagnosis category, Factory Field Basic, R&D, Production/Logistics/Quality Control, Supply Chain Management and Reference Information Standardization are high but Strategy, Facility Automation, Equipment Control, Data/Information System and Effect Analysis are low. There was little difference in smart factory level depending on whether IT system was built or not. Also, Companies with large sales amount were not necessarily advantageous to smart factories. This study will help SMEs who are interested in smart factory. In order to build smart factory, it is necessary to analyze the market trends, SW/ICT and establish a smart factory strategy suitable for the company considering the characteristics of industry and business environment.

• 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.

• Korean Journal of Digital Imaging in Medicine
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• v.9 no.1
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• pp.53-65
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• 2007

PACS has been run at the Kyung Hee University Medical Center(KHMC) since 2001, and the installation and operation of PACS have contributed to automation and quantification of KHMC's medical environment During these five years our greatest concern is how to make our own guiding principle of diagnostic monitor QA which is adapted to international standards. In accordance with the terms of 'KHMC QA Guideline', 'AAPM TG18', 'SMPTE RP133', 'DICOM Part14', 'DIN V 6868-57', 'JESRA X-0093', 'JIS Z4752-2-5' and 'KCARE', concern about quality assurance of medical images are on the increase. With the investigation of acceptance testing and quality control of international standards for medical display devices, and data collection and analysis for recommended guideline, it is reported that acceptance testing(quality control), including geometrical distortion, display reflection, luminance response, luminance uniformity, display resolution, display noise, veiling glare and color chromaticity being adequate and effective to domestic hospital environments for medical display devices and assessment methods according to each performance. Accordingly, KHMC classified the checkpoint items by period, at the time of monitor setting, monthly, quarterly, half-yearly and annually. Periodic classification of checkpoint items for monitor QA makes a good guideline for image QA/QC and useful guideline for persistent good quality of monitor.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2361-2368
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• 2015

Objective: To evaluate the diagnostic accuracy of contrast-enhanced ultrasonography (CEUS) in differentiating between benign and malignant enlarged lymph nodes using meta-analysis. Materials and Methods: Pubmed, Embase, SCI and Cochrane databases were searched for studies (up to September 1, 2014) reporting the diagnostic performance of CEUS in discriminating between benign and malignant lymph nodes. Inclusion criteria were: prospective study; histopathology as the reference standard; and sufficient data to construct $2{\times}2$ contingency tables. Methodological quality was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). Patient clinical characteristics, sensitivity and specificity were extracted. The summary receiver operating characteristic curve was used to examine the accuracy of CEUS. A meta-analysis was performed to evaluate the clinical utility in identification of benign and malignant lymph nodes. Sensitivity analysis was performed after omitting outliers identified in a bivariate boxplot and publication bias was assessed with Egger testing. Results: The pooled sensitivity, specificity and AUROC were 0.92 (95%CI, 0.85-0.96), 0.91 (95%CI, 0.82-0.95) and 0.97 (95%CI, 0.95-0.98), respectively. After omitting 3 outlier studies, heterogeneity decreased. Sensitivity analysis demonstrated no disproportionate influences of individual studies. Publication bias was not significant. Conclusions: CEUS is a promising diagnostic modality in differentiating between benign and malignant lymph nodes and can potentially reduce unnecessary fine-needle aspiration biopsies of benign nodes.

• Korean Journal of Radiology
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• v.24 no.8
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• pp.739-751
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• 2023

Objective: This systematic review and meta-analysis evaluated the accuracy of preoperative breast magnetic resonance imaging (MRI) features and tumor-to-nipple distance (TND) for diagnosing occult nipple-areolar complex (NAC) involvement in breast cancer. Materials and Methods: The MEDLINE, Embase, and Cochrane databases were searched for articles published until March 20, 2022, excluding studies of patients with clinically evident NAC involvement or those treated with neoadjuvant chemotherapy. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Two reviewers independently evaluated studies that reported the diagnostic performance of MRI imaging features such as continuity to the NAC, unilateral NAC enhancement, non-mass enhancement (NME) type, mass size (> 20 mm), and TND. Summary estimates of the sensitivity and specificity curves and the summary receiver operating characteristic (SROC) curve of the MRI features for NAC involvement were calculated using random-effects models. We also calculated the TND cutoffs required to achieve predetermined specificity values. Results: Fifteen studies (n = 4002 breast lesions) were analyzed. The pooled sensitivity and specificity (with 95% confidence intervals) for NAC involvement diagnosis were 71% (58-81) and 94% (91-96), respectively, for continuity to the NAC; 58% (45-70) and 97% (95-99), respectively, for unilateral NAC enhancement; 55% (46-64) and 83% (75-88), respectively, for NME type; and 88% (68-96) and 58% (40-75), respectively, for mass size (> 20 mm). TND had an area under the SROC curve of 0.799 for NAC involvement. A TND of 11.5 mm achieved a predetermined specificity of 85% with a sensitivity of 64%, and a TND of 12.3 mm yielded a predetermined specificity of 83% with a sensitivity of 65%. Conclusion: Continuity to the NAC and unilateral NAC enhancement may help predict occult NAC involvement in breast cancer. To achieve the desired diagnostic performance with TND, a suitable cutoff value should be considered.