• Title/Summary/Keyword: Evaluation outcomes

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Joint HGLM approach for repeated measures and survival data

  • Ha, Il Do
    • Journal of the Korean Data and Information Science Society
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    • v.27 no.4
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    • pp.1083-1090
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    • 2016
  • In clinical studies, different types of outcomes (e.g. repeated measures data and time-to-event data) for the same subject tend to be observed, and these data can be correlated. For example, a response variable of interest can be measured repeatedly over time on the same subject and at the same time, an event time representing a terminating event is also obtained. Joint modelling using a shared random effect is useful for analyzing these data. Inferences based on marginal likelihood may involve the evaluation of analytically intractable integrations over the random-effect distributions. In this paper we propose a joint HGLM approach for analyzing such outcomes using the HGLM (hierarchical generalized linear model) method based on h-likelihood (i.e. hierarchical likelihood), which avoids these integration itself. The proposed method has been demonstrated using various numerical studies.

Introducing the general management of glomerular disease from a pediatric perspective based on the updated KDIGO guidelines

  • Seon Hee Lim
    • Childhood Kidney Diseases
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    • v.27 no.2
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    • pp.55-63
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    • 2023
  • In 2021, a new chapter on the general management of glomerulonephritis (GN) was added to the Kidney Disease: Improving Global Outcomes (KDIGO). It emphasizes the importance of early general management of GN for improving long-term kidney outcomes and prognosis. The chapter introduces the management of glomerular diseases in 18 subchapters. Here, kidney biopsy for the diagnosis and evaluation of kidney function and the management of complications, such as hypertension, infection, and thrombosis, are presented. Moreover, the adverse effects of glucocorticoids and immunosuppressive therapy, which are commonly used drugs for glomerular disease, are mentioned, and a guideline for drug selection is presented. Each subtheme focused on items reflecting the interpretation of the "practice points" of the expert working group are introduced. In this review of the general treatment for GN in the KDIGO guidelines, excluding pregnancy and reproductive health, we focused on and compared various references pertaining to pediatric GN management.

Outcomes and Problems of the Management Evaluation for Korean Public Libraries During 1998~2003 (공공도서관 관리운영평가 6년의 성과와 과제 - 1998년~2003년 문화관광부 관리운영평가 결과분석 -)

  • Joung, Hyun-Tae
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.15 no.1
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    • pp.69-89
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    • 2004
  • The purposes of this research are to grasp the actual conditions regarding management of Korean public libraries and to develop the rationalized guidelines for future-oriented policy which should be realized by the government authorities. According to the result of evaluation, it is analyzed that the regional differences of evaluation scores has grown worse, and a chronic problems such as staff shortage, old facilities, lack of budget has been continued repeatedly for 6-years. Moreover the result of evaluation was utilized as a guideline of the policy development on public libraries in the knowledge-based society, based in the evaluation for the management of public libraries in general.

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Establishing and Operating Cohort Evaluation at Kosin University College of Medicine (고신대학교 의과대학 코호트 구축과 운영 사례)

  • Sejin Kim
    • Korean Medical Education Review
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    • v.25 no.2
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    • pp.114-118
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    • 2023
  • Multiple cohorts (e.g., current students and graduates) were formed to collect information on the entire educational process from admission to graduation regarding students' educational performances at Kosin University College of Medicine. Data that had already been collected and analyzed by different committees for different purposes were grouped into a more systematic and comprehensive system called the cohort system, enabling the necessary data to be collected promptly and analyzed in accordance with the purpose of providing meaningful information in each area of the educational process. Therefore, comprehensive cohort data that can be used for mission statement revision, curriculum development and improvement, student counseling, and student selection were established and utilized. The cohort data were collected from performance evaluation indicators including self-evaluation surveys, evaluation tools for learning outcomes, academic achievement, results of the Korean Medical Licensing Examination, and career placement. Based on the results obtained by analyzing cohort data, a comprehensive cohort report has been published. The data analyzed through the cohort were reported to each committee and used in various ways. Currently, however, only some data have been analyzed and used. In the future, after complete data collection, the cohort data can be used as meaningful basic data for achieving the institution's mission and educational goals, developing and improving the curriculum, counseling students, and selecting students through the analysis of learning performance data from student admission to graduation and after graduation.

Cost-effectiveness Outcomes of the National Gastric Cancer Screening Program in South Korea

  • Cho, Eun;Kang, Moon Hae;Choi, Kui Son;Suh, MiNa;Jun, Jae Kwan;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2533-2540
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    • 2013
  • Background: Although screening is necessary where gastric cancer is particularly common in Asia, the performance outcomes of mass screening programs have remained unclear. This study was conducted to evaluate cost-effectiveness outcomes of the national cancer screening program (NCSP) for gastric cancer in South Korea. Materials and Methods: People aged 40 years or over during 2002-2003 (baseline) were the target population. Screening recipients and patients diagnosed with gastric cancers were identified using the NCSP and Korea Central Cancer Registry databases. Clinical outcomes were measured in terms of mortality and life-years saved (LYS) of gastric cancer patients during 7 years based on merged data from the Korean National Health Insurance Corporation and National Statistical Office. We considered direct, indirect, and productivity-loss costs associated with screening attendance. Incremental cost-effectiveness ratio (ICER) estimates were produced according to screening method, sex, and age group compared to non-screening. Results: The age-adjusted ICER for survival was 260,201,000-371,011,000 Korean Won (KW; 1USD=1,088 KW) for the upper-gastrointestinal (UGI) tract over non-screening. Endoscopy ICERs were lower (119,099,000-178,700,000 KW/survival) than UGI. To increase 1 life-year, additional costs of approximately 14,466,000-15,014,000 KW and 8,817,000-9,755,000 KW were required for UGI and endoscopy, respectively. Endoscopy was the most cost-effective strategy for males and females. With regard to sensitivity analyses varying based on the upper age limit, endoscopy NCSP was dominant for both males and females. For males, an upper limit of age 75 or 80 years could be considered. ICER estimates for LYS indicate that the gastric cancer screening program in Korea is cost-effective. Conclusion: Endoscopy should be recommended as a first-line method in Korea because it is beneficial among the Korean population.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.21-30
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    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

A Formative Assessment Based Capstone Design Course for Improving Program Learning Outcomes (프로그램 학습성과 향상을 위한 형성평가 중심 캡스톤 디자인 교과목 설계)

  • Kim, Woong-Sup
    • Journal of Engineering Education Research
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    • v.13 no.1
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    • pp.62-69
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    • 2010
  • Program learning outcome is widely used for assessing and improving program quality. There are various methodologies that can measure program quality and improve program learning outcomes. In this paper, we used formative approach in Capstone design course, since it is the most effective in terms of improving program learning outcomes due to the course's intrinsic nature. To integrate a formative approach into Capstone design course, we develop a feedback structure which is a key element in formative approach and define several sub phases that manage feedback structures and their own evaluation criteria. As a result, we observed a noticeable improvement for students performance in capstone design course.

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Management of Femoropopliteal Vascular Injuries after Trauma: Surgical Outcomes (외상 후 대퇴-오금 혈관손상의 치료: 수술 성적)

  • Chang, Sung Wook;Han, Sun;Ryu, Kyoung Min;Ryu, Jae-Wook
    • Journal of Trauma and Injury
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    • v.28 no.1
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    • pp.15-20
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    • 2015
  • Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.

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Surgical Reconstruction Using a Flanged Mesh Cage without Plating for Cervical Spondylotic Myelopathy and a Symptomatic Ossified Posterior Longitudinal Ligament

  • Kang, Jung Hoon;Im, Soo-Bin;Yang, Sang-Mi;Chung, Moonyoung;Jeong, Je Hoon;Kim, Bum-Tae;Hwang, Sun-Chul;Shin, Dong-Seong;Park, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.671-680
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    • 2019
  • Objective : We introduce innovative method of cervical column reconstruction and performed the reconstruction with a flanged titanium mesh cage (TMC) instead of a plate after anterior corpectomy for cervical spondylotic myelopathy (CSM) and an ossified posterior longitudinal ligament (OPLL). Methods : Fifty patients with CSM or OPLL who underwent anterior cervical reconstruction with a flanged TMC were investigated retrospectively. Odom's criteria were used to assess the clinical outcomes. The radiographic evaluation included TMC subsidence, fusion status, and interbody height. Thirty-eight patients underwent single-level and 12 patients underwent two-level corpectomy with a mean follow-up period of 16.8 months. Results : In all, 19 patients (38%) had excellent outcomes and 25 patients (50%) had good outcomes. Two patients (4%) in whom C5 palsy occurred were categorized as poor. The fusion rate at the last follow-up was 98%, and the severe subsidence rate was 34%. No differences in subsidence were observed among Odom's criteria or between the single-level and two-level corpectomy groups. Conclusion : The satisfactory outcomes in this study indicate that the flanged TMC is an effective graft for cervical reconstruction.

Association of Health Outcomes with Frailty in Community-Dwelling Korean Older Adults: An Integrative Review (국내 지역사회 거주 노인의 허약과 건강결과 간의 관계에 대한 통합적 고찰)

  • Son, Youn-Jung;Lee, Suk Jeong;Choi, Yu Ri
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.1
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    • pp.5-18
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    • 2019
  • Purpose: Frailty is associated with an increased risk of adverse health outcomes. We aimed to review the relationships between frailty and health outcomes in community-dwelling Korean elderly individuals. Methods: Whittemore and Knafls' framework for conducting integrative reviews was used. PubMed, Cumulative Index to Nursing and Allied Health Literature, and six Korean databases were searched. For analysis, the study included articles written in English and Korean published between January 1960 and June 2018. Of the total 1,488 studies found in the databases, we analyzed 15 studies that met the quality of the evaluation criteria. Results: The prevalence of frailty in Korean elderly individuals ranged from 6.5% to 11.7% when divided into three levels of frailty. The health outcomes assessed in relation to frailty were divided into five domains: quality of life, physical health, psychosocial health, health behavior, and health care quality. Frailty was negatively associated with all five domains. Conclusions: Our study suggested that nurses should be aware of the limitations in the physical and cognitive functions of frail elderly individuals and provide tailored interventions for Korean elderly individuals. Furthermore, a large-scale study is needed to develop the Korean model of the frailty assessment tool and to verify the conceptual model of this study.