• 응용통계연구
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• 제20권1호
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• pp.117-132
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• 2007

두 평정자가 있는 이차원 분류표에서 우연에 의한 합치 비율을 보정한 Cohen의 합치도($\kappa$)는 문제점이 있는 측도로 알려져 있다. $\kappa$는 평정자의 분류 비율(주변확률)에 매우 민감하고, 합치도로서의 조건도 만족하지 못한다. 그러나 $\kappa$를 비롯한 기존 합치도들은 주변확률이 0.5에 가까울 때 안정되며 비슷한 값을 갖는다. 본 연구에서는 이차원 분류표의 불균형적 주변분포를 보정함으로써 $\kappa$의 역설을 해결하는 새로운 합치도 H를 제안한다. 또한 예제를 통해 기존의 합치도들과 제안된 합치도를 비교한다.

• 대한치과보철학회지
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• 제54권4호
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• pp.364-369
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• 2016

목적: 총의치를 사용하고 있는 무치악 환자에서 의치 사용에 대한 환자의 평가와 술자간의 평가를 비교하고자 하였다. 대상 및 방법: 의치를 사용한지 최소 1년 이상 경과된 총의치 장착자 중 43명의 환자가 정기검진에 응하였다. 환자에 관한 여러 정보를 얻기 위해 다양한 문헌에서 얻은 자료를 토대로 설문지를 개발하고 술자의 객관적인 평가간 일치도를 분석하였다. 술자의 평가 사항으로는 유지, 안정, 교합과 같은 기능적 항목과 의치의 상태를 포함한다. Friedman test와 Cohen's Kappa값을 이용하여 통계학적인 분석을 시행하였다. 결과: 의치 장착자의 평가와 술자의 평가 간에는 약하거나 약간의 차이가 있다. 상악 의치보다는 하악의치에서 차이가 더 크게 나타났으며 심미와 저작은 중등도의 차이가 있었다. 결론: 의치에 대한 환자의 주관적, 술자의 객관적인 평가는 일치하지 않으나 큰 차이를 보이지 않는다.

• 대한물리의학회지
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• 제16권1호
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• pp.1-7
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• 2021

PURPOSE: The purpose of this study is to conduct inter-rater and intra-rater reliability tests in patients with low back pain (LBP) using the prone instability test (PIT) and side-lying instability test (SIT). We have analyzed the Korean version Oswestry disability index (K-ODI) correlations and radiograph finding (RF) for validity. METHODS: Individuals (n = 51) (mean age of 40.27 ± 13.28) with LBP for at least over a week were recruited, together with two participating physical therapist examiners. The measurement consisted of PIT, PST, K-ODI, and RF. Sensitivity (Sn), specificity (Sp), positive predictive value, negative predictive value, prevalence index, agreement %, Cohen's kappa, and prevalence-adjusted bias-adjusted kappa (PABAK) were calculated. The PIT and SIT were compared with RF for validity analysis, while PIT, SIT, K-ODI, and RF were calculated for the correlation analysis. RESULTS: The intra-rater reliability test measured for the PIT (kappa = .79, PABAK = .88) and SIT (kappa = .73, PABAK = .84), and inter-rater reliability test measured for the SIT (kappa = .80, PABAK = .88) showed good agreements. The PIT (Sn = .65, Sp = .63) and SIT validities (Sn = .68, Sp = .70) were compared with RF, showing a significant correlation in PIT and RF (r = .69), SIT and RF (r = .73), and PIT and K-ODI (r = .53). CONCLUSION: The SIT is a more comfortable position test than the PIT in patients. Both PIT and SIT have acceptable reliability and validity.

• 대한기계학회논문집B
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• 제41권2호
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• pp.125-133
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• 2017

본 연구에서는 환자의 손가락 경직을 모사하는 손가락 시뮬레이터를 통해 손가락 경직도 검진에서의 검진자간 신뢰도에 대해 연구하였다. 시뮬레이터를 제어하기 위해 경직에서 나타나는 토크를 간단하게 모델링 하고 손가락 경직 환자로부터 간단한 측정 모듈을 이용해 각각의 Modified Ashworth Scale(MAS) 등급에 맞는 파라미터를 얻어냈다. 또한 중수지 관절에 모터가 위치한 손가락 형태의 로봇을 설계하여 경직 토크 모델을 따르는 시뮬레이터를 개발하였다. 이 시뮬레이터를 통해 일곱 명의 재활의학과 전문의들의 검진 결과를 평가해본 결과 중수지 관절에서 0.619, 근위지간 관절에서 0.514의 Cohen's Kappa 값을 보였다. 검진자간의 Fleiss' Kappa 값은 중수지 관절에서 0.513, 근위지간 관절에서 0.486으로 나타났다. 또한 검진자들은 각각의 주관적인 MAS 검진 기준을 가진다는 것을 확인하였다. 결과적으로 같은 환자에 대한 MAS 검진 신뢰도가 높지 않기 때문에 개발된 로봇 시뮬레이터는 검진자의 신뢰도를 높일 수 있는 교육용 도구로서 활용 가능함을 확인하였다.

• Imaging Science in Dentistry
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• 제30권1호
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• pp.49-54
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• 2000

Purpose : To compare the diagnostic performance of clinical and radiologic examination for the interproximal caries on intraoral periapical radiographs and to evaluate the value of periapical radiographs. Methods: One hundred seven dental patients were examined clinically, with a mouth mirror and an explorer, by a dentist at the department of oral medicine, and the presence or absence of interproximal caries lesion was recorded. The patients were prescribed one or more dental periapical radiographs. Radiographs were assessed for the presence of interproximal caries by three oral and maxillofacial radiologists independantly. Two thousand sixty interproximal surfaces were included in this study. The diagnostic accuracies of clinical and radiologic examinations for interproximal caries were calculated. To assess the degree of agreement between clinical and radiologic examinations, Cohen's coefficient of agreement was computed. Results: The specificity of clinical and radiologic examination was 0.991, 0.997 and the sensitivity was 0.279, 0.985 respectively. The diagnostic accuracy of radiologic examination was statistically significantly higher than that of clinical examination (P<0.05). Cohen's kappa value of clinical and radiologic examination was 0.335, 0.942 respectively. These results suggested that clinical examination show only fair agreement, whereas radiologic examination show perfect agreement. Conclusion: The diagnositic performance of the dental periapical radiographs on interproximal caries were higher than that of clinical examination, thus this study showed the validity of periapical radiographs for detecting interproximal caries lesion without bitewing radiograph.

• Journal of Preventive Medicine and Public Health
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• 제42권4호
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• pp.223-230
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• 2009

Objectives : This study was conducted to validate self-reported smoking among high school students using urinary cotinine. Methods : A self report of smoking behavior was collected together with urine sample for cotinine analysis from 130 male and female students in two vocational high school students in November, 2007. Validity and agreement between self-reported smoking and urinary cotinine was analyzed with STATA 9.0 for different definitions of current smokers, and frequent and daily smokers. Urinary cotinine concentration was measured by the DRI Cotinine Assay for urine (Microgenics Corp., Fremont, CA) on Toshiba 200FR. The cut-off point of urinary cotinine was 50 ng/dl. Results : The concentrations of urinary cotinine were significantly different according to the frequency and amount of smoking. Sensitivity and specificity was 90.9% and 91.8% respectively, and the Cohen s kappa value was 0.787 among the current smokers who smoked at least one day during one month preceding the survey. The comparable high sensitivity, specificity, and kappa value were shown also among the other definitions of current smokers, that is, subjective smokers, and weekly smokers. Conclusions : The results showed the high validity of self-reported smoking among high school students. However, due to the small sample size and limitation of the participants, it is cautious to generalize the results to overall high school students.

• 한방안이비인후피부과학회지
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• 제30권4호
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• pp.97-103
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• 2017

Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

• 사상체질의학회지
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• 제36권2호
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• pp.1-11
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• 2024

Objectives The purpose of this study was to compare between baseline and follow up data after 5 years about the change of Sasang constitutional value. Methods Cohort data of educational personnel in D University was used. Korean Sasang Constitutional Diagnostic Questionnaire was used to compare Sasang value including body shape, temperament, and pathological symptoms in baseline with those of follow up. Paired t test, chi-square test, correlation analysis and cohen's kappa coefficient was used. Results Total 150 subjects participated in this analysis. Taeeumin, Soeumin and Soyangin was 71, 46 and 33 respectively. Height decreased in follow-up, and weight increased, accordingly body mass index increased(p<.05). The score of nocturia was significantly increased, and the temperature of drinking water was significantly decreased. The consistency rate of the Sasang constitutional values in KS-15 between baseline and follow up was 76%, and the kappa value was 0.607. Compared to the expert's diagnosis, the agreement rate was 66.7% in baseline and 69.3% in follow up. Conclusion As times goes by, Sasang Constitutional phenotype, such as body mass index, nocturia, and temperature of drinking water, and accordingly, the predicted value of Sasang constitution may be changed. Those who use Sasang constitutional type and therapy in clinics should consider these factors.

• 대한불안의학회지
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• 제3권1호
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• pp.32-40
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• 2007

Objectives : To investigate the validity of an abbreviated self-rated Korean version of MINI (Mini International Neuropsychiatric Interview) patient health survey which screening social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder. Methods : 115 subjects completed MINI and MINI patient health survey. The validity of MINI patient health survey was assessed by whether the results from MINI patient health survey were compatible with the results from MINI or not. The Cohen's kappa value, specificity, sensitivity, positive predictive value, and negative predictive value was calculated for this purpose. Results : The Kappa values of social anxiety disorder (0.60), panic disorder (0.49), generalized anxiety disorder (0.60) and major depressive disorder without other co-morbid disorder (0.59) were at least moderate in strength of agreement. Conclusion : The abbreviated self-rated Korean version of MINI patient health survey has the moderate to good validity in social anxiety disorder, panic disorder, generalized anxiety disorder, and major depressive disorder without other co-morbid disorders. Our result suggests that this instrument might be useful for screening above 4 disorders if it is used under careful supervision of experienced clinicians.

• 대한한방내과학회지
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• 제35권4호
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• pp.483-497
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• 2014

Objectives: The aims of study were developing cut-off value of Yin-deficiency questionnaire (YDQ) for diagnosis of Yin-deficiency (YD) and compare diagnostic ability between YDQ and Yin-deficiency scale score (YDS) in xerostomia patients. Methods: We recruited 58 xerostomia patients. They were diagnosed YD or non-YD by 3 Korean medicine doctors (KMD). We assessed YD using YDQ and YDS. We evaluated xerostomia using VAS, Dry Mouth Symptom Questionnaire (DMSQ), Salivary Flow Rate (SFR), oral moisture on buccal mucosa and tongue surface (OMB and OMT). We surveyed tongue coatings using Winkel Tongue Coating Index (WTCI). Results: We diagnosed 23 patients YD and 35 patients non-YD. There were no significant differences of age, sex and body mass index between the YD and non-YD groups. Using receiver operating characteristic curve analysis, the optimal cut-off value of YDQ was defined as 304. Sensitivity, specificity and Youden index of YDQ were 86.96%, 71.43% and 1.5839 respectively. Using Cohen's coefficient of agreement, we found that degree of agreement between KMD and YDQ diagnosis was moderate (${\kappa}$=0.524, p<0.001). Using Pearson's correlation analysis, we found concurrent validity of YDQ and YDS were significant correlated. Using area under curve value, we found diagnostic ability between YDQ and YDS were not significantly different (p=0.505), but there were more strong correlations between DMSQ-symptoms and YDQ (r=0.731, p<0.001) than correlations between DMSQ-symptoms and YDS (r=0.418, p<0.01). Conclusions: The cut-off value of YDQ can diagnose YD in xerostomia and diagnostic ability of YDQ in xerostomia is better than YDS.