• Title/Summary/Keyword: survival regression

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Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.

An Empirical Study on the Effect of CRM System on the Performance of Pharmaceutical Companies (고객관계관리 시스템의 수준이 BSC 관점에서의 기업성과에 미치는 영향 : 제약회사를 중심으로)

  • Kim, Hyun-Jung;Park, Jong-Woo
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.43-65
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    • 2010
  • Facing a complex environment driven by a decade, many companies are adopting new strategic frameworks such as Customer Relationship Management system to achieve sustainable profitability as well as overcome serious competition for survival. In many business areas, CRM system advanced a great deal in a matter of continuous compensating the defect and overall integration. However, pharmaceutical companies in Korea were slow to accept them for usesince they still have a tendency of holding fast to traditional way of sales and marketing based on individual networks of sales representatives. In the circumstance, this article tried to empirically address current status of CRM system as well as the effects of the system on the performance of pharmaceutical companies by applying BSC method's four perspectives, from financial, customer, learning and growth and internal process. Survey by e-mail and post to employers and employees who were working in pharma firms were undergone for the purpose. Total 113 cases among collected 140 ones were used for the statistical analysis by SPSS ver. 15 package. Reliability, Factor analysis, regression were done. This study revealed that CRM system had a significant effect on improving financial and non-financial performance of pharmaceutical companies as expected. Proposed regression model fits well and among them, CRM marketing information system shed the light on substantial impact on companies' outcome given profitability, growth and investment. Useful analytical information by CRM marketing information system appears to enable pharmaceutical firms to set up effective marketing and sales strategies, these result in favorable financial performance by enhancing values for stakeholderseventually, not to mention short-term profit and/or mid-term potential to growth. CRM system depicted its influence on not only financial performance, but also non-financial fruit of pharmaceutical companies. Further analysis for each component showed that CRM marketing information system were able to demonstrate statistically significant effect on the performance like the result of financial outcome. CRM system is believed to provide the companies with efficient way of customers managing by valuable standardized business process prompt coping with specific customers' needs. It consequently induces customer satisfaction and retentionto improve performance for long period. That is, there is a virtuous circle for creating value as the cornerstone for sustainable growth. However, the research failed to put forward to evidence to support hypothesis regarding favorable influence of CRM sales representative's records assessment system and CRM customer analysis system on the management performance. The analysis is regarded to reflect the lack of understanding of sales people and respondents between actual work duties and far-sighted goal in strategic analysis framework. Ordinary salesmen seem to dedicate short-term goal for the purpose of meeting sales target, receiving incentive bonus in a manner-of-fact style, as such, they tend to avail themselves of personal network and sales and promotional expense rather than CRM system. The study finding proposed a link between CRM information system and performance. It empirically indicated that pharmaceutical companies had been implementing CRM system as an effective strategic business framework in order for more balanced achievements based on the grounded understanding of both CRM system and integrated performance. It suggests a positive impact of supportive CRM system on firm performance, especially for pharmaceutical industry through the initial empirical evidence. Also, it brings out unmet needs for more practical system design, improvement of employees' awareness, increase of system utilization in the field. On the basis of the insight from this exploratory study, confirmatory research by more appropriate measurement tool and increased sample size should be further examined.

A Review of Statistical Methods in the Korean Journal of Orthodontics and the American Journal of Orthodontics and Dentofacial Orthopedics (대한치과교정학회지(KJO)와 미국교정학회지(AJODO)에서 사용된 통계기법의 비교분석 및 고찰(1999-2003))

  • Lim, Hoi-Jeong
    • The korean journal of orthodontics
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    • v.34 no.5 s.106
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    • pp.371-379
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    • 2004
  • The purpose of this study was to investigate the changes and types of statistical methods used in the Korean Journal of Orthodontics (KJO) and the American Journal of Orthodontics and Dentofacial Orthopedics (AJODO) from )999 to 2003. The frequency of use, transitions, assumption check of statistical methods and types of advanced statistical methods were examined from each journal. The study consisted of 247 articles published in the KJO and randomly chosen 50 articles per year which were original articles and used statistical methods T-test, analysis of variance(ANOVA), correlation analysis, nonparametric analysis. regression analysis chi-square test. factor analysis, were the order of statistical methods most frequently used in the KJO, while t-test. ANOVA, nonparametric analysis, correlation analysis, regression analysis, chi-square test. factor analysis. were the order of statistical methods used in the AJODO The changes of statistical methods observed in the KJO were not significant $(X^2=17.4\;p=0.5881)$ but the changes observed in the AJODO was seen to be significant $(x^2=42.4,\;p=0.0397)$ Some of the studies examined had overlooked the assumptions of the statistical methods employed. Data investigation such as outlier should be performed before analysis and alternative statistical approaches are applied for a small sample size. Types of advanced statistical methods were factor analysis and discriminant analysis in the KJO and Intention-To-Treat (ITT) analysis in clinical trials through multi-center, survival analysis and Generalized Estimating Equations (GEE) in the AJODO. Appropriate analysis approaches and interpretations should be applied for the correlated and repeated measurements of the orthodontic data set.

Division of the N2 Stage According to the Multiplicity of the Involved Nodal Stations May be Necessary in the N2-NSCLC Patients Who are Treated with Postoperative Radiotherapy (비소세포성 폐암으로 수술 후 방사선치료가 시행된 N2병기 환자들에서 다발 부위 종격동 림프절 전이 여부에 따른 N2병기 구분의 임상적 의미)

  • Yoon, Hong-In;Kim, Yong-Bae;Lee, Chang-Geol;Lee, Ik-Jae;Kim, Song-Yih;Kim, Jun-Won;Kim, Joo-Hang;Cho, Byung-Chul;Lee, Jin-Gu;Chung, Kyung-Young
    • Radiation Oncology Journal
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    • v.27 no.3
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    • pp.126-132
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    • 2009
  • Purpose: We wanted to evaluate the prognostic factors for the pathologic N2 non-small cell lung cancer (NSCLC) patients who were treated by postoperative radiotherapy. Materials and Methods: We retrospectively reviewed 112 pN2 NSCLC patients who underwent surgery and postoperative radiotherapy (PORT) From January 1999 to February 2008. Seventy-five (67%) patients received segmentectomy or lobectomy and 37 (33%) patients received pneumonectomy. The resection margin was negative in 94 patients, and it was positive or close in 18 patients. Chemotherapy was administered to 103 (92%) patients. Nine (8%) patients received PORT alone. The median radiation dose was 54 Gy (range, 45 to 66), and the fraction size was 1.8~2 Gy. Results: The 2-year overall survival (OS) rate was 60.2% and the disease free survival (DFS) rate was 44.7% for all the patients. Univariate analysis showed that the patients with multiple-station N2 disease had significantly reduced OS and DFS (p=0.047, p=0.007) and the patients with an advanced T stage ($\geq$T3) had significantly reduced OS and DFS (p<0.001, p=0.025). A large tumor size ($\geq$5 cm) and positive lymphovascular invasion reduced the OS (p=0.035, 0.034). Using multivariate analysis, we found that multiple-station N2 disease and an advanced T stage ($\geq$T3) significantly reduced the OS and DFS. Seventy one patients (63.4%) had recurrence of disease. The patterns of failure were loco-regional in 23 (20.5%) patients, distant failure in 62 (55.4%) and combined loco-regional and distant failure in 14 (12.5%) patients. Conclusion: Multiple involvement of mediastinal nodal stations for the pN2 NSCLC patients with PORT was a poor prognostic factor in this study. A prospective study is necessary to evaluate the N2 subclassification and to optimize the adjuvant treatment.

An Intelligent Decision Support System for Selecting Promising Technologies for R&D based on Time-series Patent Analysis (R&D 기술 선정을 위한 시계열 특허 분석 기반 지능형 의사결정지원시스템)

  • Lee, Choongseok;Lee, Suk Joo;Choi, Byounggu
    • Journal of Intelligence and Information Systems
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    • v.18 no.3
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    • pp.79-96
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    • 2012
  • As the pace of competition dramatically accelerates and the complexity of change grows, a variety of research have been conducted to improve firms' short-term performance and to enhance firms' long-term survival. In particular, researchers and practitioners have paid their attention to identify promising technologies that lead competitive advantage to a firm. Discovery of promising technology depends on how a firm evaluates the value of technologies, thus many evaluating methods have been proposed. Experts' opinion based approaches have been widely accepted to predict the value of technologies. Whereas this approach provides in-depth analysis and ensures validity of analysis results, it is usually cost-and time-ineffective and is limited to qualitative evaluation. Considerable studies attempt to forecast the value of technology by using patent information to overcome the limitation of experts' opinion based approach. Patent based technology evaluation has served as a valuable assessment approach of the technological forecasting because it contains a full and practical description of technology with uniform structure. Furthermore, it provides information that is not divulged in any other sources. Although patent information based approach has contributed to our understanding of prediction of promising technologies, it has some limitations because prediction has been made based on the past patent information, and the interpretations of patent analyses are not consistent. In order to fill this gap, this study proposes a technology forecasting methodology by integrating patent information approach and artificial intelligence method. The methodology consists of three modules : evaluation of technologies promising, implementation of technologies value prediction model, and recommendation of promising technologies. In the first module, technologies promising is evaluated from three different and complementary dimensions; impact, fusion, and diffusion perspectives. The impact of technologies refers to their influence on future technologies development and improvement, and is also clearly associated with their monetary value. The fusion of technologies denotes the extent to which a technology fuses different technologies, and represents the breadth of search underlying the technology. The fusion of technologies can be calculated based on technology or patent, thus this study measures two types of fusion index; fusion index per technology and fusion index per patent. Finally, the diffusion of technologies denotes their degree of applicability across scientific and technological fields. In the same vein, diffusion index per technology and diffusion index per patent are considered respectively. In the second module, technologies value prediction model is implemented using artificial intelligence method. This studies use the values of five indexes (i.e., impact index, fusion index per technology, fusion index per patent, diffusion index per technology and diffusion index per patent) at different time (e.g., t-n, t-n-1, t-n-2, ${\cdots}$) as input variables. The out variables are values of five indexes at time t, which is used for learning. The learning method adopted in this study is backpropagation algorithm. In the third module, this study recommends final promising technologies based on analytic hierarchy process. AHP provides relative importance of each index, leading to final promising index for technology. Applicability of the proposed methodology is tested by using U.S. patents in international patent class G06F (i.e., electronic digital data processing) from 2000 to 2008. The results show that mean absolute error value for prediction produced by the proposed methodology is lower than the value produced by multiple regression analysis in cases of fusion indexes. However, mean absolute error value of the proposed methodology is slightly higher than the value of multiple regression analysis. These unexpected results may be explained, in part, by small number of patents. Since this study only uses patent data in class G06F, number of sample patent data is relatively small, leading to incomplete learning to satisfy complex artificial intelligence structure. In addition, fusion index per technology and impact index are found to be important criteria to predict promising technology. This study attempts to extend the existing knowledge by proposing a new methodology for prediction technology value by integrating patent information analysis and artificial intelligence network. It helps managers who want to technology develop planning and policy maker who want to implement technology policy by providing quantitative prediction methodology. In addition, this study could help other researchers by proving a deeper understanding of the complex technological forecasting field.

The Optimal Condition of Performing MTT Assay for the Determination of Radiation Sensitivity (방사선 감수성 측정법으로서 MTT 법 시행 시의 최적 조건에 대한 연구)

  • Hong, Se-Mie;Kim, Il-Han
    • Radiation Oncology Journal
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    • v.19 no.2
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    • pp.163-170
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    • 2001
  • Purpose : The measurement of radiation survival using a clonogenic assay, the established standard, can be difficult and time consuming. In this study, We have used the MTT assay, based on the reduction of a tetrazolium salt to a purple formazan precipitate by living cells, as a substitution for clonogenic assay and have examined the optimal condition for performing this assay in determination of radiation sensitivity. Materials and Methods : Four human cancer cell lines - PCI-1, SNU-1066, NCI-H630 and RKO cells have been used. For each cell line, a clonogenic assay and a MTT assay using Premix WST-1 solution, which is one of the tetrazolium salts and does not require washing or solubilization of the precipitate were carried out after irradiation of 0, 2, 4, 6, 8, 10 Gy. For clonogenic assay, cells in $25\;cm^2$ flasks were irradiated after overnight incubation and the resultant colonies containing more than 50 cells were scored after culturing the cells for $10\~14$ days. For MTT assay, the relationship between absorbance and cell number, optimal seeding cell number, and optimal timing of assay was determined. Then, MTT assay was performed when the irradiated cells had regained exponential growth or when the non-irradiated cells had undergone four or more doubling times. Results : There was minimal variation in the values gained from these two methods with the standard deviation generally less than $5\%$, and there were no statistically significant differences between two methods according to t-test in low radiation dose (below 6 Gy). The regression analyses showed high linear correlation with the $R^2$ value of $0.975\~0.992$ between data from the two different methods. The optimal cell numbers for MTT assay were found to be dependent on plating efficiency of used cell line. Less than 300 cells/well were appropriate for cells with high plating efficiency (more than $30\%$). For cells with low plating efficiency (less than $30\%$), 500 cells/well or more were appropriate for assay. The optimal time for MTT assay was after 6 doubling times for the results compatible with those of clonogenic assay, at least after 4 doubling times was required for valid results. In consideration of practical limits of assay (12 days, in this study) cells with doubling time more than 3 days were inappropriate for application. Conclusion : In conclusion, it is found that MTT assay can successfully replace clonogenic assay of tested cancer cell lines after irradiation only if MTT assay was undertaken with optimal assay conditions that included plating efficiency of each cell line and doubling time at least.

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Rearing Density of a Flounder, Paralichthys olivaceus Juveniles in a Closed Recirculating Sea Water System - Possibility of High-density Rearing - (폐쇄순환여과시스템에서의 넙치, Paralichthys olivaceus 치어의 사육밀도 - 고밀도사육의 가능성 -)

  • CHANG Young Jin;YOO Sung Kyoo
    • Journal of Aquaculture
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    • v.1 no.1
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    • pp.13-24
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    • 1988
  • In order to investigate a reasonable rearing density and the possibility of high-density rearing, flounder, Paralichthys olivaceus, juveniles of 2.53$\pm$0.24 cm in total length and 1.12$\pm$0.12 cm in body height were used in this study. The initial rearing density of them was 10 (D10), 20 (D20), 30 (D30) and 40 (D40) individuals per 137.75 $cm^2$ of bottom area, respectively. Ranges of water temperature and specific gravity during the rearing period of 65 days were $21.0\~27.0^{\circ}C$ and 1.024$\~$1.026, respectively, showing relatively higher values than that of natural sea water. Dissolved oxygen during the rearing period was 5.4$\~$7.5 ml/$\iota$ and inorganic nitrate was 0.07$\~$0.48 ppm in $NH_4^+-N$, 0.006$\~$0.33 ppm in $NO_2^{-}-N$ and 3.89$\~$34.06 ppm in $NO_3^{-}-N$. Growth in total length and body height of the juveniles in four rearing density at the end of the experiment was 8.17$\pm$0.80 em and 4.16$\pm$0.39 em, the highest in D20 and 7.72$\pm$0.40 cm and 3.94$\pm$0.21 cm, the lowest in D10. Significant differences, however, were not recognized between the slope values of growth regressions in four rearing density. Slope values of the relative growth between total length and body height of the juveniles in four rearing density were 0.5346, the highest in D10 and 0.5165, the lowest in D30, but there were no significant differences in those values. Survival rate of juveniles at the end of the experiment was $90\%$ in D10, D20 and D30, but that of D40 was $75\%$. The relationship between total length X body height (X) and body surface area of ocular side (Y) to calculate the rate of Y to bottom area in rearing tank (covering rate) as an indicator of rearing density was expressed by a linear regression, Y=0.5994X+0.1840. Covering rate in four rearing density at the end of the experiment was ranged 1.2$\~$4.1 times. Judging from the covering rate above 4 times, it seems to be possible rearing the flounder juveniles in high-density.

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The effects of neonatal ventilator care or maternal chorioamnionitis on the development of bronchopulmonary dysplasia (산모의 융모양막염 및 인공호흡기 치료가 미숙아 만성 폐질환의 발생에 미치는 영향)

  • Yun, Ki-Tae;Lee, Dong-Whan;Lee, Sang-Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.8
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    • pp.893-897
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    • 2009
  • Purpose : Advances in neonatal intensive care have improved the survival rate of low-birth-weight infants, but mild bronchopulmonary dysplasia (BPD) with the accompanying need for prolonged oxygen supplement remains problematic. Maternal chorioamnionitis and neonatal ventilator care affect the development of BPD. This study aimed to examine whether maternal chorioamnionitis or neonatal ventilator care affect the development of BPD dependently or independently. Methods : We performed a retrospective study of 158 newborn infants below 36 weeks of gestational age and 1,500 gm birth weight admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2000 and December 2006. We analyzed the incidence of BPD according to maternal chorioamnionitis and neonatal ventilator care. Result : Histologic chorioamnionitis was observed in 50 of 158 infants (31.6%). There were no significant differences in the development of BPD (P=0.735) between the chorioamnionitis (+) and chorioamnionitis (-) groups. In the multiple regression analysis, ventilator care (OR=7.409, 95% CI=2.532-21.681) and neonatal sepsis (OR=4.897, 95% CI=1.227-19.539) affected the development of BPD rather than maternal chorioamnionitis (OR=0.461, 95% CI=0.201-1.059). Conclusion : Ventilator care or neonatal sepsis may play a role in the development of BPD rather than maternal chorioamnionitis.

Long-term Clinical Outcomes after Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction-on the basis of 65 Years (급성 심근경색증 환자에서 일차적 관상동맥 중재술 후 장기적 임상 경과-65세를 기준으로)

  • Lee, Han-Ol;Jang, Seong-Joo;Kim, In-Soo;Han, Jae-Bok;Park, Soo-Hwan;Kim, Jeong-Hun;Jang, Young-Ill
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.251-261
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    • 2014
  • Primary percutaneous coronary intervention (PCI) has been found to be superior, in terms of hospital mortality and long-term outcome, compared with thrombolytic therapy in patients with acute myocardial infarction (AMI). However, the clinical benefits of primary PCI have not been precisely evaluated in elderly patients.1,974 patients (Group I: n=1,018, $age{\geq}65years$, $73.8{\pm}5.99years$; Group II: n=956, age<65years, $52.8{\pm}7.96years$) who underwent primary PCI for AMI at Chonnam National University Hospital between 2006 and 2010 were analyzed according to their clinical, angiographic characteristics for hospital and one-year survival. Group I had a higher percentage of women, diabetes mellitus, hypertension, multi-vessel disease and lower prevalence of current smoking, hyperlipidemia, familial history than Group II. Culprit lesions were at the left anterior descending artery, left circumflex artery, right coronary artery and left main artery in 42.8% vs. 45.0%, 34.1% vs. 29.6%, 14.6% vs 14.6, 2.7% vs. 1.6%, respectively (p=0.007). Stent diameter was smaller in group I ($3.17{\pm}0.39$ vs. $3.29{\pm}0.42mm$, p=0.001). In-hospital mortality was higher in group I (8.4 vs. 1.9%, p<0.001). There were significant differences in the rates of major adverse cardiac events between the two groups during one-year clinical follow-up (20.1 vs.14.0%, p<0.001). On multiple logistic regression analysis, systolic blood pressure<100mmHg, serum $creatinine{\geq}1.3mg/dL$, Killip class> I, multivessel disease, left ventricular ejection fraction <40% and cerebro vascular disease were independent predictors of one-year motality in patients over 65 years after PCI.

The Association between Vinyl House Work and Low Back Pain among Some Rural Residents (일부 농촌지역주민의 비닐하우스 작업여부와 요통과의 관련성)

  • Kim, Kwi-Nam;Ryu, So-Yeon;Park, Jong;Lee, Jun-Haeng;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.24 no.1
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    • pp.145-159
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    • 1999
  • To find the association, between vinyl house work and the prevalence of low back pain, a questionnaire survey was made toward 215 vinyl house farmers and 228 general farmers without vinyl house who are cared by Jungjung Community health Practioners at Soobuk Myun, Damyang-gun, Chollanamdo. 1. Vinyl house farmers were significantly younger in age, higher in educational status higher survival rate of spouse, higher economic state and less cared by medical aid than general farmers. 2. Vinyl house farmers showed shorter career for agricultural work, used modern farming instrument more frequently and worked with sitting position. 3. During unbusy season in general agriculture, vinyl house farmers consumed significantly more time in agricultural work and general activity, but no significant difference of time of the above activity among busy season. 4. During the last spring season when most vinyl house work was performed, vinyl house farmers showed significantly higher prevalence of low back pain than general farmers, but no significant difference of prevalence among the two groups for the last one week. 5. By the simple analysis statistical significant related variables with low back pain was found to be sex(p<0.001), educational status(p<0.05), work posture(p<0.001) and use of modern agricultural machine(p<0.05). 6. By the multiple logistic regression the odds ratio for low back pain among vinyl house farmers were 2.08(95% confidence interval 1.31-3.00) compared to general farmers, the odds ratio among female was 2.35(95% confidence interval 1.24-4.47) to male, the odds ratio among illiterate persons were 2.60(95% confidence interval 1.24-4.47) to high school graduate, and the odds ration among primary school graduate was 2.19(95% confidence interval 1.04-4.47) to high school graduate. In conclusion because vinyl house farmers showed significantly higher rates of low back pain compared to farmers without vinyl house, continuous study to find the true cause of low back pain among vinyl-house farmers and active effort to prevent low back pain are necessary.

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