• Title/Summary/Keyword: Hospital selection

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Development and Testing of a Machine Learning Model Using 18F-Fluorodeoxyglucose PET/CT-Derived Metabolic Parameters to Classify Human Papillomavirus Status in Oropharyngeal Squamous Carcinoma

  • Changsoo Woo;Kwan Hyeong Jo;Beomseok Sohn;Kisung Park;Hojin Cho;Won Jun Kang;Jinna Kim;Seung-Koo Lee
    • Korean Journal of Radiology
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    • v.24 no.1
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    • pp.51-61
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    • 2023
  • Objective: To develop and test a machine learning model for classifying human papillomavirus (HPV) status of patients with oropharyngeal squamous cell carcinoma (OPSCC) using 18F-fluorodeoxyglucose (18F-FDG) PET-derived parameters in derived parameters and an appropriate combination of machine learning methods in patients with OPSCC. Materials and Methods: This retrospective study enrolled 126 patients (118 male; mean age, 60 years) with newly diagnosed, pathologically confirmed OPSCC, that underwent 18F-FDG PET-computed tomography (CT) between January 2012 and February 2020. Patients were randomly assigned to training and internal validation sets in a 7:3 ratio. An external test set of 19 patients (16 male; mean age, 65.3 years) was recruited sequentially from two other tertiary hospitals. Model 1 used only PET parameters, Model 2 used only clinical features, and Model 3 used both PET and clinical parameters. Multiple feature transforms, feature selection, oversampling, and training models are all investigated. The external test set was used to test the three models that performed best in the internal validation set. The values for area under the receiver operating characteristic curve (AUC) were compared between models. Results: In the external test set, ExtraTrees-based Model 3, which uses two PET-derived parameters and three clinical features, with a combination of MinMaxScaler, mutual information selection, and adaptive synthetic sampling approach, showed the best performance (AUC = 0.78; 95% confidence interval, 0.46-1). Model 3 outperformed Model 1 using PET parameters alone (AUC = 0.48, p = 0.047) and Model 2 using clinical parameters alone (AUC = 0.52, p = 0.142) in predicting HPV status. Conclusion: Using oversampling and mutual information selection, an ExtraTree-based HPV status classifier was developed by combining metabolic parameters derived from 18F-FDG PET/CT and clinical parameters in OPSCC, which exhibited higher performance than the models using either PET or clinical parameters alone.

Analysis of Selection Criteria of Consumers for Dental Clinic (의료소비자의 특성별 치과의료기관 선택기준에 관한 분석)

  • Bae, Mi-Ran;Chun, Jin-Ho;Lee, Jung-Hwa
    • The Journal of the Korea Contents Association
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    • v.13 no.3
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    • pp.271-277
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    • 2013
  • The subjects of this study were the patients of H Dental Hospital in Busan, who visited for the purpose of treatment in patients over 18 years of age and 151 patients, analyzed the data of the results of the selection criteria of the dental health care consumer. The gender of the subjects by cross-analysis, importance order of selection criteria for dental hospital were cleanness and hygiene(78.1%), equipment and facilities(60.9%), career and word-of-mouth(57.6%), staff kindness(57.6%), ease of use(32.5%) and scale of dental hospital(22.5%), it was appeared similar in comparison of cross-analysis and average-analysis. Major consideration of the study subjects to select criteria for dental hospital was pain control(31.8%), infection control(30.5%), cost(29.8%), time(7.9%) respectively. Gender as a primary consideration to the part of a man in pain control(39.2%), women cost(39.1%) was most common (p<0.001). In dental health care consumer to select criteria, clean hygiene and infection control at the heavily appeared to affect the direction of change in the consciousness of consumers seeking and it is necessary to improve hospital services for the dental care of their qualitative changes.

Influences of Injury Severity and Age on Severe Anxiety in Posttraumatic Stress Disorder Patients with no Previous History of Psychiatric Disorders (정신건강의학과 치료 과거력이 없는 외상후 스트레스 장애 환자에서 나이와 손상 심각도가 중증 불안에 미치는 영향)

  • Park, Woon Yeong;Park, Sang Hag;Kim, Sang Hoon;Kim, Seung Gon;Park, Jung In;Choo, Il Han
    • Anxiety and mood
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    • v.9 no.1
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    • pp.54-60
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    • 2013
  • Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

A Study on the Criteria for Selection of Medical Care Facilities (의료기관 선택기준에 관한 연구)

  • Cho, Woo-Hyun;Kim, Han-Joong;Lee, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.53-63
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    • 1992
  • There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

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Complications of Anterior Cruciate Ligament Reconstruction (전방십자인대 재건술의 합병증)

  • Song Eun-Kyoo;Kim Jong-Seok
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.1
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    • pp.15-19
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    • 2003
  • Although the number of anterior cruciate ligament reconstruction is increasing, complications after primary ACL reconstruction are more difficult to determine. Intraoperative and postoperative complications can lead to ultimate failure of a primary reconstructive procedure. Therefore, surgical success in ACL reconstruction requires detailed knowledge and technical advancements about ACL reconstruction. Preoperatively surgeon must pay attention to selection of grafts and methods of fixation, and intraoperatively, attention to the harvest of graft, passage of graft, intraarticuar placement of the graft, notchplasty, proper tensioning of the graft, and others. Postoperative complications must be detected early, including infection, abnormal healing responses, arthrofibrosis, graft rejection, and reflex sympathetic dystrophy. Careful patient selection, appropriate surgical timing, careful surgical technique, and supervised preoperative and postoperative rehabilitation can minimize postoperative complications.

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Effect of private health insurance on health care utilization in a universal health insurance system: A case of South Korea (민간 의료 보험 가입이 의료 이용에 미치는 영향)

  • Lee, You Jin;Lee, Jinhyung
    • Korea Journal of Hospital Management
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    • v.23 no.2
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    • pp.42-53
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    • 2018
  • Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

Decision Making Algorithm for Adult Spinal Deformity Surgery

  • Kim, Yongjung J.;Hyun, Seung-Jae;Cheh, Gene;Cho, Samuel K.;Rhim, Seung-Chul
    • Journal of Korean Neurosurgical Society
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    • v.59 no.4
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    • pp.327-333
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    • 2016
  • Adult spinal deformity (ASD) is one of the most challenging spinal disorders associated with broad range of clinical and radiological presentation. Correct selection of fusion levels in surgical planning for the management of adult spinal deformity is a complex task. Several classification systems and algorithms exist to assist surgeons in determining the appropriate levels to be instrumented. In this study, we describe our new simple decision making algorithm and selection of fusion level for ASD surgery in terms of adult idiopathic idiopathic scoliosis vs. degenerative scoliosis.

Treatment Principles of Anterior Cruciate Ligament Injury (전방십자인대 손상의 치료 원칙)

  • Ha, Kwon-Ick
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.36-40
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    • 1997
  • Anterior Cruciate Ligament (ACL) plays an important biomechanical role for the stability of knee joint. ACL injury often leads to injuries of articular cartilage, menisci, or other supporting structures, and subsequent development of degenerative arthritis. Controversies still exist in the best treatment modalities of ACL injuries. hut the author considers it most important to make the appropriate patient selection for operative reconstruction or nonoperative treatment. and describes the treatment principles of ACL injury, including diagnosis, patient selection and the treatment modalities for successful treatment of ACL injury.

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An Investigation of Selection and Transfer Factors on the Admission of Rehabilitation Hospital (재활병원 입원 시 선택 및 전원 요인 조사)

  • Lee, Jae Hong;Kwon, Won An;Lee, Jin Hwan;Min, Dong Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.6
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    • pp.2819-2827
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    • 2013
  • The purpose of his study was to analyze the environmental and the medical factors of prematurely discharged patients in a rehabilitation hospital. The subjects were 107 inpatients. The data were collected using self-report questionnaire and analyzed using the SPSS Win 19.0 program. In result, Firstly, general selection of hospitals was the 'Recommendation' 35.5%, Environmental dissatisfaction factors are Hospital facilities 37.4%. Hospital choice is the highest 'Acquaintances' 23.4%. Second, the lowest group about professionalism, kindness, and description of explanation on satisfaction in survey is group of care workers for the sick. The highest group is physical and occupational therapist. Third, the satisfaction regarding medical procedures of administrative work, waiting time and medical expenses is the highest normal. Hospital facilities in one of the highest factors in environmental dissatisfaction is can be considered as an element of patient departure because of not much number of nervous special hospitals. Medical dissatisfaction factors is the lowest satisfaction of care worker even if those spend much time. this is the focus leaving hospital. Therefore, factors care workers on service satisfaction and dissatisfaction in analysis and problem solving is considered that the need to find ways to improve the quality of service care workers.