• Korean Journal of Radiology
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• 제25권6호
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• pp.540-549
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• 2024

Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

• 대한한방부인과학회지
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• 제34권1호
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• pp.1-14
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• 2021

Objectives: We studied for the adjustment of the patterns of 'The Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (hereinafter CaPSPI)' (studyI) and the correlation between CaPSPI and Korean medicine doctors' diagnosis which was carried out without knowing the results of CaPSPI (studyII). Methods: The studyI followed the previous study method in 2018 (2018-3). The studyII was conducted from June 1, 2019 to July 10, 2020 with ◯◯ University Korean Medicine Hospital IRB's approval (2019-4). Doctors' diagnosis was conducted face-to-face with the subjects. Doctors' diagnosis was carried out based on the Kupperman's questionnaire, 'Diagnosis System of Oriental Medicine (hereinafter DSOM)' and four examinations (四診) records. The diagnosis was marked with 0 for 'no', 1 for 'somewhat', 2 for 'yes' and 3 for 'very yes'. The correlation between CaPSPI and the mean of doctors diagnostic scores were investigated statistically. Results: The studyI showed that heart-heat (心火) pattern was added. The Factor loading coefficient for heart-heat was 0.551 to 0.789, and the Cronbach's coefficient was 0.896. The studyII showed that the diagnosis (Kappa statistic) of two doctors showed statistically significant concordance (all eight patterns), with correlation of them were 0.3 or higher. And the correlation between the CaPSPI score and the mean of doctors' diagnostic score showed a statistically significant correlation, with liver qi depression (肝鬱) being the highest at 0.552 and dual deficiency of the heart-spleen (心脾兩虛) being the lowest at 0.301. Conclusions: Since the diagnosis results of CaPSPI showed a significant correlation with the diagnosis of Korean traditional medicine experts, it was believed that the CaPSPI results can be trusted and used for clinical purposes.

• Journal of the Korean Data and Information Science Society
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• 제21권6호
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• pp.1203-1209
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• 2010

한국정보화진흥원에서는 2002년 개발한 한국형 인터넷 중독 진단척도를 사용하여 인터넷 중독 실태를 매년 발표하고 예방을 위해 노력하고 있다. 그러나 인터넷사용이 급증함에 따라 정보화의 역기능도 증가하고 있으며 특히 인터넷 중독의 폐해가 우려되고 있는 실정이다. 본 연구에서는 인터넷 중독 자가진단 소형척도를 제안하고자한다. 대학생들을 대상으로 킴벌리영척도와 한국형진단척도를 적용하여 인터넷 중독을 진단한 자료를 분석한다. 두 척도의 신뢰성과 타당성을 검토한 결과 한국형진단척도에서 요인타당도가 있음으로, 이를 이용하여 소형척도를 개발한다. 요인타당도의 요인적재값과 변수선택법을 이용하여 선택한 소형척도들을 비교 분석한다. 분할표와 감마 연관성측도를 이용하여 소형척도와 기존의 척도들과의 일치성을 비교하고, 소형척도들의 신뢰성과 타당성을 조사한다.

• 임상간호연구
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• 제26권2호
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• pp.254-264
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• 2020

Purpose: This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). Methods: For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's α) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. Results: Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's α was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist's diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. Conclusion: The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

• Radiation Oncology Journal
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• 제32권1호
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• pp.43-47
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• 2014

Purpose: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. Materials and Methods: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intra-class correlation coefficient (ICC). Results: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. Conclusion: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.

• 대한물리의학회지
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• 제8권1호
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• pp.137-145
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• 2013

PURPOSE: The purpose of this study is to examine assessment of test-retest reliability for 13 items of pediatric balance scales, then the intrarater reliability among the raters. METHODS: Study participants included 6 children with spastic cerebral palsy who could walk. Raters were consist of seventy-four, 2nd year physical therapy major students. The children's ability to achieve physical balance was wideotaped for PBS items. The raters watched the tapes and evlauated each child twice. Test-retest reliability was analyzed using the Spearman correlation, and interrater reliability was analyzed using the Kendall's coefficient of concordance for ranks. RESULTS: The total PBS scores averaged 49.22 and 50.06 for first and second tests. Test-retest reliability of PBS individual items were between low and high. The low itmes were 3 items, and high were 4 itmes. Interrater reliability were low agreement. CONCLUSION: Based on the study, the pediatric balance scale is an effective evaluating tool for measuring functional balance of school age child. However, the agreement of students or beginner's interpretation is necessary in conjunction to this study results. On top of that, it is important to provide detailed explanation and repetitive training, which improves the analysis reliability. Also, each category subscores level for the pediatric balance scale must be examined carefully in conjunction to performing test, only after improving match quality via preceding practice.

• Physical Therapy Rehabilitation Science
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• 제9권2호
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• pp.120-130
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• 2020

Objective: This study was conducted to identify the clinical usefulness, validity, and reliability of the Spirokit, a device that combines the pulmonary function test (PFT) and respiratory muscle strength (RMS) test. Design: Cross-sectional study. Methods: Forty young adults (male: 23, female: 17) participated in a PFT and a RMS test. The concurrent validity for pulmonary function was assessed by comparing data obtained from MicroQuark and the Spirokit and the agreements between the MicroRPM and the Spirokit for RMS were compared. The test-retest reliability of the Spirokit was determined by comparing data obtained from the first and second sessions. The test and retest were performed at the same time after one day for the PFT and RMS test. Validity was estimated using intraclass correlation coefficients (ICCs), and by calculating 95% limits of agreement (LoA). To estimate interrater reliability, ICCs were calculated. Results: The Spirokit showed a high agreement intra class coefficient (ICC [2, 1]): 0.978-0.999, 95% limits of agreements (95% LOA): -0.798 to 0.847 with MicroQuark. It also showed a high level of concordance ICC (2, 1): 0.992 to 0.993, 95% LOA: -9.313 to 11.169 with MicroRPM. The test-retest reliability of the Spirokit was analyzed using ICC (2, 1), and showed a high level of reliability (ICC [2,1]=0.960 to 0.998). Standard error of measurement % (SEM%) was 0.12% to 3.39%, and minimum detectable change% (MDC%) was 0.02% to 3.79%, indicating high level of reliability. Conclusions: The Spirokit is a device with high validity and reliability that can be used to simultaneously measure PFT and RMS tests.

• Korean Circulation Journal
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• 제54권5호
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• pp.270-287
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• 2024

Background and Objectives: Blood pressure (BP) measurement using an auscultatory sphygmomanometer is recommended for diagnosing hypertension in children. As mercury sphygmomanometers (MSs) are banned owing to environmental concerns, it is crucial to determine the accuracy of mercury-free sphygmomanometers to replace them. We analyzed the accuracy of these devices to guide the National Survey selection. Methods: BP was measured thrice each with MS, auscultatory device (AD), and oscillometric device (OD) in 104 participants aged 10-18 using the National Survey data. The difference in BP was defined as the difference between MS and other devices. The BP differences, correlations, and influencing factors were analyzed. The frequencies of hypertension were also compared. Results: Systolic BP (SBP) and diastolic BP (DBP) differences between MS and AD were 0.88±3.36 mmHg and 0.63±3.95 mmHg, and those between MS and OD were 0.43±5.83 mmHg and 4.57±6.89 mmHg, respectively. The absolute error of <10 mmHg for DBP between MS and OD was 76%. The concordance correlation coefficient between MS and AD was 0.94 for SBP and 0.90 for DBP, and 0.81 and 0.67, respectively for MS and OD. Arm circumference negatively correlated with BP differences except for SBP between the MS and OD. The frequency of hypertension was not different between MS and AD but was underestimated by OD. Conclusions: AD correlated well with MS, while OD did not, especially for DBP. The superiority of AD over OD suggests AD as a possible alternative for MS in the National Survey.

• 한국농림기상학회지
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• 제18권4호
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• pp.221-232
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• 2016

농업 생태계의 생산성을 예측하기 위한 모델의 필수 입력변수인 일사량은 비교적 적은 수의 기상관측소에서만 관측되고 있어, 이들 관측값을 대신하기 위해 일사량을 추정하는 모델들이 사용되고 있다. 특히, 간단한 계수를 사용하여 일조시간을 이용하는 Angstrom-Prescott(AP) 모델이 일사량 추정을 위해 가장 널리 쓰이고 있다. 국내에서 보편적으로 적용가능한 AP모델의 계수값을 탐색하기 위해 국내 20개 기상관측소의 30년간의 일단위 관측자료를 입력자료로 사용하여 경험적으로 얻어진 계수와 Frere and Popov(1979)가 제시한 계수($AP_{Frere}$)를 이용한 일사량을 추정하고, 이들의 신뢰도를 분석하였다. 또한, 전역최적화 과정을 통해 시공간적으로 신뢰도가 높은 일사량을 얻을 수 있는 AP계수의 범위를 탐색하였다. 분석을 위해 월별, 년도별, 지역별로 추정값과 측정값 사이의 일치도를 계산하였다. $AP_{Frere}$를 사용한 결과 작물 생산성 예측을 위한 조건에서 일치도가 높게 나타났다. $AP_{Frere}$를 사용하였을 때 전역최적화를 통해 추정한 AP계수($AP_{max}$)를 사용하였을 경우 보다 일치도가 낮았으나 경험적으로 얻어진 계수($AP_{Choi}$)보다는 일치도가 높은 일사량 추정이 가능하였다. 전역최적화를 통해 일사량 추정치의 신뢰도를 분석한 결과, 신뢰도가 높은 일사량을 얻을 수 있는 AP계수의 범위는 년도별로는 좁게 분포하였으나 월별, 지역별로는 넓게 분포하였다. 그 중에서도 변이가 작은 범위는 지역별 일치도가 월별 일치도보다 넓게 분포하였다. $AP_{Frere}$는 각각의 경우에 대해 일치도가 높고 변이가 작은 범위에 속해 국내 조건에서 $AP_{Frere}$를 적용할 경우, 신뢰도 높은 일사량 추정치를 얻을 수 있을 것으로 예상되었다.

• Korean Journal of Radiology
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• 제24권4호
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• pp.294-304
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• 2023

Objective: We aimed to investigate whether image standardization using deep learning-based computed tomography (CT) image conversion would improve the performance of deep learning-based automated hepatic segmentation across various reconstruction methods. Materials and Methods: We collected contrast-enhanced dual-energy CT of the abdomen that was obtained using various reconstruction methods, including filtered back projection, iterative reconstruction, optimum contrast, and monoenergetic images with 40, 60, and 80 keV. A deep learning based image conversion algorithm was developed to standardize the CT images using 142 CT examinations (128 for training and 14 for tuning). A separate set of 43 CT examinations from 42 patients (mean age, 10.1 years) was used as the test data. A commercial software program (MEDIP PRO v2.0.0.0, MEDICALIP Co. Ltd.) based on 2D U-NET was used to create liver segmentation masks with liver volume. The original 80 keV images were used as the ground truth. We used the paired t-test to compare the segmentation performance in the Dice similarity coefficient (DSC) and difference ratio of the liver volume relative to the ground truth volume before and after image standardization. The concordance correlation coefficient (CCC) was used to assess the agreement between the segmented liver volume and ground-truth volume. Results: The original CT images showed variable and poor segmentation performances. The standardized images achieved significantly higher DSCs for liver segmentation than the original images (DSC [original, 5.40%-91.27%] vs. [standardized, 93.16%-96.74%], all P < 0.001). The difference ratio of liver volume also decreased significantly after image conversion (original, 9.84%-91.37% vs. standardized, 1.99%-4.41%). In all protocols, CCCs improved after image conversion (original, -0.006-0.964 vs. standardized, 0.990-0.998). Conclusion: Deep learning-based CT image standardization can improve the performance of automated hepatic segmentation using CT images reconstructed using various methods. Deep learning-based CT image conversion may have the potential to improve the generalizability of the segmentation network.