• Title/Summary/Keyword: Clinician's rating

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Concordance Rate Between the Ratings of Clinician and Self Ratings of Worker on a Functional Capacity Evaluation

  • Choi, Bong-sam
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.71-80
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    • 2016
  • Background: Functional capacity evaluations (FCEs) are designed to systematically assess the capacity to perform work-related tasks and to determine worker's ability to return to the previous job following work-related injuries. These evaluations may be rated either by clinician or worker. There has been a lack of consensus between the two scoring methods. Objects: This study aimed: 1) to confirm if the data are fit to the Rasch rating scale model and 2) to investigate the item-level concordance rate between the ratings of clinician and injured worker of the FCE. Methods: A cross-sectional study was conducted with a sample (n=124) of a rehabilitation program with the Occupational Rehabilitation Data Base for workers with low back pain. The functional capacity evaluation at admission and discharge was administered to clinicians and workers. The data were analyzed using both classical test theory-based Pearson's r and intra-class coefficient followed by item-level analysis with Rasch rating scale model. Results: All items of the FCE, except sitting items rated by clinician at admission and handling items rated by both clinician and worker throughout admission and discharge, were acceptable fit statistics with minor out of ranges for a misfit criterion. This may indicate that the items of the FCE overall fit to the Rasch rating scale model. Few problematic items responding differently to clinician and worker both at admission and discharge were detected with the differential item functioning analysis despite the excellent concordance rate using the two conventional statistics-sitting and handling items at admission and handling item at discharge. Conclusion: The item-level speculations using Rasch analysis of the FCE demonstrate that the ratings of clinician and self ratings of worker were psychometrically acceptable though there was an apparent discrepancy between the raters both at admission and discharge.

Comparison of Patient's Subjective Rating Scales for Voice Evaluation in Professional Voice Users with Vocal Fold Lesions (전문직 음성사용자의 주관적 음성평가도구간의 비교)

  • Kim, Jae-Ock;Choi, Sung-Hee;Lim, Sung-Eun;Choi, Jae-Nam;Choi, Hong-Shik
    • Proceedings of the KSPS conference
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    • 2007.05a
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    • pp.292-294
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    • 2007
  • This study was designed to compare the translated patient's subjective rating scales for voice evaluation (Voice Handicap Index; VHI, Voice-Related Quality of Life; V-RQOL, Voice Rating Score; VRS) into Korean, taken from 24 professional voice users diagnosed with organic voice disorders. First, the correlation amongh those scales were observed. Second, the correlation between the patient's subjective rating scales and acoustic measures (Jitter%, Shimmer%, NHR) were examined. Third, those scales were compared by clinician's objective scale (G in GRBAS scale). Results indicated that significant correlations among the patients' subjective rating scales and significant correlations of clinician's rating scale with jitter% and Shimmer%, but not with NHR were observed. In addition, there were significant correlations of G with VHI and VHI-P (one of subscale of VHI). However, none of acoustic measures were correlated with the patient's subjective rating scales.

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Comparison between denture wearer's evaluation and clinician's rating for complete denture (총의치 사용에 대한 환자와 술자간 평가 비교)

  • Byun, Jin-Soo;Huh, Yoon-Hyuk;Cho, Lee-La;Park, Chan-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.54 no.4
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    • pp.364-369
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    • 2016
  • Purpose: The aim of this study was to compare denture wearer's evaluation and clinician's technical rating for complete denture used on edentulous patients. Materials and methods: Total 43 edentulous patients who had complete denture fabricated more than one year ago were recalled. The questionnaire based on the various literatures was modified and applied to patients for subjective assessments. Functional aspects related to retention, stability, occlusion and denture condition were included in operator's evaluation. In addition, correlations were evaluated between patient's subjective and operator's objective assessments. Friedman test and Cohen's Kappa value were used for statistical analysis. Results: It was found that denture wearers' evaluations were slightly or fairly agree to clinician's rating for complete denture. More differences were found in maxillary denture than mandibular denture and moderate difference was found in esthetic, occlusion aspects. Conclusion: There were slightly or fairly agreement between subjective and objective evaluations.

Validity and Reliability of Korean-Version of Voice Handicap Index and Voice-Related Quality of Life (한국어판 음성장애지수와 음성관련 삶의 질의 타당도 및 신뢰도 연구)

  • Kim, Jae-Ock;Lim, Sung-Eun;Park, Sun-Young;Choi, Seung-Hee;Choi, Jae-Nam;Choi, Hong-Shik
    • Speech Sciences
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    • v.14 no.3
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    • pp.111-125
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    • 2007
  • It is important to examine patients' subjective evaluation as well as objective measures and clinician's rating to assess voice disorders. This study aimed to evaluate validity and reliability of Korean-version of Voice Handicap Index (KVHI) and Voice-Related Quality of Life (KVQOL) with 113 adults with voice disorders and 111 normal adults. Content validity was verified by three experienced speech-language pathologists. Concurrent validity was revealed by examining the correlation among KVHI, KVQOL, and Voice Rating Scale as well as item discrimination coefficients. Total scores of KVHI and KVQOL of adults with voice disorders were significantly different from those of normal adults. Test-retest reliability and internal consistencies were significantly high in both KVHI and KVQOL. Correlations among scores of each subscale and total score were also significantly high in each tool. The study revealed that KVHI and KVQOL are suitable tools to be used in clinics and research areas in Korea, which can subjectively evaluate the effects of voice disorders on daily life as well as on quality of life.

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Quantitative Assessment of Tremor in PD Using a Wearable System on Both Hands (양손에서 웨어러블 시스템을 이용한 파킨슨병의 정량적 진전 평가)

  • Lee, Hongji;Kim, Sangkyong;Kim, Hanbyul;Jeon, Hyoseon;Park, Hyeyoung;Jung, Yujin;Kim, Jeonghwan;Jeon, Beomseok;Park, Kwangsuk
    • Journal of Biomedical Engineering Research
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    • v.35 no.4
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    • pp.81-86
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    • 2014
  • One of the methods for Parkinson's disease(PD) tremor evaluation is the Clinical Tremor Rating Scale(CTRS). However, the method has some limitations that clinician ratings can vary because the scores are subjectively rated. In addition, most researches usually collected data measured on the more affected arm. In this study, we developed a portable wearable system(SNUMAP system) for measuring PD tremor. The SNUMAP system captures 3-dimensional motion using tri-accelerometer and tri-gyroscope on finger and wrist. 40 PD patients participated in resting tremor and postural tremor tasks, while wearing the system on both hands simultaneously. Estimated tremor scores from Leave-One-Out Cross Validation for regression were highly correlated to the average clinician CTRS scores for rest tremor($r^2$ = 0.87, RMSE = 0.48) and postural tremor($r^2$ = 0.82, RMSE = 0.48). Therefore, the quantitative assessment model can improve treatment of PD patients.

Serum Testosterone Levels in Patients with Post-Traumatic Stress Disorder (외상 후 스트레스 장애 환자의 혈청 테스토스테론치)

  • Kim, Dong Su;Kim, Hae Jung;Bang, Yu Jin;Go, Chang Min;Chung, Moon Yong;Kang, Suk Hoon
    • Anxiety and mood
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    • v.9 no.2
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    • pp.106-112
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    • 2013
  • Objective : Several reports have found abnormal levels of androgen in post-traumatic stress disorder (PTSD) patients. This abnormality in androgen is hypothesized to due to chronic psychological stress effects on the hypothalamic-pituitary-gonadal (HPG) system. The present study was conducted to estimate serum testosterone levels in PTSD patients in comparison with normal subjects. Methods : Seventy-five male Korean veterans of the Vietnam War volunteered for the study, of which eleven were excluded because of incomplete psychological assessment. To measure basal serum testosterone, blood samples were collected between 8.00 and 9.30 a.m. The clinician administered PTSD scale (CAPS), the structured clinical interview for DSM-IV (SCID), Hamilton Anxiety Rating Scale (HAM-A), Hamilton Rating Scale for Depression (HAM-D), Mini International Neuropsychiatric Interview Plus (Korean version of MINI-Plus), CES-K (Korean version of combat exposure scale). Results : The serum testosterone level of PTSD patients ($5.4{\pm}2.5ng/mL$) was higher than that of a control group ($3.1{\pm}1.7ng/mL$, p<0.001). Testosterone levels were significantly correlated with CAPS (r=.38, p<.01), HAM-A (r=.35, p<.01) and HAM-D (r=.28, p<.01) in all subjects. Conclusion : The results of the present study suggest that chronic psychological stress affects the HPG system.

A Clinical Case Study of Guillain-Barré Syndrome with Chronic Progression (만성적 경과관찰을 보이는 Guillain-Barré Syndrome 환자 1례)

  • Roh, Ji-ae;Jang, Jae-won;Lee, Gi-eon;Hong, Jung-soo;Kim, Dong-jin
    • The Journal of Internal Korean Medicine
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    • v.39 no.1
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    • pp.76-83
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    • 2018
  • Objectives: This case study reports on one patient presenting atypical and chronic disorders after being diagnosed with $Guillain-Barr{\acute{e}}$ Syndrome (GBS). Methods: One patient was treated by Yeongseonjetong-eum-gami, Taklisodok-eum-gami, electroacupuncture, and physical therapy. Any improvement in symptoms was assessed by measuring changes in the motor grade of upper limb weakness, the numerical rating scale (NRS) of lower limb numbness, and GBS scores. Results: After 24 days of treatment, the patient's symptoms of GBS showed little improvement. Conclusions: Traditional Korean medical treatment appeared to be effective in reducing GBS symptoms, but more research is required to confirm these results. When treating GBS patients, the clinician should put effort into distinguishing GBS from other nervous disorders, such as acute onset Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).

Clinical Characteristics and Heart Rate Variability in Patients with Comorbid Panic Disorder and Major Depressive Disorder (주요우울장애가 동반된 공황장애 환자의 임상 특징과 심박변이도)

  • Choi, Young-Hee;Kim, Won;Kim, Min-Sook;Yoon, Hye-Young;Choi, Seung-Mi;Woo, Jong-Min
    • Sleep Medicine and Psychophysiology
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    • v.12 no.1
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    • pp.50-57
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    • 2005
  • Objectives: This study was designed to evaluate the differences in clinical characteristics and severity of symptoms between panic patients with and without comorbid major depressive disorder, and to ascertain the differences in the function of the autonomic nerve system measured by heart rate variability (HRV). Methods: The subjects were 60 patients who have panic disorder without major depressive disorder and 19 patients who met DSMIV criteria for both panic disorder and major depressive disorder. First, they drew up symptom checklists and self-rating scales, and were measured by Anxiety Disorder Inventory Schedule-Panic Attack & Agoraphobia (ADIS-P&A), Clinical Global Impression (CGI), Hamilton Rating Scale for Depression (HAM-D), Panic Disorder Severity Scale (PDSS) and Heart Rate Variability (HRV). For statistical analysis, we performed t-test to compare the scores of self reported scales and clinician’s rating scales in panic patients with comorbid major depressive disorder and those without major depressive disorder. ANCOVA was used to compare the variables of HRV, considering age as a covariate. Results: The subjective severities of depression and anxiety that comorbid patients complained of were higher than those of patients with only panic disorder. Futhermore, comorbid patients were more sensitive to anxiety and physical sensations, and they tend to be more negative in their thinking. The scores of clinician-rating scales such as CGI and PDSS were also higher in the comorbid patients. However, there were no significant differences in HRV variables between both groups, despite a tendency to low heart rate variability in the comorbid group. Conclusion: This study suggests that patients with panic disorder and comorbid major depressive disorder tend to complain of more symptoms and to be more sensitive to various symptoms than those with panic disorder without comorbid depression. However, in this study comorbid major depressive disorder did not have a significant impact on the HRV variables of patients with panic disorder.

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The Differences of Depression, Anxiety and Positive Thinking between Adult and Elderly Hemodialysis Patients (투석 환자에서 연령에 따른 우울, 불안 및 긍정사고의 차이)

  • Noh, Ki-Won;Ha, Juwon;Lim, Se-Won;Lee, Jae-Eun;Lee, Kyu-Beck;Kim, Hyang;Oh, Kang-Seob
    • Anxiety and mood
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    • v.9 no.1
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    • pp.38-44
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    • 2013
  • Objective : The end-stage renal disease patients who shared fear of death, functional impairment due to hemodialysis are vulnerable to depression, anxiety and other mental problems. It is possible that their psychiatric characteristics and related autonomic nervous functions have some differences depending on their age. We purpose to find the differences of psychiatric characteristics and related autonomic nervous functions between adult and elderly hemodialysis patients. Methods : Our subjects are end-stage renal disease hemodialysis patients composed of 39 adults (<65 years) and 24 seniors (${\geq}65$ years). Outcome measures included the 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale and Mini-International Neuropsychiatric Interview by clinician. And subjects fulfilled self-report scale, The Positive thinking scale and The Snaith-Hamilton Pleasure Scale. The autonomic nervous functions are measured by heart rate variability. Results : There are no significant differences in demographic factors between two groups. The 17-item Hamilton Rating Scale for Depression, The Hamilton Rating Scale for Anxiety, The Apathy Evaluation Scale, The Snaith-Hamilton Pleasure Scale and autonomic nervous functions are also not different. But only positive thinking scale is higher in adult hemodialysis group than the elderly (F=5.395, p=0.024). Conclusion : This study compared depression, anxiety and autonomic nervous functions between adult and senior hemodialysis patients. There are no significant differences in psychiatric characteristics and autonomic nervous functions between two groups except positive thinking traits. Senior patients endured their chronic disease similar to adult patients did in spite of their old age. This result suggests that elderly's higher positive thinking traits affect their endurances about the negative situations.

Comparison of the Pattern of Changes in Salivary Cortisol by Degree of Burn and CAPS Score (화상 정도 및 CAPS 점수에 따른 타액 코티졸의 변화 양상 비교)

  • Kim, Jin-Na;Kim, Jee Wook;Choi, Ihn-Geun;Chun, Wook;Seo, Cheong Hoon;Kim, Kyung Ja;Lee, Boung Chul
    • Anxiety and mood
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    • v.8 no.2
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    • pp.93-98
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    • 2012
  • Objective : Cortisol, a product of hypothalamus-pituitary-adrenal axis (HPA axis), is one of our defensive mechanisms in response to stress. The level of cortisol in the saliva is a major biomarker of the stress response by HPA axis and shows diurnal variation. We measured salivary cortisol level and its diurnal variation to compare the pattern of changes by degree of burn and Clinician-Administered PTSD Scale (CAPS) score. Methods : We measured the salivary cortisol levels of 37 subjects hospitalized in the burn center at our facility from March to June 2012. Salivary cortisol levels were measured at 6 : 00 AM and at 7 : 00 PM. All subjects were tested for CAPS to evaluate the severity of posttraumatic stress disorder and the Hamilton Depression Rating Scale to evaluate and to control the coexisting depression. Results : Factorial ANOVA test revealed that there was a statistically significant difference in terms of the effect of the interaction between the degree of burn and the patient's CAPS score. Unlike the mild burn group, in the severe burn group, the patients who had a low CAPS score didn't show a normal diurnal variation and the patients who had a high CAPS score showed the normal diurnal variation. After a few months follow up, we found a greater degree of psychiatric complications in severe burn patients that had a lower cortisol stress response. Conclusion : We suppose that the disappearance of the stress response changes in salivary cortisol seen in the severe burn group may be caused by an impaired stress response. Through followed observation of the subjects, this disruption of cortisol response may cause psychiatric problems afterwards.