• Asian Pacific Journal of Cancer Prevention
• /
• 제16권6호
• /
• pp.2441-2445
• /
• 2015

Background: Several risk factors leading to malignant transformation of hydatidiform moles have been described previously. Many studies showed that prophylactic chemotherapy for high risk hydatidiform moles could significantly decrease the incidence of malignancy. Thus, it is essential to discover a breakthrough to determine patients with high risk malignancy so that prophylactic chemotherapy can be started as soon as possible. Objectives: Development of a scoring system of risk factors as a predictor of hydatidiform mole malignant transformation. Materials and Methods: This research is a case control study with hydatidiform mole and choriocarcinoma patients as subjects. Multiple logistic regression was used to analyze the data. Odds ratios (OR), attributable at risk (AR : OR-1) and risk index ($ARx{\beta}$) were calculated for develoipment of a scoring system of malignancy risk. The optimal cut-off point was determined using receiver operating characteristic (ROC) curve. Results: This study analyzed 34 choriocarcinoma cases and 68 benign hydatidiform mole cases. Four factors significantly increased the risk of malignancy, namely age ${\geq}35$ years old (OR:4.41, 95%CI:1.07-16.09, risk index 5); gestational age ${\geq}$ 12weeks (OR:11.7, 95%CI:1.8-72.4, risk index 26); uterine size greater than the gestational age (OR:10.2, 95%CI:2.8-36.6, risk index 21); and histopathological grade II-III (OR:3.4, 95%CI:1.1-10.6, risk index 3). The lowest and the highest scores for the risk factors were zero and 55, respectively. The best cut-off point to decide high risk malignancy patients was ${\geq}31$. Conclusions: Malignant transformation of hydatidiform moles can be predicted using the risk scoring by analyzing the above four parameters. Score ${\geq}31$ implies high risk patients so that prophylactic chemotherapy can be promptly administered for prevention.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권11호
• /
• pp.6327-6330
• /
• 2013

Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross-sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low r isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.

• Journal of Chest Surgery
• /
• 제57권3호
• /
• pp.302-311
• /
• 2024

Background: Unexpected conversion to thoracotomy during planned video-assisted thoracoscopic surgery (VATS) can lead to poor outcomes and comparatively high morbidity. This study was conducted to assess preoperative risk factors associated with unexpected thoracotomy conversion and to develop a risk scoring model for preoperative use, aimed at identifying patients with an elevated risk of conversion. Methods: A retrospective analysis was conducted of 1,506 patients who underwent surgical resection for non-small cell lung cancer. To evaluate the risk factors, univariate analysis and logistic regression were performed. A risk scoring model was established to predict unexpected thoracotomy conversion during VATS of the lung, based on preoperative factors. To validate the model, an additional cohort of 878 patients was analyzed. Results: Among the potentially significant clinical variables, male sex, previous ipsilateral lung surgery, preoperative detection of calcified lymph nodes, and clinical T stage were identified as independent risk factors for unplanned conversion to thoracotomy. A 6-point risk scoring model was developed to predict conversion based on the assessed risk, with patients categorized into 4 groups. The results indicated an area under the receiver operating characteristic curve of 0.747, with a sensitivity of 80.5%, specificity of 56.4%, positive predictive value of 1.8%, and negative predictive value of 91.0%. When applied to the validation cohort, the model exhibited good predictive accuracy. Conclusion: We successfully developed and validated a risk scoring model for preoperative use that can predict the likelihood of unplanned conversion to thoracotomy during VATS of the lung.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권3호
• /
• pp.1643-1647
• /
• 2013

Background: To identify the risk factors and assess the role of survivin in predicting progessivity precancerous cervical lesions. Materials and Methods: This case-control study was conducted from October 2009 until May 2010. We obtained 74 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 19 samples for CIN 1, 18 samples for CIN 2, 18 samples for CIN 3, and 19 samples as controls. Demographic profiles and risk factors assesment, histopathologic examination, HPV DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples. Data was analyzed with bivariate and multivariate analysis. Results: Multivariate analysis revealed significant risk factors for developing precancerous cervical lesions are age <41 years, women with ${\geq}2$ sexual partners, course of education ${\geq}13$ years, use of oral contraceptives, positive high-risk HPV DNA, and high survivin expression by ICC or IHC staining. These factors were fit to a prediction model and we obtained a scoring system to predict the progressivity of CIN lesions. Conclusions: Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of CIN lesions. Application of this scoring system may be beneficial in determining the action of therapy towards the patient.

• Journal of Korean Neurosurgical Society
• /
• 제62권6호
• /
• pp.643-648
• /
• 2019

Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

• 응용통계연구
• /
• 제22권3호
• /
• pp.489-498
• /
• 2009

언더라이팅은 보험자가 청약자에 대한 인수여부를 결정하는 보험계약 운영의 초기단계로서, 그 기준의 정교성 여부에 따라 회사에 안정적인 수익을 가져올 수도 있고 예기치 못한 큰 손실을 야기할 수도 있다. 일반적으로, 각 청약자의 위험요소를 파악, 평가하여 위험정도를 평가할 수 있는 점수를 이용하는 스코어링 시스템을 언더라이팅 기준으로 이용하는데, 점수를 산출하기 위한 방법은 각 위험요소별 점수 기준을 설정하고 위험요소별 점수를 합산하는 형태가 보편적이다. 최근 위험율차 이익의 중요성이 강조됨에 따라 기존의 방법에 비해 보다 효과적인 언더라이팅 기법이 요구되고 있다. 본 연구에서는 일반화 선형모형을 이용하여 보다 합리적으로 보험 계약자에 대한 위험도를 추정하는 방법을 제시하였다. 실증분석을 통해 위험집단의 위험도를 평가하고 점수화하는 구체적인 언더라이팅 모형을 설계하였고, 제시된 언더라이팅 모형의 적용효과를 반영하여 언더라이팅 기준을 설정하는 방법에 대해서도 설명하였다.

• Journal of the Korean Data and Information Science Society
• /
• 제24권1호
• /
• pp.85-94
• /
• 2013

금융시장의 규모가 점점 더 커짐에 따라 고객정보 관리 미숙 또는 부실한 의사결정, 즉 신용 리스크 관리 실패로 인한 손실이 막대하게 증가하고 있다. 따라서 신용 리스크 관리가 점차 더 중요해지고, 이런 신용 리스크를 최소화하는 기본적인 도구인 신용 평점 모형이 절실히 요구된다. 신용평점 모형은 주로 이항형 목표변수만 이용하여 개발 연구되었다. 본 논문에서는 순서형 다항 자료 또는 경시적 이항 자료 같은 다른 형태의 목표 변수를 고려한 신용평점 모형구축 방법을 제시한다. 그 개발된 모형을 실제 자료와 랜덤화한 자료에 적용하여 Kolmogorov-Smirnov 통계량으로 비교 분석한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권16호
• /
• pp.6819-6822
• /
• 2014

Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

• Environmental Analysis Health and Toxicology
• /
• 제24권2호
• /
• pp.95-105
• /
• 2009

Chemical Ranking and Scoring (CRS) system is a useful tool to screen priority chemicals of large body of substances. The relative ranking of chemicals based on CRS system has served as a decision-making support tools. Exposure potential and toxicity are significant parameters in CRS system, and there are differences in evaluating those parameters in each CRS system. In this study, the parameters of exposure potential, human toxicity, and ecotoxicity were extensively compared. In addition the scoring methods in each parameter were analyzed. The CRS systems considered in this study include the CHEMS-1 (Chemical Hazard Evaluation for Management Strategies), SCRAM (Scoring and Ranking Assessment Model), EURAM (European Union Risk Ranking Method), ARET (Accelerated Reduction/Elimination of Toxics), and CRS-Korea. An comparative analysis of the several CRS systems is presented based on their assessment parameters and scoring methods.

• 대한토목학회논문집
• /
• 제37권1호
• /
• pp.175-185
• /
• 2017

가스 사용의 지속적인 증대로 이에 따른 가스의 제조, 취급, 사용이 점점 확대되어 관련 시설이 대형화, 복잡화되어, 이로 인한 크고 작은 사고가 지속적으로 발생하고 있다. 이러한 사고는 인명피해 및 물적 손실 뿐만 아니라 국가의 경제적인 손실의 큰 원인이 된다. 가스시설의 공통적으로 많은 부분을 차지하고 있는 Pipe Line 부분에 외부의 영향에 의한 사고가 가장 큰 위험요소를 가지고 있다. 특히, 도심지역 및 인구밀집지역의 경우의 고압가스배관의 사고 발생은 경제적 손실을 비롯한 보다 많은 손실을 야기시킬 수 있다. 이러한 매설배관의 사고에 대한 예방대책으로 여러 관련 기관에서는 가스배관에 대한 안전성을 확보하기 위해서는 전체 시스템의 파손 및 위험요소를 효과적으로 평가할 필요가 있다. 특히 가스배관이 설치되거나 작동되어 질 때에 이러한 파손(failure)의 가능성을 매우 작게 하더라도 위험요소가 존재하게 된다. 그러나 일단 파손이 발생하면 인명 및 재산상의 피해가 매우 크기 때문에 파손의 원인을 분석하여 파손사고의 비율을 최소한으로 낮추는 것이 필요하다. 그러므로 본 논문에서는 Scoring Model의 정성적 위험성 분석기법을 이용하여 매설배관의 위험성을 점수로 표현하여 정량적인 숫자로 표현하였다. 이러한 가시적인 평가의 결과는 매설배관의 안전을 확보하여 실질적인 매설배관의 유지관리를 하는데 있어서 매우 효율적으로 적용될 수 있을 것이다.