• Asian Pacific Journal of Cancer Prevention
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• 제13권12호
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• pp.6181-6185
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• 2012

Background: The aim of the study was to evaluate the available breast nomograms (MSKCC, Stanford, Tenon) to predict non-sentinel lymph node metastasis (NSLNM) and to determine variables for NSLNM in SLN positive breast cancer patients in our population. Materials and Methods: We retrospectively reviewed 170 patients who underwent completion axillary lymph node dissection between Jul 2008 and Aug 2010 in our hospital. We validated three nomograms (MSKCC, Stanford, Tenon). The likelihood of having positive NSLNM based on various factors was evaluated by use of univariate analysis. Stepwise multivariate analysis was applied to estimate a predictive model for NSLNM. Four factors were found to contribute significantly to the logistic regression model, allowing design of a new formula to predict non-sentinel lymph node metastasis. The AUCs of the ROCs were used to describe the performance of the diagnostic value of MSKCC, Stanford, Tenon nomograms and our new nomogram. Results: After stepwise multiple logistic regression analysis, multifocality, proportion of positive SLN to total SLN, LVI, SLN extracapsular extention were found to be statistically significant. AUC results were MSKCC: 0.713/Tenon: 0.671/Stanford: 0.534/DEU: 0.814. Conclusions: The MSKCC nomogram proved to be a good discriminator of NSLN metastasis in SLN positive BC patients for our population. Stanford and Tenon nomograms were not as predictive of NSLN metastasis. Our newly created formula was the best prediction tool for discriminate of NSLN metastasis in SLN positive BC patients for our population. We recommend that nomograms be validated before use in specific populations, and more than one validated nomogram may be used together while consulting patients.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4487-4490
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• 2016

Background: Methylation at cg 16941656 of FRY is exclusively found in normal pancreatic tissue and has been proven to be specific for pancreatic-in-origin among several adenocarcinomas. Here, we investigated methylated DNA in the bile as a biomarker to differentiate the cause of obstruction between pancreatic cancer and benign causes. Materials and Methods: Bile samples of 45 patients with obstructive jaundice who underwent ERCP were collected and classified into pancreatic cancer (group 1) and benign causes (group 2) in 24 and 21 patients, respectively. DNA was extracted from bile and bisulfite modification was performed. After, methylation in cg 16941656 of FRY was identified by real-time PCR, with beta-actin used as a positive control. Results: Methylated DNA was identified in 10/24 (41.67%) and 1/21 (4.8%) of cases in groups 1 and 2, respectively (P= 0.012). The sensitivity, specificity, positive predictive value and negative predictive value to differentiate pancreatic cancer from benign causes were 42%, 95%, 91%, and 59%, respectively. Conclusions: Detecting a methylation at cg 16941656 of FRY in bile has high specificity, with an acceptable positive likelihood rate, and may therefore be helpful in distinguish pancreatic cancer from benign strictures.

• 한국컴퓨터정보학회논문지
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• 제17권3호
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• pp.95-103
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• 2012

현대 사회는 다양한 범죄들이 발생하고 있고, 범죄를 예방하기 위한 연구가 진행되고 있다. 기존의 범죄에 관련된 연구들은 범죄가 발생하는 공간과 지리정보를 분석하거나, 범죄자들의 범죄 유형을 분석하는 연구들이 진행되어 왔다. 그러나 기존의 연구들은 지리적, 심리학적인 연구를 통해 범죄가 발생하는 지역과 동기들을 분석하여 범죄를 예방하기 위한 연구들이 대부분이다. 본 논문에서는 마코프 프로세서를 도입하여 범죄를 예측하기 위한 모델링을 제시한다. 여러 범죄 중 살인, 공무원 범죄, 폭력의 범죄 발생 건수를 사용하여 시간에 따른 범죄 발생 건수를 예측하였다. 본 논문에서 제시한 범죄 예측 모델링에서 사용될 범죄 발생 평균값에 범죄가 발생한 기간에 발생한 범죄 발생 건수의 전체 평균값, 1년 평균값, 최근 평균값으로 분류하여 어느 것이 예측 확률을 높일 수 있는 지 비교하였고, 최근 평균값을 적용하는 것이 범죄 발생 예측확률을 높일 수 있음을 확인하였다.

• Communications for Statistical Applications and Methods
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• 제24권6호
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• pp.561-581
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• 2017

Bayesian statistics can play a key role in the design and analysis of clinical trials and this has been demonstrated for medical device trials. By 1995 Bayesian statistics had been well developed and the revolution in computing powers and Markov chain Monte Carlo development made calculation of posterior distributions within computational reach. The Food and Drug Administration (FDA) initiative of Bayesian statistics in medical device clinical trials, which began almost 20 years ago, is reviewed in detail along with some of the key decisions that were made along the way. Both Bayesian hierarchical modeling using data from previous studies and Bayesian adaptive designs, usually with a non-informative prior, are discussed. The leveraging of prior study data has been accomplished through Bayesian hierarchical modeling. An enormous advantage of Bayesian adaptive designs is achieved when it is accompanied by modeling of the primary endpoint to produce the predictive posterior distribution. Simulations are crucial to providing the operating characteristics of the Bayesian design, especially for a complex adaptive design. The 2010 FDA Bayesian guidance for medical device trials addressed both approaches as well as exchangeability, Type I error, and sample size. Treatment response adaptive randomization using the famous extracorporeal membrane oxygenation example is discussed. An interesting real example of a Bayesian analysis using a failed trial with an interesting subgroup as prior information is presented. The implications of the likelihood principle are considered. A recent exciting area using Bayesian hierarchical modeling has been the pediatric extrapolation using adult data in clinical trials. Historical control information from previous trials is an underused area that lends itself easily to Bayesian methods. The future including recent trends, decision theoretic trials, Bayesian benefit-risk, virtual patients, and the appalling lack of penetration of Bayesian clinical trials in the medical literature are discussed.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.483-493
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• 2021

Background Direct-to-implant (DTI) breast reconstruction after nipple-sparing mastectomy (NSM) with the use of acellular dermal matrix (ADM) provides reliable outcomes; however, the use of ADM is associated with a higher risk of complications. We analyzed our experiences of post-NSM DTI without ADM and identified the predictive factors of adverse surgical outcomes. Methods Patients who underwent NSM and immediate DTI or two-stage tissue expander (TE) breast reconstruction from 2009 to 2020 were enrolled. Predictors of adverse endpoints were analyzed. Results There were 100 DTI and 29 TE reconstructions. The TE group had a higher rate of postmastectomy radiotherapy (31% vs. 11%; P=0.009), larger specimens (317.37±176.42 g vs. 272.08±126.33 g; P=0.047), larger implants (360.84±85.19 g vs. 298.83±81.13 g; P=0.004) and a higher implant/TE exposure ratio (10.3% vs. 1%; P=0.035). In DTI reconstruction, age over 50 years (odds ratio [OR], 5.43; 95% confidence interval [CI], 1.50-19.74; P=0.010) and a larger mastectomy weight (OR, 1.65; 95% CI, 1.08-2.51; P=0.021) were associated with a higher risk of acute complications. Intraoperative radiotherapy for the nipple-areolar complex increased the risk of acute complications (OR, 4.05; 95% CI, 1.07-15.27; P=0.039) and the likelihood of revision surgery (OR, 5.57; 95% CI, 1.25-24.93; P=0.025). Conclusions Immediate DTI breast reconstruction following NSM is feasible in Asian patients with smaller breasts.

• 대한간호학회지
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• 제34권8호
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• pp.1460-1467
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• 2004

Purpose. This study examined the predictive factors enabling access to children's oral health care at the level of financial barriers, beliefs, and the provider. Methods. In-depth interviews were conducted with 320 immigrant mothers of low-income families regarding their use of oral health services for children aged four to eight years old. Access to oral health care was measured with frequency of planned dental visits, continuity of care, and age at first visit to dentist. Results. The mother took her child to the dentist at a younger age if she received referrals to a dentist from pediatrician. Regular dental visits were significantly related to household income, provider availability on week-ends, and insurance coverage. The extended clinic hours in the evenings, and the belief in the importance of the child's regular dentist visits increased the likelihood of continuing care. The mothers perceiving a cost burden for the child's dental care were also less likely to return to the dentist. Conclusion. The available care delivery system, coordinated medical care, and health beliefs were among important predictors of the health service use. The study findings suggest need for culturally competent dental health interventions to enhance access to oral health care among particularly vulnerable populations such as low-income children in Korean communities.

• Ocean Science Journal
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• 제42권2호
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• pp.69-79
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• 2007

A vertical transect with 4 km length was established for the macrofaunal survey on the Chokchon macrotidal flat in Kyeonggi Bay, Incheon, Korea, 1994. Tidal elevation (m) and sediment mean grain size $(\phi)$ were inversely predicted by the transfer functions from the faunal assemblages. Three methods: weighted average using optimum value (WA), tolerance weighted version of the weighted average (WAT) and maximum likelihood calibration (MLC) were employed. Estimates of tidal elevation and mean grain size obtained by using the three different methods showed positively corresponding trends with the observations. The estimates of MLC were found to have the minimum value of sum of squares due to errors (SSE). When applied to the previous data $(1990\sim1992)$, each of three inference models exhibited high predictive power. This result implied there are visible relationships between species composition and faunas' critical environmental factors. Although a potential significance of the two major abiotic factors was re-affirmed, a weak tendency of biological interaction was detected from faunal distribution patterns across the flat. In comparison to the spatial and temporal patterns of the estimates, it was suggested that sediment characteristics were the primary factors regulating the distribution of macrofaunal assemblages, rather than tidal elevation, and the species composition may be sensitively determined by minute changes in substratum properties on a tidal flat.

• Journal of the Korean Data and Information Science Society
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• 제10권2호
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• pp.369-385
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• 1999

성장곡선모형에서 다중 이상값들이나 영향관측값들을 탐지하는 문제는 선형회귀모형에서의 문제에 비해 매우 복잡하여 거의 이루어지지 않고 있는 실정이다. 본 연구에서는 이상점을 포함하고 있는 성장곡선모형에서 이들을 탐지하는 방법으로 평균이동모형을 이용하는 방법을 소개하였다. 이 방법을 이용하여 찾아낸 자료가 이상점인지의 여부를 예측표본재이용 의사 베이즈 우도 기준법을 이용한 등분산성의 검정을 통해 알아보았다. 끝으로 Potthoff(1964)등이 사용한 자료를 이용한 예제를 통해 이상점 탐지와 등분 산성 검정을 실시한 결과를 제시하였다.

• 응용통계연구
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• 제11권2호
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• pp.377-387
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• 1998

컴퓨터의 발전에 따른 마코브체인 몬테카를로방법을 소프트웨어 신뢰확률모형에 이용하였다. 베이지안 추론에서 조건부분포를 가지고 사후분포를 결정하는데 있어서의 계산문제와 이론적인 정당성을 고려, 마코프연쇄와 메트로폴리스방법의 관계를 고찰하였으며, 특히 Mus-Okumoto와 Erlang(2)의 중첩모형에 대하여 깁스샘플링 알고리즘과 메트로폴리스 알고리즘을 활용하며 베이지안 계산과 예측 우도기준에 의 한 모형선택을 제안하고 Cox-Lewis에 의해 계시된 Thing method를 이용한 모의실험자료를 이용하여 수치적인 계산을 시행하고 그 결과가 제시되었다.

• 한국임상수의학회지
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• 제32권4호
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• pp.319-323
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• 2015

The performance of diagnostic test accuracy is usually summarized by a variety of statistics such as sensitivity, specificity, predictive value, likelihood ratio, and kappa. These indices are most commonly presented when evaluations of competing diagnostic tests are reported, and it is of utmost importance to compare the accuracies of diagnostic tests to decide on the best available test for certain medical disorder. However, it is important to emphasize that specific point values of these indices are merely estimates. If parameter estimates are reported without a measure of uncertainty (precision), knowledgeable readers cannot know the range within which the true values of the indices are likely to lie. Therefore, when evaluations of diagnostic accuracy are reported the precision of estimates should be stated in parallel. To reflect the precision of any estimate of a diagnostic performance characteristic or of the difference between performance characteristics, the computation of confidential interval (CI), an indicator of precision, is widely used in medical literatures in that CIs are more informative to interpret test results than the simple point estimates. The majority of peer-reviewed journals usually require CIs to be specified for descriptive estimates, whereas domestic veterinary journals seem less vigilant on this issues. This paper describes how to calculate the indices and associated CIs using practical examples when assessing diagnostic test performance.