• Title/Summary/Keyword: screening assessment

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Cost-effectiveness Analysis of Cervical Cancer Screening Strategies Based on the Papanicolaou Smear Test in Korea

  • Ko, Min Jung;Kim, Jimin;Kim, Younhee;Lee, Yoon Jae;Hong, Sung Ran;Lee, Jae Kwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2317-2322
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    • 2015
  • Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.

Validation of the Korean Version of the Standardized Swallowing Assessment and the National Institute of Health Stroke Scale Among Acute Stroke Patients

  • Yun, Sukkyung;Kim, Hyemin;Mo, Eunji;Kim, Mingyeong;Kim, Minji;Gil, Chorong;Chang, HeeKyung
    • International Journal of Advanced Culture Technology
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    • v.6 no.4
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    • pp.124-130
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    • 2018
  • Proper management and prevention of dysphagia are urgently needed in acute care of stroke patients in Korea. However, no highly sensitive and accessible nurse-led screening tools have been validated within the Korean settings. The purpose of this study was to validate a screening tool led by nurses to identify dysphagia and aspiration risks among acute stroke patients. Registered nurses (RNs) screened 131 residents from a university hospital in South Korea using the Korean version of the Standardized Swallowing Assessment (K-SSA). Results were validated against those from the Gugging Swallowing Screen (GUSS). Compared to results from the GUSS, with 9- and 14-point cutoffs, the K-SSA had a sensitivity of 0.80 and specificity of 0.90 [95% CI 0.806, 0.992] for screening dysphagia and 1.00 sensitivity and 0.94 specificity [95% CI 0.862, 1.000] for screening aspiration risks. The K-SSA demonstrated excellent sensitivity and specificity for screening individuals at risk of dysphagia and aspiration when led by RNs for acute stroke patients.

Design of Screening Inspection Procedures Based on Guard Bands Considering Measurement Errors (측정오류를 고려한 가드밴드 기반 스크리닝 검사방식의 설계)

  • Kim, Young Jin
    • Journal of Korean Society for Quality Management
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    • v.41 no.4
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    • pp.673-681
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    • 2013
  • Purpose: The purpose of this study is to investigate the design optimization modeling of screening procedures based on the assessment of misclassification errors. Methods: Misclassification errors due to measurement variability are derived for normally distributed quality characteristics. Further, an optimization model for ensuring the level of outgoing quality is proposed and demonstrated through an illustrative example. Results: It is shown that two types of misclassification errors (i.e., false acceptance and false rejection) may be properly compromised through an analytical assessment of measurement errors and an optimization modeling. It is also discussed that a variety of optimization modeling may be enabled based on the derivation of measurement errors. Conclusion: It may be concluded that the design of screening inspection may further be facilitated by including the effect of measurement errors on the performance of screening inspection procedure.

Simple priority setting method for Screening in public health assessment of waste incineration facilities (폐기물 소각시설 주변 환경보건평가 중 스크리닝 단계에서의 우선순위 선정기법에 관한 연구)

  • Kim, Gi Young;Hong, Seung Cheol
    • Journal of Environmental Impact Assessment
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    • v.21 no.5
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    • pp.813-821
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    • 2012
  • Environmental and public health concern for the emission of air pollutants from burn-up process in waste incineration plants located in the vicinity of living environment was increased during the past decade. The purpose of this study was to suggest of the simple and rapid method of priority setting model for the decision of full-scale public health assessment. This method was consists of total 5-step. Step 1 was "secure the satellite map" and we can use the satellite map which serves from the website such as NAVER Co. Step 2 was "drawing mesh on the map" for catch the point of occupation of environmental sensitivity facilities, and step 3 was "identification and sorting of the facilities", Step 4 was "setting of weight" using the "weighted linear combination (WLC) method". Finally, all facility was sorted by score. As a result, we can set a priority of 145 facilities based on 177 facilities which managed in local government. Facilities in Seoul metropolitan area was high rank in priority list. On the other side, Facilities located at the country or rural area was low rank because of low occupation of the house and the environmental sensitivity facilities such as kindergarten, elementary school, and hospital. In this study, we suggested simple and rapid method that using for screening procedure of public health assessment.

Analysis on the Risk-Based Screening Levels Determined by Various Risk Assessment Tools (I): Variability from Different Analyses of Cross-Media Transfer Rates (다양한 위해성평가 방법에 따라 도출한 오염토양 선별기준의 차이에 관한 연구 (I): 매체 간 이동현상 해석에 따른 차이)

  • Jung, Jae-Woong;Ryu, Hye-Rim;Nam, Kyoung-Phile
    • Journal of Soil and Groundwater Environment
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    • v.16 no.2
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    • pp.12-29
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    • 2011
  • Risk-based screening levels (RBSLs) of some pollutants for residential adults were derived with risk assessment tools developed by United States Environmental Protection Agency (USEPA), American Society for Testing and Materials (ASTM), and Korea Ministry of Environment (KMOE) and compared each other. To make the comparison simple, ingestion of soil, dermal contact with soil, outdoor inhalation of vapors, indoor inhalation of vapors, and inhalation of soil particulates were chosen as exposure pathways. The results showed that the derived RBSLs varied for every exposure pathway. For direct exposure pathways (i.e., ingestion of soil and dermal contact with soil), the derived RBSLs varied mainly due to the different default values for exposure factors and toxicity data. When identical default values for the parameters were used, the same RBSLs could be derived regardless of the assessment tools used. For inhalation of vapors and inhalation of soil particulates, however, different analysis methods for cross-media transfer rates were used and different assumptions were established for each tool, identical RBSLs could not be obtained even if the same default values for exposure factors were used. Especially for inhalation of soil particulates pathway, screening level derived using KMOE approach (most conservative) was approximately 5000~10000 times lower than the screening level derived using ASTM approach (least conservative). Our results suggest that, when deriving RBSL using a specific tool, it is a prerequisite to technically review the analysis methods for cross-media transfer rates as well as to understand how the assessment tool derives the default values for exposure factors.

The study of development on CFT(Cognitive Function Test) in mild cognitive impairment (경도인지장애 대상자의 인지기능평가도구(CFT) 개발 연구)

  • Lee, Seon-Myeong;Ju, Eun-U;Song, Jin-Seok;Park, Sin-Jun;Kim, Heon-Mo;Jeong, Eun-Seung;Im, Chae-Ho;Son, Seong-Min;Ha, Hye-Jeong
    • Journal of Korean Clinical Health Science
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    • v.8 no.2
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    • pp.1426-1435
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    • 2020
  • Objective: This study aims to develop CFT, a screening test for dementia that can be conducted on patients with mild cognitive impairment or early dementia. Methods: This study was conducted on therapists working at occupational therapy hospital in Gyeongsangnam-do. The data collection period is two months from July to September 2020, and the research participants were briefed on the purpose, significance, and anonymity of the research in consideration of ethical issues. A total of 33 copies of the data were finally analyzed, excluding those containing insufficient answers and errors, by distributing 40 copies of the data. SPSS Data Access pack 8.0 was used for data analysis, Cronbach's α value was evaluated for internal consistency reliability of each item, and Pearson Correlation coeffient between the lower scales of the assessment tool was measured. Results: The Cronbach's α value of the CFT was shown as .892 and the reliability of the assessment paper was shown to be quite high. The Cronbach's α value for each item in the cognitive assessment tool was the highest at .899 in the subtraction item, with exercise control (mook Chi Pa) at 888, visual memory, plus .887. The correlation of each item of cognitive assessment tools was found to be most correlated with the number of sustained concentrates and word2 to .934; in the stop word-numeric item and visual memory to be .85; and in the addition to the auditory memory item .739. Conclusion: Therefore, this study developed cognitive evaluation tools that can distinguish the diversity and cognitive level of screening tests and clarify standards, which are different from the existing dementia screening tools in Korea. Furthermore, the cognitive assessment tools of this study can be verified by applying them to patients with mild cognitive impairment and early dementia, and the criteria for generalization can be established.

A Study on the Priority for the Hazard and Risk Evaluation of Chemicals (HREC) According to the Industrial Safety and Health Act (ISHA) (산업안전보건법 상 관리수준 검토를 위한 화학물질 유해성.위험성 평가대상 후보물질 선정에 관한 연구)

  • Yang, Jeong Sun;Lim, Cheol Hong;Park, Sang Young
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.22 no.1
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    • pp.73-81
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    • 2012
  • Object: The aim of this study is to suggest a list of priority chemicals for the Hazard & Risk Evaluation of Chemicals (HREC) controlled by the Industrial Safety and Health Act (ISHA). Method: Screening assessment was done for 642 chemicals whose exposure threshold limit values were set by the Ministry of Employment and Labor (MOEL). Hazard data were collected from Korea Occupational Safety & Health Agency (KOSHA) and/or other toxicity database. Exposure data were obtained from KOSHA internal database. The hazard and exposure scores of chemicals were listed by order of priority in accordance with GHS classification and exposure index data. Result: From the result of screening risk assessment for 642 chemicals, we extracted a list of 13 priority chemicals for HREC performed by the ISHA. A priority list of 27 chemicals which have carcinogen, mutagen and/or reproductive toxicity but not controlled by the ISHA was suggested for additional evaluation as "chemicals for special management".

Value of Nutritional Screening Tools Versus Anthropometric Measurements in Evaluating Nutritional Status of Children in a Low/Middle-Income Country

  • Shaimaa Sayed;Mortada H. F. El-Shabrawi ;Eman Abdelmonaem ;Nehal El Koofy;Sara Tarek
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.26 no.4
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    • pp.213-223
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    • 2023
  • Purpose: Pediatric patients in low-income countries are at a high risk of malnutrition. Numerous screening tools have been developed to detect the risk of malnutrition, including the Subjective Global Nutritional Assessment (SGNA), Pediatric Yorkhill Malnutrition Score (PYMS), Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP), and Screening Tool for Risk of Nutritional Status and Growth (STRONGkids). However, anthropometry remains the main tool for assessing malnutrition. We aimed to identify the value of four nutritional screening tools versus anthropometry for evaluating the nutritional status of children. Methods: We conducted a cross-sectional study of 1,000 children aged 1-12 years who visited the outpatient clinic of Cairo University Pediatric Hospital. Each participant was evaluated using anthropometric measurements (weight, length/height, and weight for length/height) as well as the PYMS, STAMP, STRONGkids, and SGNA screening tools. The sensitivities and specificities of these four tools were assessed using anthropometry as the gold standard. Results: Of the patients, 1.7% were underweight, 10.2% were wasted, and 35% were stunted. STRONGkids demonstrated the highest sensitivity (79.4%) and a high specificity (80.2%) for detecting malnutrition compared with weight for height, followed by STAMP, which demonstrated lower sensitivity (73.5%) but higher specificity (81.4%). PYMS demonstrated the lowest sensitivity (66.7%) and the highest specificity (93.5%), whereas SAGA demonstrated higher sensitivity (77.5%) and lower specificity (85.4%) than PYMS. Conclusion: The use of nutritional screening tools to evaluate the nutritional status of children is valuable and recommended as a simple and rapid method for identifying the risk of malnutrition in pediatric patients.

Risk Factors and Early Screening Behavior for Breast Cancer in Rural Women (일 지역 여성의 유방암 위험요인과 유방암 조기검진 행위 분포)

  • Hur, Hea-Kung;Park, So-Mi;Kim, Gi-Yon
    • Women's Health Nursing
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    • v.11 no.1
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    • pp.46-51
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    • 2005
  • Purpose: The aim of this study was to identify risk factors for breast cancer and early screening behavior in women in the community. Method: The participants were 125 women residing in W city. Data was collected using an instrument developed by the researchers. Analysis was done using descriptive statistics, and the $x^2$ test. Result: For risk based on the Gail Model, age (above 50 years) had a distribution of 24.8%, first degree family history, 4.9%, age at first full term pregnancy, 13.8%, and benign breast cancer history, 4.9%. For risk based on other common risk factors, menopause had a distribution of 20.7%, did not breast feed, 15.4%, history of HRT, 7.3%, meat preference, 35.0%, and history of smoking or drinking, 2.4% and 43.5%, respectively. There was a significant difference in BSE and mammography screening behavior ($x^2=22.5$, p<.00), but no difference in distribution of risk factors and screening behavior. Conclusion: For effective prevention of breast cancer, it is necessary to develop an instrument for risk assessment and, through assessment, select women at high risk. It is also necessary to provide education and appropriate recommendations on screening behavior.

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AGING ASSESSMENT OF CANDU PLANT MAJOR COMPONENTS

  • Jeong, Il-Seok;Lee, Kyoung-Soo;Kim, Tae-Ryong
    • Proceedings of the Korea Society for Energy Engineering kosee Conference
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    • 2003.05a
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    • pp.415-423
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    • 2003
  • Korea Electric Power Research Institute(KEPRI) had worked a comprehensive Plant Lifetime Management (PLiM) project for a CANDU plant in corporation with Korea Hydro and Nuclear Power(KHNP). The project had been performed to understand the aging status of major components screened from the plant and to address provisions for the continued operation over its design life. A feasibility of the continued operation was reviewed in the aspects of technology, economics, and regulatory environments. This paper introduces general approach of aging assessment, screening of critical components and an experience of aging assessment for an example of fuel channel that is the most critical component in CANDU plant.

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