• Title/Summary/Keyword: Evaluation outcomes

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography (수술 후 컴퓨터 단층촬영을 이용한 관절 내 종골 골절의 정복과 임상 결과 간의 연관성 분석)

  • Eom, Joon-Sang;Joo, Young-Deuk;Kim, Seong-Jun;Shin, Min-Ho;Lee, Dong-Oh;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.165-172
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    • 2014
  • Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.

Effectiveness of a Clinical Pathway for Breast Cancer Patients Undergoing Surgical Operation on Clinical Outcomes and Costs

  • Jeong Hyun Park;Danbee Kang;Seok Jin Nam;Jeong Eon Lee;Seok Won Kim;Jonghan Yu;Byung Joo Chae;Se Kyung Lee;Jai Min Ryu;Yeon Hee Park;Mangyeong Lee;Juhee Cho
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.120-131
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    • 2024
  • Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

  • Kim, Ha-Young;Shin, Sang-Wan;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • v.6 no.5
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    • pp.325-332
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    • 2014
  • PURPOSE. The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS. A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS. Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION. For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva level. It is also suggested that prosthetic evaluation criteria include loose matrix, female detachment, denture fracture, denture relining, abutment fracture, abutment screw loosening, and occlusal adjustment. Finally standardized criteria like OHIP-EDENT or VAS are required for patient satisfaction.

Descriptive literature review on the evaluation of the youth smoking prevention program effectiveness (청소년 흡연중재 교육프로그램의 효과평가에 관한 설명적 문헌고찰)

  • Park, Kyoung-Ok;Lee, Kyung-Won
    • The Journal of Korean Society for School & Community Health Education
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    • v.6
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    • pp.35-48
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    • 2005
  • The age of the very first smoking is a significant indicator of life-long health status. Smoking prevention intervention was actively conducted based in middle and high schools with the support of the Korean Act for Health Promotion since 1998. These governmental supports became large and various smoking prevention programs were developed and conducted in diverse standards and perspectives. This study made a comprehensive descriptive literature review on smoking prevention educational programs for youth in Korea to identify the intervention quality and effectiveness of them for future smoking prevention program development. A total of 28 peer-reviewed journal articles published between May, 1995 and May 2005 (for the last 10 years) were finally included in this review process. The study participants should be adolescences in middle or high schools in Korea and the intervention types of the review studies should be smoking prevention or cessation educational programs. The outcomes of the reviewed studies were reanalyzed by the participants' characteristics, theory basement, evaluation design, intervention period, evaluation outcomes, and program effectiveness Most smoking intervention programs were not specified by sex and smoking status. Largely most intervention programs focused on male students although female students' smoking percent is increasing including both smokers and nonsmokers. Based on the school grades, the large percents of smoking intervention were conducted to the first grade of middle school and the first grade of high school. Almost 70% of the reviewed studies did not apply any health behavior change theories and the Transtheoretical model and social cognitive theory were utilized in 7 studies among the last reviewed 30%. The theory-based intervention studies had greater effectiveness than the non-theory based studies. More than 90% had quasi-experimental evaluation design and the effectiveness of the non-experimental designed study seemed over estimated than the quasi-experimental or experimental designed studies. More than 60% of the reviewed studies made their education for less than j days, over a short period and the evaluation factors were knowledge and attitude in general which can be obtained in short intervention period. Therefore, smoking intervention programs for youth in Korea need to be modified in terms of research design such as the intervention period, intervention-evaluation design, theory-based approach, and population-focused intervention specification.

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A case study on the difference of communication competency for dental hygiene process of care in the students of a dental hygiene department by the evaluator (일개 치위생(학)과 학생의 평가자에 따른 치위생관리과정에서의 커뮤니케이션 역량 차이에 관한 사례연구)

  • Choi, Jin-Sun;Jeong, Su-Ra;Choi, Yong-Keum
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.1
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    • pp.139-151
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    • 2018
  • Objectives: This study was to compare the self-evaluated outcomes of communication competency in dental hygiene process of care in the students of a dental hygiene department with the teaching evaluation, and to confirm the difference of communication competency by the evaluator. Methods: This study attempted to confirm the value and usefulness of self-evaluation and teaching evaluation on the communication competency. The subjects of this study were 43 junior students who took a course of dental medical communication at the dental hygiene department of a university located in 'A' city, and the self-evaluation and teaching evaluation were conducted using the evaluation paper which was modified from the communication evaluation tool in the previous studies. The collected data were subjected to the correspondence sample t-test to compare the difference between the communication competency self-evaluation before and after the education, and after communication education, while an independent sample T-test was conducted to compare the differences between the evaluators. Results: The student's self-evaluations before and after the education showed the statistically significant difference, moreover, the post-education competency scores were improved mostly in all the items more than the pre-education competency scores. The score of self-evaluation was higher than that of the teaching evaluation in all items except one question in the case of history-information collection stage. Conclusions: It is confirmed that there is an effect to allow the students to improve their communication competency in the dental health communication education in the dental hygiene department. To evaluate the student's communication competency, the mutual complement of self-evaluation and teaching evaluation should be confirmed in parallel each other.

Development of Program Evaluation Indicator : Community Health Center's Health Promotion Program (보건소 건강증진사업 평가지표 개발)

  • 송현종;진기남
    • Health Policy and Management
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    • v.13 no.4
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    • pp.1-27
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    • 2003
  • The purpose of this study was to develop the evaluation indicator for the health promotion programs of the Community Health Centers and to test its validity. The modified logic model was used as the evaluation model based on the literature reviews. Using this model, four dimensions, eleven sub­dimensions, and forty­one individual indicators were developed. These evaluation indicators are superior in reflecting the distinctiveness of the community health promotion programs, and also flexible enough to accommodate diverse programs. These indicators also emphasize the role of process evaluation, and the diversity of outcomes. To test content validity, survey method of experts in the community health promotion field was conducted. Eleven in three expert groups(professionals, practitioners in Community Health Centers, and policy makers) generally agreed with the validity of evaluation indicators. To examine criteria and construct validity, these indicators were used to evaluate the health promotion programs conducted by the 18 Key Community Health Centers. The data came from the interview surveys of the main health promotion practitioner and 30 visitors from each center. The ranks of these eighteen Community Health Centers were computed from these data. There was no significant difference in ranking either by these indicators or by the existing indicators, which was developed by Technical Support and Evaluation Team for criteria validity. There was no statistically significant difference in ranking between input, process and outcome dimensions. Based on these study results, evaluation indicators developed in this study are valid to evaluate Community Health Center's health promotion program. It can be used both by the Community Health Center for internal evaluation, and by the stakeholders for external evaluation.

A Fuzzy BOXES Scheme for the Cartpole Control

  • Kwon, Sung-Gyu
    • 제어로봇시스템학회:학술대회논문집
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    • 2005.06a
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    • pp.1710-1715
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    • 2005
  • Two fuzzy controllers are coordinated to control a cartpole such that the pole is balanced as well as the cart is brought back to the track origin. The coordination is due to the BOXES scheme that is established through the evaluation of the outcomes of the control action by one of the fuzzy controllers. It is found that the control scheme is good at selecting proper fuzzy controller so that the pole is balanced fast while the cart moves back to the track origin steadily.

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Surgery of the Trachea

  • Allen, Mark S.
    • Journal of Chest Surgery
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    • v.48 no.4
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    • pp.231-237
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    • 2015
  • Surgical procedures on the trachea have only been undertaken within the past 50 years. Knowing the unique blood supply of the trachea and how to reduce tension on any anastomosis are key to a successful outcome. Tracheal conditions requiring surgery usually present with shortness of breath on exertion, and preoperative evaluation involves computed tomography and rigid bronchoscopy. Tracheal resection and reconstruction can be safely performed with excellent outcomes by following a well-described technique.

Development of an evaluation tool for the quality of nursing care in neurosurgical intensive care unit patients (신경외과 중환자 간호의 질평가 도구개발)

  • Kim, Nam-Young;Jang, Keum-Seong
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.285-300
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    • 2001
  • To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.

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