• 대한융합한의학회지
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• 제6권1호
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• pp.37-42
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• 2024

Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

• 사상체질의학회지
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• 제12권2호
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• pp.34-42
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• 2000

Background and Purpose ; Sasang Constitutional medicine is dividing individual's constitutions into four categories. Determination of an individual's constitution however, can be different according to what diagnostic standards apply. In this study, We investigated how different the applying results of the three diagnostic standards-the yong-mo(容貌), the body type(體形), and the mind(心性)-are and what the inter-diagnostic standard agreement is. Methods ; 36 patients in cerebral-infarction, admitted into the Dong-Eui Korean hospital from 1. May. 2000 to 12. October. 2000, were diagnosed by three diagnostic standards - the yong-mo(容貌), the body type(體形), and the mind(心性). Each patient was treated by Sasang constitutional medicine. The agreement of the final constitutional diagnosis and the result of each diagnostic standard was analyzed. Results 1. The number of Taeeumin was 13(40.6%), Soyangin was 10(31.3%), Soeumin was 9(28.1%). 2. In terms of analysis on the agreement of the final constitutional diagnosis and the result of each diagnostic standard, the yong-mo(容貌) showed the highest agreement of 93.8%, followed by 68.8% of the mind(心性), and the body type(體形) showed the lowest agreement of 53.1%. 3. The yong-mo(容貌) standard showed high diagnostic rate of the three constitutions(Soyangin, Taeeumin, Soeumin) generally and diagnostic rate of Soeumin was especially high. The body type(體形) standard showed low diagnostic rate of Taeeumin, and high diagnostic rate of Soeumin. The mind(心性) standard showed low diagnostic rate of Soeumin. 4. In terms of analysis on the agreement of inter-diagnostic standard result, the yong-mo(容貌) and the mind(心性) show the highest agreement, the mind(心性) and the body type(體形) showed the lowest agreement. 5. If the results come out that the three diagnostic standards have no concentration on one constitution, it was effective to choose the result of the yong-mo(容貌) standard. If it is the case the result of inter-diagnostic standard agreed more than two, it was better to follow the two agreed result than to follow the result of one specific characteristic standard.

• 대한한방내과학회지
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• 제33권1호
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• pp.1-13
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• 2012

Background : In oriental medicine, the status of the tongue is an important indicator to diagnose the condition of one's health, such as physiological and the clinicopathological changes of internal organs. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is greatly affected by examination circumstances, patient's posture, and doctor's diagnosis criteria. Objectives : This study was designed to assure the necessity for standardization of tongue diagnosis based on diagnostic criteria of tongue coating thickness (TCT). Methods : Thirty tongue photographs were acquired and analyzed by digital tongue diagnosis system (DTDS) which measured the percentage of TCT on the tongue surface. Fifteen oriental medical doctors evaluated TCT in 30 photographs. Afterward, the 15 assessors were trained for diagnostic criteria of TCT and evaluated the photographs again. The intraclass correlation coefficient (ICC) was used to obtain the agreement rate among the 15 assessors and the agreement rate between assessors' TCT scores and DTDS values. Results : The agreement rate among the 15 assessors after training was higher than before training. The agreement rate between assessors' TCT scores and DTDS values after training was also higher than before training. Furthermore, the difference of the agreement rate between before and after training was significant (p<0.05). Conclusions : The standardization of diagnostic criteria of TCT increased the agreement rate among the assessors and the agreement rate between assessors' TCT scores and DTDS values. Therefore, the standardization of diagnostic criteria is expected to contribute to the objectification and quantification of the tongue diagnosis system.

• 동의생리병리학회지
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• 제30권3호
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• pp.177-183
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• 2016

The purpose of this study was to evaluate the reliabilities of questions and diagnostic value of the Korean Sasang Constitutional Diagnostic Questionnaire(KS-15). The young adults aged 20's participated in this study. The first survey was conducted in march, 2016, and the second one was conducted two weeks later. Three hundred and three questionnaires and the informed consent were obtained from all participants. The test-retest kappa analysis was used to identify the reliabilities of the questions and diagnostic value, and the significance level was .05. The number of subjects was 303 [87(28.7%)males and 216(71.3%)females]. The Cronbach's α were .630 in 6 characteristic questions. The test-retest reliabilities of questions were ranged from .469 to 734. The agreement rate of KS-15 between the first and second constitutional diagnostic value was 87.13%(Kappa=0.794). The higher Sasang constitutional probability score in first survey resulted in the higher agreement rate between first and second diagnostic value. KS-15 seems to be a reliable implement. Further studies for the reliability of the people of different ages and suitable cut off point in Sasang constitutional probability score are needed for the practical use of KS-15.

• Imaging Science in Dentistry
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• 제48권2호
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• pp.121-125
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• 2018

Purpose: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. Materials and Methods: A total of 312 regions(142 bilateral, 10 left, 18 right) in 170 patients(140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient(${\kappa}$) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators(sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values <.05 were considered to indicate statistical significance. Results: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P<.05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (${\kappa}=0.684$ and P<.05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. Conclusion: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

• Imaging Science in Dentistry
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• 제47권4호
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• pp.233-239
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• 2017

Purpose: This study was performed to quantify the repeat rate of imaging acquisitions based on different clinical examinations, and to assess the prevalence of error types in intraoral bitewing and periapical imaging using a digital complementary metal-oxide-semiconductor(CMOS) intraoral sensor. Materials and Methods: A total of 8,030 intraoral images were retrospectively collected from 3 groups of undergraduate clinical dental students. The type of examination, stage of the procedure, and reasons for repetition were analysed and recorded. The repeat rate was calculated as the total number of repeated images divided by the total number of examinations. The weighted Cohen's kappa for inter- and intra-observer agreement was used after calibration and prior to image analysis. Results: The overall repeat rate on intraoral periapical images was 34.4%. A total of 1,978 repeated periapical images were from endodontic assessment, which included working length estimation (WLE), trial gutta-percha (tGP), obturation, and removal of gutta-percha (rGP). In the endodontic imaging, the highest repeat rate was from WLE (51.9%) followed by tGP (48.5%), obturation (42.2%), and rGP (35.6%). In bitewing images, the repeat rate was 15.1% and poor angulation was identified as the most common cause of error. A substantial level of intra- and inter-observer agreement was achieved. Conclusion: The repeat rates in this study were relatively high, especially for certain clinical procedures, warranting training in optimization techniques and radiation protection. Repeat analysis should be performed from time to time to enhance quality assurance and hence deliver high-quality health services to patients

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권5호
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• pp.462-469
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• 2000

Positron Emission Tomography(PET) is a new diagnostic method that can create functional images of the distribution of positron emitting radionuclides, which when administered intravenously in the body, makes possible anatomical and functional analysis by quantity of biochemical and physiological process. After genetic and biochemical changes in initial stage, malignant tumor undergoes functional changes before undergoing anatomical changes. So, early diagnosis of malignant tumors by functional analysis with PET can be achieved, replacing traditional anatomical analysis, such as computed tomography(CT) and magnetic resonance image(MRI), etc. Similarly, PET can identify malignant tumor without confusion with scar and fibrosis in follow up check. In the Korea Cancer Center Hospital(KCCH) from October 1997 to September 1999, clinical study was performed in 79 cases that underwent 89 times PET evaluation with [18F]-Fluorodeoxyglucose for diagnosis of oral and maxillofacial tumors, and the data was analysed by Bayesian $2{\times}2$ Classification Table. The results were as follows : Evaluation for initial diagnosis with FDG-PET (P<0.005) 1. Agreement rate or accuracy rate is 88.9%. 2. Sensitivity is 95.2%, and specificity 66.7%. 3. Positive predictive rate is 90.9%, and negative predictive rate 80.0%. 4. In consideration of tumor stage, diagnostic rate in less than stage II was 90% and in greater than stage III 100%. 5. In consideration of tumor size, diagnostic rate in less than T2 was 92.3% and in greater than T3 100%. After primary treatment, evaluation for follow up check with FDG-PET (P < 0.001) 1. Agreement rate or accuracy rate is 85.4%. 2. Sensitivity is 87.5%, and specificity 82.4%. 3. Positive predictive rate is 87.5%, and negative predictive rate 82.4%. 4. In 24 recurred cases, 6 had distant metastasis, and 5 of them were diagnosed with FDG-PET, resulting in diagnostic rate of FDG-PET of 83.3%. From the above results, Positron Emission Tomography with [18F]- Fluorodeoxyglucose appears to be more sensitive and accurate for detecting the presence of oral and maxillofacial tumors, and has various clinical applications such as early diagnosis of tumor in initial and follow up check and detection of distant metastasis.

• Asian Pacific Journal of Cancer Prevention
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• 제16권12호
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• pp.4971-4975
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• 2015

Background: Several methods have been presented for the evaluation of the endometrium in patients with abnormal uterine bleeding, which include minimal invasive and invasive approaches such as diagnostic curettage or endometrial biopsy by Pipelle. Many studies have been performed in order to compare two methods; diagnostic curettage and outpatient endometrial biopsy. This investigation compared sampling adequacy, endometrial histopathology, failure rates, duration and costs between diagnostic curettage in a hospital and endometrial biopsy. Materials and Methods: This single blind clinical trial was performed on 130 patients older than 35 years who was referred to Amir training hospital in 2013 for elective diagnostic curettage because of abnormal uterine bleeding. For all patients eligible for the study, an endometrial sample by Pipelle was taken without anesthesia or dilatation. Then under general anesthesia diagnostic curettage was performed by sharp curette. Sampling duration was calculated and both samples were sent to the same pathologist. The diagnostic values of two methods in the diagnosis of normal endometrium, endometrial hyperplasia and carcinoma were compared. The costs of these two methods were also compared. Data analysis was performed by SPSS (version 16.0) software. Chi-Square, Fisher, and Pearson tests were used and were considered statistically significant at P values less than 0.05. Results: Two methods were agreed upon 88% of sampling adequacy and 94% of pathological results. Specificity of 100% and sensitivity of 90% for detection of proliferative endometrium, secretory endometrium, simple hyperplasia without atypia and 100% for cancer were recorded. Pipelle diagnostic accuracy in comparison with curettage, have been reported over 97%, so the failure rate in this study was below 5%. Sensitivity of Pipelle for detection of atrophic endometrium was reported below 50%. Duration and cost was lower in Pipelle versus curettage. Conclusions: It is concluded that due to high agreement and cohesion coefficient between curettage and Pipelle on the issue of sampling adequacy, histopathology finding (except atrophic endometrium), low failure rate, duration of sampling and cost, Pipelle can be introduced as a suitable alternative of diagnostic curettage.

• 정신신체의학
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• 제9권2호
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• pp.174-181
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• 2001

연구목적: 신경정신과에 자문 의뢰된 사례 중 섬망상태를 주 증상으로 한 환자들을 대상으로 자문의사와 의뢰의사간의 진단 일치율 및 정신과 권고사항에 대한 반영도를 조사하여 자문시 상호 협조정도를 알아보고 치료 반영도에 영향을 미치는 요인을 밝히려 하였다. 방법: 1995년 7월 1일부터 1997년 12월 31일 사이에 한양대학교 구리병원에 입원하여 신경정신과에 자문 의뢰되었던 583명 중 54명의 섬망환자를 대상으로 하였다. 대상자의 자문요청서와 과거입원기록을 통해서 환자들의 인적사항, 입원진단명, 증상, 의뢰 전 처방, 정신과 처방, 의뢰 후 처방, 섬망에 대해 의뢰의사가 내린 진단과 자문의사의 진단 등에 대한 정보를 얻었다. 권고사항에 대한 반영도는 완전 반영, 부분 반영, 비반영으로 나누어 이중 완전 반영과 부분 반영을 반영한 것으로 평가하였다 의뢰한 과를 각 과별 그리고 내과계와 외과계로 나누어 각각의 반영도를 비교하였다. 결과: 섬망상태의 원인에 대한 진단 일치율은 자문과의 진단 기준으로 보면 원인이 기질성 뇌 증후군 (organic brain syndrome)인 경우가 가장 높았고 (85.7%) 전반적인 의학적 상태(general medical condition)의 경우가 가장 낮았다 (0%). 반영도는 의뢰과별로 유의한 차이가 없었으며, 내과계와 외과계간에도 유의한 차이가 없었다. 반영도에 영향을 미치는 중상을 비교한 결과 충동적 공격적 행동이 동반된 경우에 반영도가 73.5%이고, 행동변화가 동반되지 않은 경우가 40.0%여서 행동상의 문제가 동반되었을 때 정선과 의견에 대한 반영도가 통계적으로 유의하게 높았다. 수면장애가 동반된 경우에도 반영도가 높았는데 행동변화와 수연장애의 두 증상을 하나의 변인으로 비교한 결과, 두 증상이 모두 있는 경우는 반영도가 80.0%, 하나의 증상만 있거나 모두 없는 경우 반영도가 44.8%여서 유의한 차이가 있었다. 의뢰과에서 평가가 용이하지 않은 증상인 의식상태, 지남력상태, 환각의 유무는 반영도와 통계적 유의성이 없었다. 결론: 섬망의 원인에 대한 진단 일치율은 병변의 확인이 용이한 기질성 뇌 증후군의 경우가 가장 높았고 권고사항에 대한 반영도에 영향을 주는 요인은 행동변화와 수면장애의 증상이 나타나는 경우였다.

• Journal of Acupuncture Research
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• 제15권2호
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• pp.199-209
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• 1998

We compared and studied the results on two diagnostic machines called Yangdorack and EAV on 18 recovering paralytic patients. The results were as folIows ; 1. Patients with weak motor ability showed an average of 25% fewer units of Yangdorack and an average of 49% fewer units of EAV. 2. Deficiency/excess diagnostic results on meridian and internal organs showed 58.5% deficiency and 41.5% excess on the Yangdorack ; 67.9% of decline-degenerative activity and 32.1% of stimulus-inflarrunation activity on the EAV. 3. In the attack of meridian and internal organs in view of the five elements(五行), in rate of deficiency, decline and degeneration of the fire meridian(火經) in view of the highest rate accounts showed 19.5% on the Yangdorack and 20.4% on the EAV. 4. In comparing deficiency/excess results on the Yangdorack with results of decline-degenerative value and stimulus-inflammation value on the EAV, they both showes a 39% rate. 5. In comparing clinical syndromes on the Yangdorack and common diseases on the EAV, they showed a 72% agreement.