• Title/Summary/Keyword: 진단 일치율

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Accuracy of the Registered Cause of Death in a County and its Related Factors (일개 군 사망신고자료에 기재된 사인의 정확성과 관련요인)

  • Shin, Hee-Young;Shin, Jun-Ho;Nam, Hae-Sung;Ryu, So-Yeon;Im, Jeong-Soo;Rhee, Jung-Ae;Chung, Eun-Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.2
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    • pp.153-159
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    • 2002
  • Objectives : To evaluate the accuracy of the registered cause of death in a county and its related factors. Methods : The data used in this study was based on 504 cases, in a county of Chonnam province, registered between January and December 1998. Study subjects consisted of 388 of the 504 cases, and their causes of death were established by an interview survey of the next of kin or neighbor and medical record surveys. We compared the registered cause of death with the confirmed cause of death, determined by surveys and medical records, and evaluated the factors associated with the accuracy of the registered cause of death. Results : 62.6% of the deaths were concordant with 19 Chapters classification of cause of death. external causes of mortality, endocrine, nutritional and metabolic diseases, neoplasms and diseases of the circulatory system showed the good agreement between the registered cause of death and the confirmed cause of death. The factors relating to the accuracy of the registered cause of death were the doctors' diagnosis for the cause of death (adjusted Odds Ratio: 2.67, 95% Confidence Interval: 1.21-5.89) and the grade of the public officials in charge of the death registry (adjusted Odds Ratio: 0.30, 95% CI=0.12-0.78). Conclusions : The accuracy of the registered cause of death was not high. It could be improved by using the doctors' diagnosis for death and improving the job specification for public officials who deal with death registration.

A Study of Inter-observer Agreements of Spiral Chest Computed Tomography in Diagnosing Pulmonary Embolism (폐색전증에서 나선형 컴퓨터 전산화 단층촬영의 관찰자간의 일치도에 관한 연구)

  • Kim, Yang-Ki;Lee, Young Mok;Kim, Ki-up;Uh, Soo-taek;Kim, Yong Hoon;Park, Choon Sik;Hwang, Jung-Hwa;Kim, Dong Hun;Goo, Dong-Erk;Choi, Deuk-Lin
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.473-479
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    • 2005
  • Background : A pulmonary embolism often presents with nonspecific symptoms and signs. However, a delayed diagnosis can result in catastrophic outcome. The majority of preventable deaths associated with a pulmonary embolism can be ascribed to a missed diagnosis rather than to the failure of existing treatments. Therefore, accurate and rapid diagnostic methods are essential for the management of a pulmonary embolism. The recent generation of multidetector-row spiral CT scanners appears to outperform other imaging modalities in detecting a central and peripheral pulmonary embolism. However, there are some variations in the interpretations of the findings between observers. This study examined the inter-observer differences of the diagnoses in patients with a pulmonary embolism. Method : 64 patients who were diagnosed with a pulmonary embolism either clinically or with spiral chest CT from 2002 to 2004, were included. Two thoracic radiologists interpreted the multidetector-row spiral CT in terms of the diagnosis of a pulmonary embolism and the location of the thrombus independently. Among 64 patients, 14 patients were excluded because there was no evidence of a pulmonary embolism or there was different interpretation of the pulmonary embolism between radiologists. A clinical diagnosis was based on "Rules for predicting the probability of embolism". Results : The mean score of the patients according to the Wells method was $3.91{\pm}0.30$ (0-9). The accordance of the radiologists was 95% in the main, 85% in the lobar, 91.2% in the segmental, and 96% in the sub-segmental pulmonary arteries. After excluding the negative interpretation from both radiologists, their agreement was 76.2%(${\kappa}.$ 0.83) in the main, 57.6%(${\kappa}.$ 0.63) in the lobar, 51.5%(${\kappa}.$ 0.63) in the segmental, and 34.6%(${\kappa}.$ 0.49) in the sub-segmental pulmonary arteries. Conclusion : Chest CT has been recently applied to patients suspected of having a pulmonary embolism. It was found that spiral CT is a rapid test for diagnosing a thrombus, and there was reliable accordance between the observers from the area of the large pulmonary arteries. However, there was a lack of agreement between the observers in diagnosing thrombi located distal to the sub-segmental arteries.

Fine Needle Aspiration Cytology of the Mediastinal Lesions (종격동 병변의 경흉 세침흡인 세포학적 진단)

  • Park, In-Ae;Ham, Eui-Keun
    • The Korean Journal of Cytopathology
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    • v.1 no.1
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    • pp.43-50
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    • 1990
  • The authors report 16 cases of mediastinal fine-needle aspiration cytology from Jan. 1985 to Mar. 1988 at the Seoul National University Hospital. Among them, diagnostic material were obtained in fifteen cases, establishing the diagnosis of 7 thymomas, 2 germinomas, 2 neurogenic tumosr, 1 lymphoma, and 3 meastatic carcinomas. The 9 cytologic diagnoses could be confirmed by histologic examination in 8 patients and by another cytologic method in one patient, allowing concordance rate of 77%.

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Physical characteristics according to Sasang constitution typology determined by Sasang Constitution Analysis Tool(SCAT) and a specialist (사상체질 진단 도구(SCAT)와 전문가에 의해 판정된 사상체질별 신체적 특성)

  • Kim, Soon Mi
    • Journal of the Korea Convergence Society
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    • v.11 no.12
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    • pp.363-371
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    • 2020
  • The purpose of this study was to find out the body shape characteristics of each Sasang constitution typology. The constitution type of the subjects was determined by Sasang Constitution Analysis Tool(SCAT) and a Sasang specialist. The body circumference of the subjects and their respective proportions were analyzed. Concordance rates between SCAT and the specialist were 33.0% and 41.5% for men and women, respectively, and Soyangin had the lowest concordance rate. Forehead/neck, chest/iliac, rib/iliac, and rib/curvature circumference ratios of female subjects showed the same results in both SCAT and the specialist. In determining the constitution type, it was confirmed that the ratio between specific circumferences can be a more meaningful criterion than the circumference.

Development of diagnosis index for tick/click and tone noise of blower motor using vibration signals (진동 신호를 이용한 블로워 모터 틱/클릭과 톤 소음의 진단 지수 개발)

  • Lee, Songjune;Cheong, Cheolung;Lee, In-Hyuk
    • The Journal of the Acoustical Society of Korea
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    • v.38 no.3
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    • pp.363-369
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    • 2019
  • Various studies have been conducted for the diagnosis of noise condition of complex rotary machines. In this study, diagnosis index using vibration signal is developed for the efficient and objective assessment of noise condition of a blower motor. The noise most commonly caused by the abnormal blower motor are Tick/Click noise and Tone noise. According to cause and noise characteristics, time-frequency analysis is used to diagnose Tick/Click noise, and smoothing in frequency domain is used to diagnose tone noise condition. The noise condition of the blower motors were diagnosed using the developed index and these results are compared with the diagnostic results by the experts. As a result, the agreement rate was about 95 %.

Histologic Accuracy of Diagnostic Methods in Lung Cancer (폐암에서 진단수기의 조직학적 분류의 정확성에 관한 연구)

  • Lee, Sang-Min;Koh, Won-Jung;Yoon, Ho-Il;Choi, Seung-Ho;HwangBo, Bin;Park, Gye-Young;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.4
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    • pp.488-497
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    • 1999
  • Background : Identification of the histologic cell type of lung cancer is important because it is related to the treatment modality and prognosis. Currently, many diagnostic methods are used to determine the cell type. We have studied to evaluate the histologic accuracy of each diagnostic methods in lung cancer. Method : 168 cases were analysed retrospectively, who underwent curative thoracotomy for lung cancer in Seoul National University Hospital from January, 1994 to February, 1997. Sputum cytology, percutaneous needle aspiration(PCNA), percutaneous needle biopsy(PCNB), bronchial washing cytology and flexible bronchoscopic biopsy were evaluated respectively. The k coefficient was applied to evaluate the degree of concordance between the histologic diagnosis obtained by each methods and the one derived from thoracotomy. Results : The k value in sputum cytology was 0.86. In the 34 cases with squamous cell carcinoma(SQ), 32 cases were finally diagnosed as having such by thoracotomy. 7 of the 8 cases with adenocarcinoma(AD) turned out to have the same. The k value in PCNA was 0.51. In the 31 cases with SQ, only 14 cases were finally diagnosed as having such. All of the 3 cases with small cell carcinoma(SC) turned out to have the same. The k value in PCNB was 0.77. The diagnosis was correct in 13 of the 16 patients with SQ and in 30 of the 32 cases with AD. The k value in bronchial washing cytology was 1.0. In all of the 29 cases with SQ and all of the 7 cases with AD, the diagnosis was correct. The k value in flexible bronchoscopic biopsy was 0.77. The diagnosis was correct in 51 of the 52 cases with SQ and in 1 of the 2 cases with SC. Conclusion : The concordance rate with the final histologic diagnosis in sputum cytology, PCNB, bronchial washing cytology and flexible bronchoscopic biopsy were excellent ($k{\geq}0.75$), while that in PCNA was fair (k=0.53). Because PCNA showed lower concordance rate than other diagnostic methods, PCNA is recommended to perform with PCNB.

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GIS Condition Monitoring and Diagnosis System by Using Convergence Sensors (융복합센서를 이용한 GIS 감시진단 시스템)

  • Kwon, Young-Jin;Song, Wan-Seak;Seo, Duck-Ki;Noh, Yu-Il
    • Proceedings of the KIEE Conference
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    • 2011.07a
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    • pp.786-787
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    • 2011
  • 본 논문에서는 초고압 GIS의 감시진단을 위한 여러센서를 하나의 융복합 센서로 개발한 결과를 보였다. GIS 차단부 이상 검출을 위해서는 압력파 센서를 이용한 진폭 변화와 주파수 스펙트럼 분석 방법의 사용을 제안하였고, 가스구획 부분방전 검출 능력 향상을 위해서는 SWNT 센서를 사용하여 발생 위치를 찾고 진단 일치율을 향상 시키는 것을 제안하였다. 간이 합성 설비와 GIS Mock-up을 제작하여 실험을 수행하여 제안한 방법들의 타당성을 검증하였다.

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A study on classification of tongue coating using multi-dimensional color vectors (다차원 컬러벡터를 이용한 설태 분류 - 백태, 황태)

  • Lee, J.;Choi, E.J.;Ryu, H.H.;Lee, H.J.;Lee, Y.J.;Kim, J.Y.
    • Proceedings of the KIEE Conference
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    • 2007.07a
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    • pp.1900-1901
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    • 2007
  • 한의학에서 혀는 인체 내 생리, 병리적 변화를 반영하여 진단에 있어 중요한 지표자료로 사용하고 있다. 하지만 설진은 진단환경에 의한 영향을 많이 받게 되어 객관적이고 정량화된 결과를 얻기 힘들며, 그로 인해 한의사의 진단에 대한 신뢰성도 낮아 널리 활용되지 못하고 있다. 이를 해결하기 위해 본 연구에서는 제한된 측정환경을 제공하는 디지털 설진 시스템을 통해 한의사로부터 황태라 진단받은 48명과 백태라 진단받은 14명의 설 영상을 획득하고, 설태의 컬러벡터값을 구하여 백태와 황태를 구분하는데 유의한 변수를 도출하였으며, 이를 이용하여 한의사의 설태 진단과 일치율이 높은 판별함수를 도출하였다. 이와같은 연구방법은 백태, 황태 뿐 아니라 회태나 흑태 또는 후태나 박태를 구분하는 데에도 유용하게 쓰일 수 있을 것이며 앞으로 한의사의 설진과정을 객관화, 과학화하는 과정에 기여할 수 있을 것이다.

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Comparison of Clinical Significance Between Chest CT Scan and Bronchoscopy Prior to Bronchial Artery and Outcome of Embolization in Patients with Hemoptysis (객혈환자의 기관지동맥 조영술 전 흉부 전산화 단층촬영과 기관지내시경 검사의 유용성 비교 및 색전술 성적)

  • Jang, Jung Hyun;Ryu, Kum-Hei;Kwon, Jung Mi
    • Tuberculosis and Respiratory Diseases
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    • v.55 no.6
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    • pp.551-559
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    • 2003
  • Background : Emergency management in hemoptysis is bronchial artery angiography and embolization. This study was designed to investigate the accuracy of localization of bleeding site by simple roentgenogram, computed tomography(CT) and bronchoscopy prior to embolization and to evaluate the outcome of embolotherapy. Method : We retrospectively evaluated 50 patients performed bronchial artery embolization(BAE), admitted to tertiary university hospital due to hemoptysis. Results : The most common causes were pulmonary tuberculosis, old tuberculous related parenchymal damage, aspergilloma, and bronchiectasis. The success rate of BAE within one month was 90%; within 3 months was 88%; during follow up period of mean 11.6 months was 76%. The concordant rate of simple roentgenogram with angiographic outcome in terms of bleeding site is 70%; in chest CT 80%; in bronchoscopy 81%; in combined information of simple roentgenogram and CT 83%; in combined information of simple roentgenogram and bronchoscopy 78%. Conclusion : The diagnostic accuracy for the bleeding site was similar between chest CT and bronchoscopy, showing high diagnostic yield. The success rate of BAE was comparative to prior studies. Further study will be needed in a large scale in near future.

The Evaluation of Usefulness of Wide Beam Reconstruction Method on Segmental Perfusion and Regional Wall Motion in Myocardial Perfusion SPECT (심근관류 SPECT의 분절별 관류 및 국소벽 운동에서 Wide Beam Reconstruction기법의 유용성 평가)

  • Seong, Yong-Joon;Kim, Tae-Yeob;Moon, Il-Sang;Cho, Seong-Wook;Woo, Jae-Ryong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.51-57
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    • 2011
  • Purpose: The aim of this study is to identify clinical usefulness of Wide Beam Reconstruction (WBR) which is called Xpress.cardiac$^{TM}$ to confirm the agreement between segmental perfusion and regional wall motion in myocardium compared to conventional OSEM method. Materials and Methods: Subjects were separated two groups. First group was composed of 20 normal control group. Second group was composed of 10 patients (abnormal group) who had coronary artery disease. Subjects underwent myocardial perfusion SPECT ($^{201}Tl$ rest and $^{99m}Tc$-MIBI stress). Image acquisition and reconstruction were that rest stage was each step per 30, 15 seconds and stress stage was each step per 25, 13 seconds, OSEM and WBR methods were applied. Segmental perfusion and regional wall motion were applied 20-segment model of QPS, QGS algorithm in AutoQuant. Status of perfusion was composed of 5 point scoring system (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). Status of regional wall motion was also composed of 5 point scoring (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). We evaluated the agreement between conventional OSEM and WBR through automatic quantification value. Results: The agreement of rest segmental perfusion between conventional OSEM and WBR in normal patients was 99% (396/400, k=0.662, p<0.0001) and one of rest regional wall motion was 83.8% (335/400, k=0.283), the agreement of stress segmental perfusion was 95.8%(383/400, k=0.656), one of stress regional wall motion was 87.3% (349/400, k=0.390). The match rate of rest segmental perfusion in abnormal patients was 83% (166/200, k=0.605, p<0.0001) and one of rest regional wall motion was 55.5% (111/200, k=0.385), the agreement of stress segmental perfusion was 79.5% (159/200, k=0.682), one of stress regional wall motion was 63.5% (127/200, k=0.486). Conclusion: Compared to conventional OSEM, WBR method had a good agreement of segmental perfusion in myocardium in normal and abnormal groups. However regional wall motion showed meaningful low agreement. Although WBR offers high resolution and contrast ratio, it is not useful method for gated myocardial perfusion SPECT.

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