• Title/Summary/Keyword: standard of diagnosis

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Analysis of Standard Nursing Statements Recorded in an Electronic Nursing Record System and User Satisfaction (전자간호기록에 사용된 표준간호진술문 활용실태와 시스템 사용자 만족도)

  • Jung, Joo Hee;Myung, Geun Hee;Kang, Kyung Hyun;Park, Eun Hee
    • Perspectives in Nursing Science
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    • v.9 no.2
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    • pp.146-153
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    • 2012
  • Purpose: The aims of this study were to analyze the frequency of standard nursing statements used in the Electronic Nursing Record (ENR) and to evaluate the degree of satisfaction by users of the ENR system. Methods: We retrospectively reviewed the ENR of 1914 patients who were admitted to our center between 1 May 2011 and 31 May 2011. Additionally, we collected questionnaires from 100 doctors and 300 nurses to evaluate the satisfaction of the users. Results: The frequency of use for the following standard nursing statements was investigated: standard nursing assessment statements (43.6%), standard nursing diagnosis statements (61.8%), standard nursing plan statements (46.7%), standard nursing intervention statements (56.9%), and standard nursing evaluation statements (41.7%). The mean satisfaction score was 3.03 out of 5 in the nurse's group, and 3.11 in the doctor's group. The nurses said the advantages of the ENR system were as follows: easy to access, informative, and standardized terms. However 75.7% of the nurse answered that they cannot express actual nursing situations exactly with the currently limited standard nursing statements. Conclusion: Development of various standard nursing statements is needed to meet the demands of the users. As a result, the use of the ENR system would become easier and more efficient for its users.

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A Study on Standardized Healthcare System based on HL7 (HL7 기반 표준화된 헬스케어시스템에 관한 연구)

  • Oh, Am-Suk
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.17 no.3
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    • pp.656-664
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    • 2013
  • U-healthcare system supports healthcare service of prevention, diagnosis, medical treatment and currently various medical service systems. Therefore, utilization of medical information thru hospitals, medical agencies is unevitable in this society. However, the standard draft of HL7 which is a standard of medical information does not support specification of medical information being used currently. Thus, in this paper, we study standard HL7 message system to analyze and adjust the medical information and it will help to utilize efficient medical information and the method is verified to be sufficiently effective.

Dental students' ability to detect maxillary sinus abnormalities: A comparison between panoramic radiography and cone-beam computed tomography

  • Rosado, Lucas de Paula Lopes;Barbosa, Izabele Sales;de Aquino, Sibele Nascimento;Junqueira, Rafael Binato;Verner, Francielle Silvestre
    • Imaging Science in Dentistry
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    • v.49 no.3
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    • pp.191-199
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    • 2019
  • Purpose: To compare the diagnostic ability of undergraduate dental students to detect maxillary sinus abnormalities in panoramic radiographs(PR) and cone-beam computed tomography (CBCT). Materials and Methods: This was a retrospective study based on the evaluation of PR and CBCT images. A pilot study was conducted to determine the number of students eligible to participate in the study. The images were evaluated by 2 students, and 280 maxillary sinuses were assessed using the following categories: normal, mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, antrolith, and antrolith associated with mucosal thickening. The reference standard was established by the consensus of 2 oral radiologists based on the CBCT images. The kappa test, receiver operating characteristic curves, and 1-way analysis of variance with the Tukey-Kramer post-hoc test were employed. Results: Intraobserver and interobserver reliability showed agreement ranging from substantial (0.809) to almost perfect (0.922). The agreement between the students' evaluations and the reference standard was reasonable (0.258) for PR and substantial(0.692) for CBCT. Comparisons of values of sensitivity, specificity, and accuracy showed that CBCT was significantly better(P<0.05). Conclusion: CBCT was better than PR for the detection of maxillary sinus abnormalities by dental students. However, CBCT should only be requested after a careful analysis of PR by students and more experienced professionals.

Which factors related to apical radiolucency may influence its radiographic detection? A study using CBCT as reference standard

  • Rocharles Cavalcante Fontenele;Eduarda Helena Leandro Nascimento;Hugo Gaeta-Araujo;Lais Oliveira de Araujo Cardelli;Deborah Queiroz Freitas
    • Restorative Dentistry and Endodontics
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    • v.46 no.3
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    • pp.43.1-43.9
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    • 2021
  • Objectives: This study aimed to evaluate the detection rate of apical radiolucencies in 2-dimensional images using cone-beam computed tomography (CBCT) as the reference standard, and to determine which factors related to the apical radiolucencies and the teeth could influence its detection. Materials and Methods: The sample consisted of exams of patients who had panoramic (PAN) and/or periapical (PERI) radiography and CBCT. The exams were assessed by 2 oral radiologists and divided into PAN+CBCT (227 teeth-285 roots) and PERI+CBCT (94 teeth-115 roots). Radiographic images were evaluated for the presence of apical radiolucency, while CBCT images were assessed for presence, size, location, and involvement of the cortical bone (thinning, expansion, and destruction). Diagnostic values were obtained for PERI and PAN. Results: PERI and PAN presented high accuracy (0.83 and 0.77, respectively) and specificity (0.89 and 0.91, respectively), but low sensitivity, especially for PAN (0.40 vs. 0.65 of PERI). The size of the apical radiolucency was positively correlated with its detection in PERI and PAN (p < 0.001). For PAN, apical radiolucencies were 3.93 times more frequently detected when related to single-rooted teeth (p = 0.038). The other factors did not influence apical radiolucency detection (p > 0.05). Conclusions: PERI presents slightly better accuracy than PAN for the detection of apical radiolucency. The size is the only factor related to radiolucency that influences its detection, for both radiographic exams. For PAN, apical radiolucency is most often detected in single-rooted teeth.

Synthesis of T2-weighted images from proton density images using a generative adversarial network in a temporomandibular joint magnetic resonance imaging protocol

  • Chena, Lee;Eun-Gyu, Ha;Yoon Joo, Choi;Kug Jin, Jeon;Sang-Sun, Han
    • Imaging Science in Dentistry
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    • v.52 no.4
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    • pp.393-398
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    • 2022
  • Purpose: This study proposed a generative adversarial network (GAN) model for T2-weighted image (WI) synthesis from proton density (PD)-WI in a temporomandibular joint(TMJ) magnetic resonance imaging (MRI) protocol. Materials and Methods: From January to November 2019, MRI scans for TMJ were reviewed and 308 imaging sets were collected. For training, 277 pairs of PD- and T2-WI sagittal TMJ images were used. Transfer learning of the pix2pix GAN model was utilized to generate T2-WI from PD-WI. Model performance was evaluated with the structural similarity index map (SSIM) and peak signal-to-noise ratio (PSNR) indices for 31 predicted T2-WI (pT2). The disc position was clinically diagnosed as anterior disc displacement with or without reduction, and joint effusion as present or absent. The true T2-WI-based diagnosis was regarded as the gold standard, to which pT2-based diagnoses were compared using Cohen's ĸ coefficient. Results: The mean SSIM and PSNR values were 0.4781(±0.0522) and 21.30(±1.51) dB, respectively. The pT2 protocol showed almost perfect agreement(ĸ=0.81) with the gold standard for disc position. The number of discordant cases was higher for normal disc position (17%) than for anterior displacement with reduction (2%) or without reduction (10%). The effusion diagnosis also showed almost perfect agreement(ĸ=0.88), with higher concordance for the presence (85%) than for the absence (77%) of effusion. Conclusion: The application of pT2 images for a TMJ MRI protocol useful for diagnosis, although the image quality of pT2 was not fully satisfactory. Further research is expected to enhance pT2 quality.

Morphometric Analysis for Cytological Diagnosis of Thyroid Papillary Carcinoma (갑상샘 유두암종의 세포진단에서 형태학적 계측의 분석)

  • Kim, Jong-Ok;Yang, Bo-Seong;Kim, Hye-Soo;Lee, Jong-Min;Lee, Dong-Ho;Shin, So-Young;Kang, Chang-Suk;Lee, Hye-Kyung
    • The Korean Journal of Cytopathology
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    • v.17 no.2
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    • pp.116-119
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    • 2006
  • The diagnosis of papillary thyroid cancer is generally based on the findings of intranuclear cytoplasmic inclusions and nuclear grooves. Although anisokaryosis and poikilokaryosis, in papillary thyroid cancer, are not distinct when compared to other cancers, cytological examination can provide useful preoperative information. Our study evaluated the diagnostic role of computer-assisted image analysis for the pre-surgical assessment of papillary thyroid carcinoma. Thyroid aspirates from twenty female patients who were histologically confirmed to have both papillary carcinoma and benign nodules were studied. Different populations of 50 benign cells and 50 malignant cells were analyzed. Five morphometric parameters were selected for analysis: nuclear area, perimeter, maximum length, maximum width and intensity standard variation. The values obtained for papillary carcinomas were higher than the surrounding benign nodules as follows: nuclear area 63.5 vs. 36.1 (p=0.000), nuclear perimeter were 29.4 vs. 22.0 (p=0.000), maximum length 9.6 vs. 7.1 (p=0.000), maximum width 8.2 vs. 6.3 (p=0.000), the ratio between maximal length and maximal width 1.16 vs. 1.13 (p=0.000), the standard variation of intensity 14.9 vs. 15.9 (p=0.101) respectively. Therefore, morphometric information can be helpful for the differential cytological diagnosis of papillary thyroid carcinoma.

Cone-beam computed tomography texture analysis can help differentiate odontogenic and non-odontogenic maxillary sinusitis

  • Andre Luiz Ferreira Costa;Karolina Aparecida Castilho Fardim;Isabela Teixeira Ribeiro;Maria Aparecida Neves Jardini;Paulo Henrique Braz-Silva;Kaan Orhan;Sergio Lucio Pereira de Castro Lopes
    • Imaging Science in Dentistry
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    • v.53 no.1
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    • pp.43-51
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    • 2023
  • Purpose: This study aimed to assess texture analysis(TA) of cone-beam computed tomography (CBCT) images as a quantitative tool for the differential diagnosis of odontogenic and non-odontogenic maxillary sinusitis(OS and NOS, respectively). Materials and Methods: CBCT images of 40 patients diagnosed with OS (N=20) and NOS (N=20) were evaluated. The gray level co-occurrence (GLCM) matrix parameters, and gray level run length matrix texture (GLRLM) parameters were extracted using manually placed regions of interest on lesion images. Seven texture parameters were calculated using GLCM and 4 parameters using GLRLM. The Mann-Whitney test was used for comparisons between the groups, and the Levene test was performed to confirm the homogeneity of variance (α=5%). Results: The results showed statistically significant differences(P<0.05) between the OS and NOS patients regarding 3 TA parameters. NOS patients presented higher values for contrast, while OS patients presented higher values for correlation and inverse difference moment. Greater textural homogeneity was observed in the OS patients than in the NOS patients, with statistically significant differences in standard deviations between the groups for correlation, sum of squares, sum of entropy, and entropy. Conclusion: TA enabled quantitative differentiation between OS and NOS on CBCT images by using the parameters of contrast, correlation, and inverse difference moment.

Infantile Hypertrophic Pyloric Stenosis -Clinical Differences between Premature and Full-term Infants (미숙아와 만삭아에서의 비후성 유문 협착증의 임상적 차이)

  • Lee, Suk-Koo;Kim, Seong-Hwan;Lee, Woo-Yong;Kim, Hyun-Hahk
    • Advances in pediatric surgery
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    • v.4 no.1
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    • pp.34-38
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    • 1998
  • Infantile hypertrophic pyloric stenosis(IHPS) is common in full-term babies, and relatively rare in prematures. The diagnosis of IHPS in premature infants may be obscured because of the lack of classic symptoms and signs and the absence of the standard criteria for ultrasonic diagnosis. The purpose of this study is to discover the clinical differences between premature and full-term infants with pyloric stenosis, and determine the appropriate diagnostic methods for early diagnosis in premature infants. The clinical records of 52 IHPS patients who had been operated upon from October, 1994 to April, 1997 were reviewed. The incidence of IHPS in premature infants was 25 %. The onset of symptom was 4.7 weeks of age in premature, and 2.9 weeks in full-term babies. Diagnosis was established by typical symptoms. signs. and diagnostic imaging studies. In two premature infants, diagnosis was confirmed by upper gastrointestinal(GI) series, because ultrasonography did not meet the diagnostic criteria. Two premature infants initially diagnosed as gastroesophageal reflux by esophagography. were found to have IHPS by upper GI series. For the diagnosis of IHPS, a new set of criteria for premature babies has to be developed.

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The Amputation Rate and Associated Risk Factors within 1 Year after the Diagnosis of Diabetic Foot Ulcer (당뇨병성 족부 궤양 환자의 진단 1년 내의 절단율 및 위험 인자의 분석)

  • Chun, Dong-Il;Jeon, Min Chul;Choi, Sung-Woo;Kim, Yong-Beom;Nho, Jae-Hwi;Won, Sung Hun
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.3
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    • pp.121-125
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    • 2016
  • Purpose: This study investigates the amputation rate within 1 year after the diagnosis of diabetic foot ulcer and its associated risk factors. Materials and Methods: This study enrolled 60 patients with diabetic foot ulcer. The mean and standard deviation age was $64.4{\pm}12.8years$ (range, 32~89 years); the mean and standard deviation prevalence period for diabetes mellitus was $21.0{\pm}7.5years$ (range, 0.5~36 years). The amputation rate was evaluated by dividing the subjects into two groups - the major and minor amputation groups - within 1 year following the initial diagnosis of diabetic foot ulcer. Multivariate Cox proportional hazards regression analysis was used to identify the risk factors for amputation. Results: The total amputation rate of 38.3% (n=23) was comprised of the amputation rate for the major amputation group (10.0%) and rate for the minor amputation group (23.8%). There was a high correlation between peripheral artery disease (toe brachial pressure index <0.7) and amputation (hazard ratio [HR] 5.81, confidence interval [CI] 2.09~16.1, p<0.01). Nephropathy was significantly correlated with the amputation rate (HR 3.53, CI 1.29~9.64, p=0.01). Conclusion: Clinicians who treat patients with diabetic foot complications must understand the fact that the amputation rate within 1 year is significant, and that the amputation rate of patients with peripheral artery disease or nephropathy is especially high.

Agreement between Colposcopic Diagnosis and Cervical Pathology: Siriraj Hospital Experience

  • Tatiyachonwiphut, Molpen;Jaishuen, Atthapon;Sangkarat, Suthi;Laiwejpithaya, Somsak;Wongtiraporn, Weerasak;Inthasorn, Perapong;Viriyapak, Boonlert;Warnnissorn, Malee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.1
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    • pp.423-426
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    • 2014
  • Aim: To evaluate the agreement between colposcopic diagnosis and cervical pathology a retrospective chart review was performed. Materials and Methods: This study included 437 patients who underwent colposcopy and cervical biopsy or conization at Siriraj Hospital from October 2010 - December 2012. The patient clinical characteristics, cervical cytology results, colposcopic diagnoses, cervical pathology results were recorded and correlations between variables were analyzed. Results: Agreement of colposcopic diagnosis and cervical pathology was matched in 253 patients (57.9%). The strength of agreement with weighted Kappa statistic was 0.494 (p<0.001). Colposcopic diagnoses more often overestimated (31.1%) than underestimated (11%) the cervical pathology. Agreement of colposcopic diagnosis and cervical pathology within 1 grade was found in 411 patients (94.1%). Positive predictive value (PPV) of high grade colposcopy or more was 75.5%, whereas the negative predictive value (NPV) of insignificant and low grade colposcopy was 83.8%. False positives of high grade colposcopy or more were 21%. False negatives of insignificant or low grade colposcopy were 19.1%. Conclusions: Strength of agreement between colposcopic diagnosis and cervical pathology was found to be only moderate. A biopsy at colposcopy should be performed at a gold standard level to detect high grade lesions.