• 제목/요약/키워드: standardization diagnosis

검색결과 169건 처리시간 0.029초

암환자의 통합의학 치료경험 - 근거이론을 중심으로 - (Integrated medical treatment experience of cancer patients -grounded theory around-)

  • 문준석;신헌태
    • 대한예방한의학회지
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    • 제21권1호
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    • pp.107-119
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    • 2017
  • Purpose : Recently, cancer has become a chronic disease that requires supervision because of early diagnosis and the development of therapeutic technology. As a result, cancer patients are interested in improving the quality of their lives besides the treatment of cancer itself. Therefore, it is necessary to conduct a qualitative research to understand the vivid experiences of cancer patients and structure their treatment experience. Among qualitative researches, grounded theory is developed based on the data collected in the field. The grounded theory research method is easy to analyze for the process and structure of the treatment experience. Therefore, the purpose of this study is to provide basic data on the integrated medical experience of cancer patients Methods : Participants were conveniently selected, and the criteria for selection were for those who had more than 1 month of hospitalization so that they could dictate their situation and experience in a meaningful manner. Data was collected through in-depth interviews and continued until the data were saturated through theoretical sensitivity and continuous comparison methods. The collected data were analyzed through the process of open-coding, axial coding, and selection coding, which are the research methods of grounded theory. Results : Cancer patients differ in their path, purpose, and attitudes depending on their respective situations and the internal and external resources of individuals. There is also a difference in the perception of their situation among the cancer patients and their families. Cancer patients were shown to recognize and cope with problems in the integrated medical treatment process, and have been classified into 6 different types after the results. Cancer patients showed positive changes in terms of physical, emotional, and lifestyle after their integrated medical treatment. Cancer patients perceived the integrated medical treatment process as a horizontal relationship structure and with diversity. Conclusions : The experience of integrated medical treatment of cancer patients is a process of rehabilitation that heals the body and restores life within the interaction of support system, contextual situation, and internal resources of the individual. Despite this, there is a need not only for the efforts of integrated medical service providers but also institutional support in the future with regards to the current weaknesses and points for improvement. In addition, there is a need for an objective criterion to measure the outcome of integrated medicine for the standardization of integrated medical services.

성별을 고려한 중풍 변증진단 판별모형개발(V) (Discriminant Model V for Syndrome Differentiation Diagnosis based on Sex in Stroke Patients)

  • 강병갑;이정섭;고미미;권세혁;방옥선
    • 동의생리병리학회지
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    • 제25권1호
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    • pp.138-143
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    • 2011
  • In spite of abundant clinical resources of stroke patients, the objective and logical data analyses or diagnostic systems were not established in oriental medicine. As a part of researches for standardization and objectification of differentiation of syndromes for stroke, in this present study, we tried to develop the statistical diagnostic tool discriminating the 4 subtypes of syndrome differentiation using the essential indices considering the sex. Discriminant analysis was carried out using clinical data collected from 1,448 stroke patients who was identically diagnosed for the syndrome differentiation subtypes diagnosed by two clinical experts with more than 3 year experiences. Empirical discriminant model(V) for different sex was constructed using 61 significant symptoms and sign indices selected by stepwise selection. We comparison. We make comparison a between discriminant model(V) and discriminant model(IV) using 33 significant symptoms and sign indices selected by stepwise selection. Development of statistical diagnostic tool discriminating 4 subtypes by sex : The discriminant model with the 24 significant indices in women and the 19 significant indices in men was developed for discriminating the 4 subtypes of syndrome differentiation including phlegm-dampness, qi-deficiency, yin-deficiency and fire-heat. Diagnostic accuracy and prediction rate of syndrome differentiation by sex : The overall diagnostic accuracy and prediction rate of 4 syndrome differentiation subtypes using 24 symptom and sign indices was 74.63%(403/540) and 68.46%(89/130) in women, 19 symptom and sign indices was 72.05%(446/619) and 70.44%(112/159) in men. These results are almost same as those of that the overall diagnostic accuracy(73.68%) and prediction rate(70.59%) are analyzed by the discriminant model(IV) using 33 symptom and sign indices selected by stepwise selection. Considering sex, the statistical discriminant model(V) with significant 24 symptom and sign indices in women and 19 symptom and sign indices in men, instead of 33 indices would be used in the field of oriental medicine contributing to the objectification of syndrome differentiation with parsimony rule.

전력소비를 이용한 실물경기지수 개발에 관한 연구 (Electricity Consumption as an Indicator of Real Economic Status)

  • 오승환;김태중;곽동철
    • 유통과학연구
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    • 제14권3호
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    • pp.63-71
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    • 2016
  • Purpose - A variety of indicators are used for the diagnosis of economic situation. However, most indicators explain the past economic situation because of the time difference between the measurement and announcement. This study aims to argue for the resurrection of an idea: electricity demand can be used as an indicator of economic activity. In addition, this study made an endeavor to develop a new Real Business Index(RBI) which could quickly represent the real economic condition based on the sales statistics of industrial and public electricity. Research design, data, and methodology - In this study monthly sales of industrial and public electricity from 2000 to 2015 was investigated to analyze the relationship between the economic condition and the amount of electricity consumption and to develop a new Real Business Index. To formulate the Index, this study followed next three steps. First, we decided the explanatory variables, period, and collected data. Second, after calculating the monthly changes for each variable, standardization and estimating the weighted value were conducted. Third, the computation of RBI finalized the development of empirical model. The principal component analysis was used to evaluate the weighted contribution ratio among 3 sectors and 17 data. Hodrick-Prescott filter analysis was used to verify the robustness of out model. Results - The empirical results are as follows. First, compatibility of the predictability between the new RBI and the existing monthly cycle of coincident composite index was extremely high. Second, two indexes had a high correlation of 0.7156. In addition, Hodrick-Prescott filter analysis demonstrated that two indexed also had accompany relationship. Third, when the changes of two indexes were compared, they were found that the times when the highest and the lowest point happened were similar, which suggested that it is possible to use the new RBI index as a complementing indicator in a sense that the RBI can explain the economic condition almost in real time. Conclusion - A new economic index which can explain the economic condition needs to be developed well and rapidly in a sense that it is useful to determine accurately the current economic condition to establish economic policy and corporate strategy. The salse of electricity has a close relationship with economic conditions because electricity is utilized as a main resource of industrial production. Furthermore, the result of the sales of electricity can be gathered almost in real time. This study applied the econometrics model to the statistics of the sales of industrial and public electricity. In conclusion, the new RBI index was highly related with the existing monthly economic indexes. In addition, the comparison between the RBI index and other indexes demonstrated that the direction of the economic change and the times when the highest and lowest points had happened were almost the same. Therefore, this RBI index can become the supplementary indicator of the official indicators published by Korean Bank or the statistics Korea.

사상체질병증 임상진료지침 개발 연구 - 목적, 개발 전략 및 절차 - (Development of Clinical Practice Guidelines for Sasang Constitutional Medicine Symptomatology - Purpose, Development Strategy and Procedure -)

  • 김제신;황민우;이준희;이의주;고병희;유정희;배나영;김윤희;배효상;주종천;박혜선;신미란;유준상
    • 사상체질의학회지
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    • 제25권1호
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    • pp.23-33
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    • 2013
  • Objectives This study was aimed to develop the clinical practice guidelines, which focuses on Sasang Constitutional Medicine symptomology. By developing clinical practice guidelines, we should present prevention, diagnosis, treatment and assessment of Sasang Constitutional Medicine. Methods We used the method of University of Michigan Health System Guidelines model. Electronic databases including English, Korean databases were systematically searched for clinical articles investigating Sasang Constitutional Medicine symptomology up to March 2010. And "Donguisusebowon-ShinChukbon" was basically used to develop clinical guidelines. Results and Conclusions 12,694 Articles were reviewed. Only 25 articles described adequate methods of this study. Using clinical practice guidelines, we can manage th quality of medicine, emphasis treatment appropriacy and educate patients and doctors. Finally We can get the Sasang Constitutional Medicine standardization and socioeconomic benefit.

JPEG 표준안을 이용한 의료 영상 압축 (Medical Image Compression Using JPEG International Standard)

  • 안창범;한상우;김일연
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 1993년도 하계학술대회 논문집 A
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    • pp.504-506
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    • 1993
  • JPEG(Joint Photographic Experts Group) 표준안은 디지털 정지 압축을 위하여 국제표준화기구(ISO/SC29/WG10)와 국제전신전화 자문회의(CCITT SG VIII)에 의해서 제안되었다. JPEG 표준안은 전자영상, 컴퓨터 그래픽, 멀티미디어 등과 관련하여 널리 응용되고 있으나, 의료 영상분야에서는 JPEG 압축의 손실 특성 때문에 사용이 매우 제한적이었다. 본 논문에서는 JPEG 표준안을 핵자기 공명 단층 영상 (256 gray levels, $256{\times}256$ size) 압축에 적용하여 그 성능을 조사하였다. 이를 위하여 JPEG 표준안 중 DCT에 기반을 둔 순차식 부호화 압축을 C-Cube Microsystems의 CL550 chip을 사용하여 구현하였고, 점진식 및 무손실 부호화 방식은 특별한 Hardware 없이 Software로 구현하여 실험하였다. 본 실험을 통하여 핵자기 공명 단층 시험 영상에 대해 거의 왜곡없이 약 10-20 정도의 압축률이 얻어짐을 확인할 수 있었다. 특히 JPEG으로 압축하였을 경우 재구성한 영상과 원영상과의 에러 신호가 random noise에 가깝게 나타남으로써 특별한 artifact가 없는 것도 JPEG의 큰 장점으로 부각된다. 한편 JPEG의 점진식 및 게층식 부호화 방식은 압축률과 신호대 잡음비에 있어서는 순차식과 동일하나, 거대한 영상 데이터 베이스 내에서의 빠른 탐색과 비교적 속도가 느린 공중망을 통한 원격 진단에 유용한 특성을 갖는다.

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치매에 대한 최신 실험적 연구 동향;2000년 이후 한의학 학술지를 중심으로 (A Review of Experimental study on Dementia in Oriental medicine;within Oriental medicine journal since 2000)

  • 최성열;김대현;김상태;김태헌;강형원;류영수
    • 동의신경정신과학회지
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    • 제19권1호
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    • pp.125-146
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    • 2008
  • Objectives : The purpose of this study is to suggest for the following experimental study of dementia by reviewing recent oriental medicine journals that have been published since 2000. Methods: We have investigated various types of studies in relation to dementia through 90 articles that have been published from 2000 to 2007 in recent oriental medicine journals were registered Korea research foundation. Results and Conclusions : 1. Since 2000, 88 articles in relation to dementia have been published and almost of them are herbal medicine-centered studies. Also they show a tendency to increase every year. The journal of oriental neuropsychiatry carries the highest number of studies in relation to dementia. 2. According to the experimental paper, there are 30 cases of using herb simplexes, 48 cases of herb-combined prescription, and 10 cases of other ways. Especially 7 cases of using herb-combined prescription relation to Sasang constitution are all for the Taeumin. 3. There are 85 cases of Animal and cellular experimental, 60 cases of using pathologic model induced cytotoxic activity, a case of using L-NAME, 3 cases of 192 saporin, 4 cases of ibotenic acid, 10 cases of focal cerebral ischemia, 3 cases of alcohol-administered, and one case of natural degradation. 4. Moms water maze, Radial arm maze Passive avoidance learning model were using for examining learning and memory of model animal 5. We propose that following studies of dementia are to he investigated of the applied method of using siRNA with tranceduced gene, sample preparation by water-soaking, oriental medical diagnosis, standardization of differentiating symptom and herb simplexes, building the database by classified prescriptions, and experiment model which are based on precise examining mechanism with cell line as like mouse H19-7 hippocampus, rat HT22 hippocampus, astrocyte, microglia, using the model of animals at APP, PS1, BACE, CT99/PS1, APOE4, Tau, APP/PSI/Tau

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신장과 체중의 변화가 사구체 여과율에 미치는 영향 (A Study on How Height and Weight Affects Glomerular Filtration Rate)

  • 박아랑;최종숙;이영희;정우영
    • 핵의학기술
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    • 제23권1호
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    • pp.40-44
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    • 2019
  • 목적: $^{99m}Tc$-DTPA를 이용한 사구체 여과율 측정에서 신장(Height)과 체중(Weight)의 변동에 따른 사구체 여과율의 변화 정도를 확인하고 표준화된 신체 계측의 중요성에 대해 제고하고자 한다. 실험재료 및 방법: 서울아산병원 핵의학과에 사구체 여과율 검사를 위해 내원한 50명을 대상으로 전자의무기록(EMR)에 기록된 한 달 이내의 신체 계측 값의 변화를 조사하였고, 신장(Height)과 체중(Weight)의 변화 폭이 가장 컸던 값을 기준으로 신장(Height)과 체중(Weight)을 변화시키며 사구체 여과율을 재산출하여 그 변화를 분석하였다. 결과: 신장(Height)이 1cm 증가할 때마다 사구체 여과율은 평균 0.6%씩 감소하였고. 체중(Weight)이 1kg 증가할 때마다 사구체 여과율은 평균 1.6%씩 증가하였다. 결론: 신장(Height)과 체중(Weight)의 오류로 인한 사구체 여과율의 오류를 줄이기 위해서는 신체 계측 방법에 대한 표준화가 필요하며, 신체 계측에 영향을 줄 수 있는 변수에 대한 통제가 필요할 것으로 사료된다.

3D 프린터를 이용한 Dose Calibrator의 품질관리 (Quality Control of Dose Calibrator using 3D Printery)

  • 류찬주
    • 한국방사선학회논문지
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    • 제15권3호
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    • pp.307-312
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    • 2021
  • 핵의학에서 Dose calibrator는 단일 핵종의 방사능을 측정하기 위해 사용하는 장비이다. 인체에 정확한 용량의 투여는 진단과 치료에 중요한 요인으로 작용하며, 투여 전 Dose calibrator를 통한 방사능 측정은 가장 중요한 요소이다. 이러한 Dose calibrator는 각 의료기관에서 설치 후 일상적인 정도 관리를 시행한다. 정도관리는 설치 후 품질관리를 보증하는 하나의 방편이며 진료의 질을 향상시키고 환자의 안전을 도모하는 데 필수적이다. 이에 정확하고 표준화된 성능 평가 방법을 구축해야 한다. 따라서 본 연구는 정도관리의 정확도와 기준성을 높여 품질 관리의 정량적 평가를 위해 3D 프린트를 이용하였다. 연구 방법은 정도관리를 위한 Q.C 표준선원이 중앙에 장착될 수 있는 3D 프린트를 이용한 보조기구를 재작하였다. 재현성 검사를 시행하였을 때 3D 프린트의 장착 유무에 따른 정도관리 선원의 오차율 값의 차이를 비교하였다. 연구 결과 표준선원의 정도관리 기댓값과 판독값의 오차 범위가 F-18 핵종에서는 0.302% 감소하였고, 99mTc-pertechneate 핵종에서는 0.09% 로 나타났다. 향후 정량적이고 표준화된 정도관리를 통해 장비의 노후화, 표준선원의 반감기에 따른 계산 오류 등 정도관리의 영향을 주는 요인을 감소시키고 정확한 방사성의약품을 투여할 수 있는 기본적인 요인으로 작용할 수 있을 것이라 사료된다.

급성기 뇌경색 환자에 있어 변증형별 유의한 임상지표의 분석 (Analysis of Clinical Indicators related to Pattern-Identification in Acute Cerebral Infarction Patient)

  • 이은찬;현상호;곽승혁;우수경;박주영;정우상;문상관;조기호;박성욱;고창남
    • 대한중풍순환신경학회지
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    • 제13권1호
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    • pp.33-42
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    • 2012
  • Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

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Quality of Radiomics Research on Brain Metastasis: A Roadmap to Promote Clinical Translation

  • Chae Jung Park;Yae Won Park;Sung Soo Ahn;Dain Kim;Eui Hyun Kim;Seok-Gu Kang;Jong Hee Chang;Se Hoon Kim;Seung-Koo Lee
    • Korean Journal of Radiology
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    • 제23권1호
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    • pp.77-88
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    • 2022
  • Objective: Our study aimed to evaluate the quality of radiomics studies on brain metastases based on the radiomics quality score (RQS), Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) checklist, and the Image Biomarker Standardization Initiative (IBSI) guidelines. Materials and Methods: PubMed MEDLINE, and EMBASE were searched for articles on radiomics for evaluating brain metastases, published until February 2021. Of the 572 articles, 29 relevant original research articles were included and evaluated according to the RQS, TRIPOD checklist, and IBSI guidelines. Results: External validation was performed in only three studies (10.3%). The median RQS was 3.0 (range, -6 to 12), with a low basic adherence rate of 50.0%. The adherence rate was low in comparison to the "gold standard" (10.3%), stating the potential clinical utility (10.3%), performing the cut-off analysis (3.4%), reporting calibration statistics (6.9%), and providing open science and data (3.4%). None of the studies involved test-retest or phantom studies, prospective studies, or cost-effectiveness analyses. The overall rate of adherence to the TRIPOD checklist was 60.3% and low for reporting title (3.4%), blind assessment of outcome (0%), description of the handling of missing data (0%), and presentation of the full prediction model (0%). The majority of studies lacked pre-processing steps, with bias-field correction, isovoxel resampling, skull stripping, and gray-level discretization performed in only six (20.7%), nine (31.0%), four (3.8%), and four (13.8%) studies, respectively. Conclusion: The overall scientific and reporting quality of radiomics studies on brain metastases published during the study period was insufficient. Radiomics studies should adhere to the RQS, TRIPOD, and IBSI guidelines to facilitate the translation of radiomics into the clinical field.