• Title/Summary/Keyword: risk scoring

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Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis

  • Lee, Kangho;Ryu, Dongyeon;Kim, Hohyun;Jeon, Chang Ho;Kim, Jae Hun;Park, Chan Yong;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.25-33
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    • 2022
  • Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

Assessment of Prognosis and Risk Stratification in Coronary Artery Disease (관상동맥질환의 예후 및 위험도 평가)

  • Lim, Seok-Tae
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.3
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    • pp.222-228
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    • 2009
  • Risk stratification and assessment of prognosis in patients with known or suspected CAD is of crucial important for the practice of contemporary medicine. Noninvasive testing such as myocardial perfusion scintigraphy, coronary artery calcium scoring or CT coronary angiography is increasingly being used to determine the need for aggressive medical therapy and to select patients for catheterization. The integrated anatomic and functional information may provide more additional information for the cardiologist or other clinician by the improved risk stratification and diagnostic accuracy of integrated techniques. The development of SPECT/CT or PET/CT hybrid systems is therefore of important value for the nuclear cardiology.

The application of simplified risk assessment for tunnel (터널 리스크 평가 기법의 적용성에 대한 연구)

  • Kim, Sang-Hwan;Lee, Chung-Hwan
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.9 no.1
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    • pp.63-74
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    • 2007
  • Unexpected ground conditions have always been a major problem for the construction of tunnel. Therefore, it is necessary to evaluate the risk capacity before and/or during construction of new tunnel. This paper presents the simplified risk assessment system using modified stability number (N), namely Underground Risk Index (URI) system, to evaluate the tunnel risk possibility in the design stage. URI is a scoring system for risk possibility by rating the each appraisal elements. The modified stability number (N) which is one of risk factor in the Interaction Matrix parameters such as RQD, UCS, weathering, overburden, stability number, ground water-table, RMR, permeability and so on, is used in the system. In addition, the case study is performed in order to verify the applicability of URI-system in practice.

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A Risk Prediction Model for Operative Mortality after Heart Valve Surgery in a Korean Cohort

  • Kim, Ho Jin;Kim, Joon Bum;Kim, Seon-Ok;Yun, Sung-Cheol;Lee, Sak;Lim, Cheong;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan;Lee, Seung Hyun;Yoo, Jae Suk;Sung, Kiick;Je, Hyung Gon;Hong, Soon Chang;Kim, Yun Jung;Kim, Sung-Hyun;Chang, Byung-Chul
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.88-98
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    • 2021
  • Background: This study aimed to develop a new risk prediction model for operative mortality in a Korean cohort undergoing heart valve surgery using the Korea Heart Valve Surgery Registry (KHVSR) database. Methods: We analyzed data from 4,742 patients registered in the KHVSR who underwent heart valve surgery at 9 institutions between 2017 and 2018. A risk prediction model was developed for operative mortality, defined as death within 30 days after surgery or during the same hospitalization. A statistical model was generated with a scoring system by multiple logistic regression analyses. The performance of the model was evaluated by its discrimination and calibration abilities. Results: Operative mortality occurred in 142 patients. The final regression models identified 13 risk variables. The risk prediction model showed good discrimination, with a c-statistic of 0.805 and calibration with Hosmer-Lemeshow goodness-of-fit p-value of 0.630. The risk scores ranged from -1 to 15, and were associated with an increase in predicted mortality. The predicted mortality across the risk scores ranged from 0.3% to 80.6%. Conclusion: This risk prediction model using a scoring system specific to heart valve surgery was developed from the KHVSR database. The risk prediction model showed that operative mortality could be predicted well in a Korean cohort.

An Economic Evaluation of FMS Considering the Safety and Flexibility Factors (FMS에서 유연성과 안전성 요인을 고려한 경제성 평가)

  • 강영식;함효준
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.22 no.51
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    • pp.63-72
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    • 1999
  • Many firms have applied flexible manufacturing systems as a means of increasing productivity, profitability, and quality. Therefore, the purpose of this paper is to develop the more efficient justification model through an analytical scoring model with the quantitative factors, flexibility factors, and safety factors under uncertainty. In this paper, the three factors for properly comparing and evaluating of flexible manufacturing systems are presented. Especially, this paper has emphasized the flexibility and safety factor; the one consists of organization assessment, process treatment function, products and products quantity, useful life assesment, and software function, the other presents risk assesment, Y2K problem, safety device analysis, total productive management system, safety management. Finally, a normalized scoring model by the new flexibility and safety factors can be used in real fields for flexible manufacturing systems project selection under uncertainty.

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An Ensemble Model for Credit Default Discrimination: Incorporating BERT-based NLP and Transformer

  • Sophot Ky;Ju-Hong Lee
    • Proceedings of the Korea Information Processing Society Conference
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    • 2023.05a
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    • pp.624-626
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    • 2023
  • Credit scoring is a technique used by financial institutions to assess the creditworthiness of potential borrowers. This involves evaluating a borrower's credit history to predict the likelihood of defaulting on a loan. This paper presents an ensemble of two Transformer based models within a framework for discriminating the default risk of loan applications in the field of credit scoring. The first model is FinBERT, a pretrained NLP model to analyze sentiment of financial text. The second model is FT-Transformer, a simple adaptation of the Transformer architecture for the tabular domain. Both models are trained on the same underlying data set, with the only difference being the representation of the data. This multi-modal approach allows us to leverage the unique capabilities of each model and potentially uncover insights that may not be apparent when using a single model alone. We compare our model with two famous ensemble-based models, Random Forest and Extreme Gradient Boosting.

Targetoid Primary Liver Malignancy in Chronic Liver Disease: Prediction of Postoperative Survival Using Preoperative MRI Findings and Clinical Factors

  • So Hyun Park;Subin Heo;Bohyun Kim;Jungbok Lee;Ho Joong Choi;Pil Soo Sung;Joon-Il Choi
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.190-203
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    • 2023
  • Objective: We aimed to assess and validate the radiologic and clinical factors that were associated with recurrence and survival after curative surgery for heterogeneous targetoid primary liver malignancies in patients with chronic liver disease and to develop scoring systems for risk stratification. Materials and Methods: This multicenter retrospective study included 197 consecutive patients with chronic liver disease who had a single targetoid primary liver malignancy (142 hepatocellular carcinomas, 37 cholangiocarcinomas, 17 combined hepatocellular carcinoma-cholangiocarcinomas, and one neuroendocrine carcinoma) identified on preoperative gadoxetic acid-enhanced MRI and subsequently surgically removed between 2010 and 2017. Of these, 120 patients constituted the development cohort, and 77 patients from separate institution served as an external validation cohort. Factors associated with recurrence-free survival (RFS) and overall survival (OS) were identified using a Cox proportional hazards analysis, and risk scores were developed. The discriminatory power of the risk scores in the external validation cohort was evaluated using the Harrell C-index. The Kaplan-Meier curves were used to estimate RFS and OS for the different risk-score groups. Results: In RFS model 1, which eliminated features exclusively accessible on the hepatobiliary phase (HBP), tumor size of 2-5 cm or > 5 cm, and thin-rim arterial phase hyperenhancement (APHE) were included. In RFS model 2, tumors with a size of > 5 cm, tumor in vein (TIV), and HBP hypointense nodules without APHE were included. The OS model included a tumor size of > 5 cm, thin-rim APHE, TIV, and tumor vascular involvement other than TIV. The risk scores of the models showed good discriminatory performance in the external validation set (C-index, 0.62-0.76). The scoring system categorized the patients into three risk groups: favorable, intermediate, and poor, each with a distinct survival outcome (all log-rank p < 0.05). Conclusion: Risk scores based on rim arterial enhancement pattern, tumor size, HBP findings, and radiologic vascular invasion status may help predict postoperative RFS and OS in patients with targetoid primary liver malignancies.

Predictive Factors of Methicillin-Resistant Staphylococcus aureus Infection in Elderly Patients with Community-Onset Pneumonia

  • Jwa, Hyeyoung;Beom, Jong Wook;Lee, Jong Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.2
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    • pp.201-209
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    • 2017
  • Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. Methods: This study was retrospectively conducted in elderly patients aged ${\geq}65years$, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014. We analyzed the risk factors of MRSA in these patients and developed a scoring system to predict MRSA infection. Results: A total of 762 patients were enrolled in this study, including 19 (2.4%) with MRSA infection. Healthcare-associated pneumonia (HCAP) showed more frequent MRSA infection compared to community-acquired pneumonia (4.4% vs. 1.5%, respectively; p=0.016). In a multivariate logistic regression analysis, admissions during the influenza season (odds ratio [OR], 2.896; 95% confidence interval [CI], 1.022-8.202; p=0.045), chronic kidney disease (OR, 3.555; 95% CI, 1.157-10.926; p=0.027), and intensive care unit admission (OR, 3.385; 95% CI, 1.035-11.075; p=0.044) were identified as predictive factors for MRSA infection. However, the presence of HCAP was not significantly associated with MRSA infection (OR, 1.991; 95% CI, 0.720-5.505; p=0.185). The scoring system consisted of three variables based on the multivariate analysis, and showed moderately accurate diagnostic prediction (area under curve, 0.790; 95% CI, 0.680-0.899; p<0.001). Conclusion: MRSA infection would be considered in elderly CO-pneumonia patients, with three risk factors identified herein. When managing elderly patients with pneumonia, clinicians might keep in mind that these risk factors are associated with MRSA infection, which may help in selecting appropriate antibiotics.

Assessment of DNA Ploidy Patterns in Connection with Prognostic Factors in Patients with Papillary Thyroid Carcinoma (유두상 갑상선암에서 예후인자와 DNA배수성의 상관관계)

  • Chung Woung-Youn;Lee Jong-Hoon;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.153-160
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    • 1996
  • Regardless of the prognostic factors in papillary thyroid cancer, such as sex, age, size of tumor, extent of disease, and distant metastasis, the prognosis of papillary thyroid cancer is sometimes difficult to predict from clinical and microscopic analysis alone and additional prognostic indicators are needed. Recent studies of thyroid cancer have indicated that DNA aneuploidy may be correlated to the biological behavior of malignancy and inversely correlated to the prognosis, but it still remains contraversal. We performed this study to assess DNA ploidy patterns in relation with the previously known prognostic factors in AMES scoring system and lateral neck node metastasis in papillary thyroid cancer. A series of 132 patients with papillary thyroid cancer and 80 patients with benign thyroid tumor(27 follicular adenomas and 53 adenomatous goiters) as a control group from October 1993 to Feburary 1995 were analyzed and their nuclear DNA content was measured with flow cytometry using fresh tissue specimens. DNA aneuploidy was found in 8(6.1%) in papillary cancer and 8(10%) in benign tumor. S-phase traction(SFP) and proliferative index(PI) were higher in thyroid cancers, being 2.18$\pm$4.24%, 6.34$\pm$4.94% in the papillary thyroid cancers and 1.97$\pm$2.93%, 4.44$\pm$3.80% in the benign tumors, respectively. However there was no significant difference of values between two groups(p>0.05). Among variable prognostic factors studied(age, sex, size of tun or, extent of disease, distant metastasis in AMES scoring system and lateral neck node metastasis), DNA aneuploidy was found to be common in distant metastasis(p<0.001) and in lateral neck node metastasis(p>0.035), but there was no significant difference between the high risk and low risk group according to the AMES scoring system(p<0.08). In our study, DNA aneuploidy was not valuable in determining the presence of malignancy and did not correlate to the AMES scoring system. However, follow-up study of more cases will be needed for accurate information about the DNA ploidy as a independent prognostic factor.

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Assessment factors for the Selection of Priority Soil Contaminants based on the Comparative Analysis of Chemical Ranking and Scoring Systems (국내.외 Chemical Ranking and Scoring 체계 비교분석을 통한 우선순위 토양오염물질 선정을 위한 평가인자 도출)

  • An, Youn-Joo;Jeong, Seung-Woo;Kim, Tae-Seung;Lee, Woo-Mi;Nam, Sun-Hwa;Baek, Yong-Wook
    • Journal of Soil and Groundwater Environment
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    • v.13 no.6
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    • pp.62-71
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    • 2008
  • Soil quality standards (SQS) are necessary to protect the human health and soil biota from the exposure to soil pollutants. The current SQS in Korea contain only sixteen substances, and it is scheduled to expand the number of substances. Chemical ranking and scoring (CRS) system is very effective to screen the priority chemicals for the future SQS in terms of their toxicity and exposure potential. In this study, several CRS systems were extensively compared to propose the assessment factors that required for the screening of soil pollutants 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), CRSKorea, and other systems. The additional assessment factors of CRS suitable for soil pollutants were suggested. We suggest soil adsorption factor as an appropriate factor of CRS system to consider chemical transport from soil to groundwater. Other factors such as soil emission rate and cases of accident of soil pollutants were included. These results were reflected to screen the priority chemicals in Korea, as a part of the project entitled ‘Setting the Priority of Soil Contaminants'.