• 제목/요약/키워드: medical error

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Healthcare Data Supervision and Secrecy in Cloud Computing

  • 알 아민 후세인;모하메드 마타하리 이슬람;모하메드 아잠;이승진;허의남
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2013년도 춘계학술발표대회
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    • pp.695-697
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    • 2013
  • Medical data sharing is increasing due to treatment duplication which increases the cost of medication. Medical healthcare system has been improved to combine with cloud computing. It reduces treatment delay and the medical data error. However, the concern about the privacy protection of medical information is also significant. Medical information is more sensitive than other information because involuntary disclosure can affect in both personal and social life. Privacy cloud brokerage has conquered great attention for solving these problems. Our method provides a security model in the cloud computing environment that facilitates the exchange of medical records between assigned custodians. It allows doctors to obtain a complete patient medical records which can help to avoid duplication, reduce the medical error and healthcare cost as well. In addition, our method offers a trustworthy solution against the privacy violence.

간호사가 인지한 투약오류관리풍토와 오류보고의도의 관계에서 변혁적 리더십의 역할 (Role of Transformational-leadership in the Relationship between Medication Error Management Climate and Error Reporting Intention of Nurse)

  • 김명수
    • 성인간호학회지
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    • 제25권6호
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    • pp.633-643
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    • 2013
  • Purpose: The objective of this study was to identify the moderating and mediating effects of transformational-leadership in the relationship between medication error management climate and error reporting intention. Methods: Participants in this study were 118 nurses from 11 hospitals in Korea. The scales of medication error management climate, transformational-leadership and error reporting intention of nurses were used in this study. Descriptive statistics, t-test, ANOVA, partial Pearson correlation coefficient, and stepwise multiple regression were used for data analysis. Results: Higher transformational leadership group members had higher error management climate (t=3.88~4.64, p<.001) and higher intention to error reporting (t=2.49, p=.014). There were significant positive correlations between subcategories of medication error management climate and transformational leadership (r=.37~.51, p<.001). But error reporting intention was related to the transformational leadership (r=.28 p=.002), two subcategories such as 'learn from error' (r=.26, p=.004) and 'medication error competence' (r=.25, p=.008) of medication error management climate. Transformational-leadership was a moderator and a mediator between medication error management climate and error reporting intention. Conclusion: Based on the results of this study, transformational-leadership promotion training program to construct medication error management climate and to improve error reporting intention should be needed.

2상 하이브리드 스테핑 모터의 벡터 제어 시 초기 각 오차 및 토크 리플 보상 (Compensation of Initial Position Error and Torque Ripple in Vector Control of Two-phase Hybrid Stepping Motors)

  • 김도현;김상훈
    • 전력전자학회논문지
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    • 제27권6호
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    • pp.481-488
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    • 2022
  • This study proposes compensation methods for the initial position error and torque ripple in vector control of two-phase hybrid stepping motors. Stepping motors have an asymmetrical structure due to misalignment, such as the eccentricity generated by the manufacturing and assembly process. When vector control is applied using the position information measured by an incremental encoder attached to the rotor shaft of such stepping motors, the following problems occur. First, an initial position error occurs during the forced excitation process for the initial rotor position alignment. Second, torque ripple corresponding to the mechanical rotation frequency is generated. In this study, these non-ideal phenomena that occur in vector control of the stepping motor are analyzed, and compensation methods are proposed to eliminate them. The validity of the proposed initial position error and torque ripple compensation methods is verified through experiments on a two-phase hybrid stepping motor drive system.

시뮬레이션 교육을 통한 일반 X선 검사의 오류 분석 (Error Analysis of General X-ray Examination by Using Simulation Training)

  • 성열훈
    • 한국방사선학회논문지
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    • 제12권7호
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    • pp.919-927
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    • 2018
  • 본 연구에서는 일반 X선 검사를 대상으로 시뮬레이션 교육 모델을 제시하고 실습 시 발생하는 오류를 분석하고자 하였다. 2012년부터 2018년까지 총 183명 (남자 77명, 여자 106명)의 학생이 참가하였다. 시뮬레이션 X선 시스템은 컴퓨터방사선영상(computed radiography, CR) 시스템을 이용하였다. 환자 보호, X선 검사의 정확성, 영상의 안정성 등의 검사 프로세스에 발생하는 오류 빈도수를 분석하였다. 그 결과 환자 자세 설정 오류, X선 중심선의 정확성 오류, 영상검출판의 크기 및 위치 설정 오류, 그리드 사용의 오류, 마킹의 오류, X선 조사조건 설정 오류, 조사야 설정의 오류, X선 입사각도의 오류, X선 조사거리의 오류 순으로 분석되었다. 이러한 오류를 중심으로 개선된 방사선사 실습 교육이 필요할 것이며 그로 인하여 정밀한 검사와 고품질의 의료서비스를 제공하여 국민들의 보건의료에 조금이나마 기여할 수 있기를 기대한다.

Segmental Analysis Trial of Volumetric Modulated Arc Therapy for Quality Assurance of Linear Accelerator

  • Rahman, Mohammad Mahfujur;Kim, Chan Hyeong;Huh, Hyun Do;Kim, Seonghoon
    • 한국의학물리학회지:의학물리
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    • 제30권4호
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    • pp.128-138
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    • 2019
  • Purpose: Segmental analysis of volumetric modulated arc therapy (VMAT) is not clinically used for compositional error source evaluation. Instead, dose verification is routinely used for plan-specific quality assurance (QA). While this approach identifies the resultant error, it does not specify which machine parameter was responsible for the error. In this research study, we adopted an approach for the segmental analysis of VMAT as a part of machine QA of linear accelerator (LINAC). Methods: Two portal dose QA plans were generated for VMAT QA: a) for full arc and b) for the arc, which was segmented in 12 subsegments. We investigated the multileaf collimator (MLC) position and dosimetric accuracy in the full and segmented arc delivery schemes. A MATLAB program was used to calculate the MLC position error from the data in the dynalog file. The Gamma passing rate (GPR) and the measured to planned dose difference (DD) in each pixel of the electronic portal imaging device was the measurement for dosimetric accuracy. The eclipse treatment planning system and a MATLAB program were used to calculate the dosimetric accuracy. Results: The maximum root-mean-square error of the MLC positions were <1 mm. The GPR was within the range of 98%-99.7% and was similar in both types of VMAT delivery. In general, the DD was <5 calibration units in both full arcs. A similar DD distribution was found for continuous arc and segmented arcs sums. Exceedingly high DD were not observed in any of the arc segment delivery schemes. The LINAC performance was acceptable regarding the execution of the VMAT QA plan. Conclusions: The segmental analysis proposed in this study is expected to be useful for the prediction of the delivery of the VMAT in relation to the gantry angle. We thus recommend the use of segmental analysis of VMAT as part of the regular QA.

몬테칼로 전산모사를 이용한 셋업오차가 임상표적체적에 전달되는 선량과 셋업마진에 대하여 미치는 영향 평가 (Evaluation of Setup Uncertainty on the CTV Dose and Setup Margin Using Monte Carlo Simulation)

  • 조일성;곽정원;조병철;김종훈;안승도;박성호
    • 한국의학물리학회지:의학물리
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    • 제23권2호
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    • pp.81-90
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    • 2012
  • 방사선 치료에서 부정확한 환자 셋업이 표적에 전달되는 선량에 미치는 영향과 치료 마진과의 연관성을 몬테칼로 기법을 사용한 전산모사를 통하여 분석하였다. 실제 방사선 치료를 받은 직장암 환자에 대한 임상표적체적(CTV: Clinical Target Volume) 및 주요장기의 구조와 치료계획 시스템(Eclipse 8.9, USA)을 이용하여 수립된 세기조절 방사선치료계획에서의 선량분포에 대한 데이터를 전산모사에서 사용하였다. 전산모사 프로그램은 리눅스환경에서 오픈소스인 ROOT 라이브러리와 GCC를 기반으로 본 연구를 위하여 개발되었다. 환자셋업오차의 확률분포를 정규분포로 가정한 것에 따라 무작위로 생성된 크기만큼 셋업이 부정확한 경우를 모사하여 임상표적체적에서의 선량분포의 변화와 오차크기에 따른 마진크기를 3차원입체조형 방사선치료에 사용되는 마진공식과 비교분석 하였다. 셋업오차 생성에 사용된 정규분포의 표준편차 크기는 1 mm부터 10 mm까지 1 mm간격으로 두었으며 계통오차와 통계오차별로 2,000번 전산모사했다. 계통오차의 경우 전산모사에 사용된 표준편차가 커질수록 임상표적체적에 조사되는 최소선량 $D_{min}^{stat{\cdot}}$은 100.4%에서 72.50%로 감소하였고 평균선량 $\bar{D}_{syst{\cdot}}$도 100.45%에서 97.88%로 감소한 반면에 표준편차${\Delta}D_{sys}$는 0.02%에서 3.33%로 증가하였다. 통계오차의 경우 최소선량 $D_{min}^{rand{\cdot}}$은 100.45%에서 94.80%감소하였고 평균선량 $\bar{D}_{syst{\cdot}}$도 100.46%에서 97.87%로 감소하였으며 표준편차 ${\Delta}D_{rand}$는 0.01%에서 0.63%로 증가하였다. 그리고 마진공식으로부터 전산모사에 사용된 셋업오차에 해당되는 마진크기를 구하고 모집단비율(population ratio)을 정의하여 기존 마진공식의 목적이 세기조절방사선치료에 만족함을 확인했다. 개발된 전산모사 프로그램은 해당 환자의 치료계획 정보를 직접 사용하므로 직장암만 아니라 두경부암, 전립선암 등 여러 환부에 적용 가능하며 셋업오차 및 선량변화에 연관된 연구에도 사용할 수 있을 것으로 사료된다.

의학적 의사결정 지표의 고찰 및 해석에 기초한 품질통계기법의 적용 (Application of Quality Statistical Techniques Based on the Review and the Interpretation of Medical Decision Metrics)

  • 최성운
    • 대한안전경영과학회지
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    • 제15권2호
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    • pp.243-253
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    • 2013
  • This research paper introduces the application and implementation of medical decision metrics that classifies medical decision-making into four different metrics using statistical diagnostic tools, such as confusion matrix, normal distribution, Bayesian prediction and Receiver Operating Curve(ROC). In this study, the metrics are developed based on cross-section study, cohort study and case-control study done by systematic literature review and reformulated the structure of type I error, type II error, confidence level and power of detection. The study proposed implementation strategies for 10 quality improvement activities via 14 medical decision metrics which consider specificity and sensitivity in terms of ${\alpha}$ and ${\beta}$. Examples of ROC implication are depicted in this paper with a useful guidelines to implement a continuous quality improvement, not only in a variable acceptance sampling in Quality Control(QC) but also in a supplier grading score chart in Supplier Chain Management(SCM) quality. This research paper is the first to apply and implement medical decision-making tools as quality improvement activities. These proposed models will help quality practitioners to enhance the process and product quality level.

CT절편두께와 RP방식이 3차원 의학모델 정확도에 미치는 영향에 대한 연구 (Influence of slice thickness of computed tomography and type of rapid protyping on the accuracy of 3-dimensional medical model)

  • 엄기두;이병도
    • Imaging Science in Dentistry
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    • 제34권1호
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    • pp.13-18
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    • 2004
  • Purpose : This study was to evaluate the influence of slice thickness of computed tomography (CT) and rapid protyping (RP) type on the accuracy of 3-dimensional medical model. Materials and Methods: Transaxial CT data of human dry skull were taken from multi-detector spiral CT. Slice thickness were 1, 2, 3 and 4 mm respectively. Three-dimensional image model reconstruction using 3-D visualization medical software (V-works /sup TM/ 3.0) and RP model fabrications were followed. 2-RP models were 3D printing (Z402, Z Corp., Burlington, USA) and Stereolithographic Apparatus model. Linear measurements of anatomical landmarks on dry skull, 3-D image model, and 2-RP models were done and compared according to slice thickness and RP model type. Results: There were relative error percentage in absolute value of 0.97, 1.98,3.83 between linear measurements of dry skull and image models of 1, 2, 3 mm slice thickness respectively. There was relative error percentage in absolute value of 0.79 between linear measurements of dry skull and SLA model. There was relative error difference in absolute value of 2.52 between linear measurements of dry skull and 3D printing model. Conclusion: These results indicated that 3-dimensional image model of thin slice thickness and stereolithographic RP model showed relative high accuracy.

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로봇 자동화 바늘삽입형 중재시술을 위한 자동화 생검장치의 바늘삽입 특성: 바늘삽입 깊이 및 삽입정확도 (Characteristics of Needle Insertion Performance of Automated Biopsy Device for Robotic Needle Insertion Type Intervention: Insertion Depth and Accuracy)

  • 문영진;최재순
    • 한국정밀공학회지
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    • 제33권7호
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    • pp.565-570
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    • 2016
  • This paper presents the characteristics related to needle insertion of a robotic device for the automated biopsy procedure. The automated biopsy device, a main component of the robotic needle insertion type intervention system, allows performance of the full biopsy procedure, except for anesthesia, without direct handling of a radiologist or a tele-operated control. In this study, the needle length parameters corresponding to various insertion depths and precision for needle insertion of the automated biopsy device, are discussed. There were two combinations of needle length parameters for appropriate needle insertion and motion capture-based measurement was performed; 0.156 mm error for the 90 mm length commanded insertion displacement was measured. The pre-defined goal is a maximum 1 mm error and thus our measured error is within the acceptable range. In the repeatability check, it was also shown that the device can implement a highly accurate insertion.