• Title/Summary/Keyword: Indication bias

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The Effects of Panax Ginseng on Streptozotocin-Induced Diabetic Rats: Meta Analysis

  • Kook, Se-Jeong;Kim, Gun-Hee;Choi, Ki-Heon
    • The Korean Journal of Applied Statistics
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    • v.22 no.1
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    • pp.107-114
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    • 2009
  • The present study was carried out to summarize the effect of ginseng in the experimental diabetic rats by meta-analysis related studies. The association measure to test effect of ginseng was the mean difference(MD) between group of rats induced streptozotocin(STZ) and group of rats induced STZ treated with ginseng about the considered effect factors. The level of FI, glucose and TG were significantly reduced(< 0.01), and the level of glycogen was significantly increased by treatment with ginseng (< 0.01) After checking the indication of publication bias for the combined MDs by using the funnel plots, the anti-diabetic effects of ginseng is clearly presented in FI, glucose, TG and glycogen (< 0.05).

Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices

  • Lim, Seon Hee;Kim, Seong Heon
    • Clinical and Experimental Pediatrics
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    • v.65 no.2
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    • pp.73-80
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    • 2022
  • A mercury sphygmomanometer (MS) has been the gold standard for pediatric blood pressure (BP) measurements, and diagnosing hypertension is critical. However, because of environmental issues, other alternatives are needed. Noninvasive BP measurement devices are largely divided into auscultatory and oscillometric types. The aneroid sphygmomanometer, the currently used auscultatory method, is inferior to MS in terms of limitations such as validation and regular calibration and difficult to apply to infants, in whom Korotkoff sounds are not audible. The oscillometric method uses an automatic device that eliminates errors caused by human observers and has the advantage of being easy to use; however, owing to its measurement accuracy issues, the development of an international validation protocol for children is important. The hybrid method, which combines the auscultatory and electronic methods, solves some of these problems by eliminating the observer bias of terminal digit preference while maintaining measurement accuracy; however, the auscultatory method remains limited. As the age-related characteristics of the pediatric group are heterogeneous, it is necessary to reconsider the appropriate BP measurement method suitable for this indication. In addition, the mobile application-based BP measurement market is growing rapidly with the development of smartphone applications. Although more research is still needed on their accuracy, many experts expect that mobile application-based BP measurement will effectively reduce medical costs due to increased ease of access and early BP management.

The Study on Relation between Implementation of Six Sigma Quality Management and Financial Performance using Propensity Score Matching (식스 시그마 품질경영활동이 기업의 재무적 성과지표에 미치는 영향연구: 경향점수매칭을 이용하여)

  • Park, Byounghwa;Park, Taeyoung;Park, Minjae
    • Journal of Korean Society for Quality Management
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    • v.44 no.2
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    • pp.341-356
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    • 2016
  • Purpose: The purpose of this paper is to study whether the adoption of Six Sigma quality management by a firm positively affects its financial performance. The correlation between the duration of Six Sigma implementation period and the financial status of the firm is investigated as well. Methods: We conduct the analysis using data from Manufacturing Industry Productivity Panel Survey 2013 provided by Korea Productivity Center and Ministry of Trade, Industry and Energy. Propensity score matching is used to reduce sample selection bias of observational study. Furthermore, we use multiple linear regression in order to study the relationship between the implementation of Six Sigma quality management and financial performance. The return on assets and ratio of net income to net sales are considered as dependent variable and implementation of Six Sigma as independent variable. Results: The indication of this analysis is that implementation of Six Sigma quality management does not significantly enhance financial status. The firms that adopted Six Sigma quality management were categorized into three groups according to the implementation period. Comparison of each group with the firms that do not adopt Six Sigma quality management does not show statistically significant enhancement of financial status. Conclusion: In conclusion, both adoption and duration of six sigma quality management do not affect financial performance significantly.

Intensity-modulated radiation therapy in early stage squamous cell carcinoma of the larynx: treatment trends and outcomes

  • Wegner, Rodney E.;Abel, Stephen;Bergin, John J.;Colonias, Athanasios
    • Radiation Oncology Journal
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    • v.38 no.1
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    • pp.11-17
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    • 2020
  • Purpose: Definitive radiotherapy remains a primary treatment option for early stage glottic cancer. Intensity-modulated radiation therapy (IMRT) has emerged as the standard treatment technique for advanced head and neck cancers, whereas three-dimensional conformal radiotherapy (3D-CRT) has remained standard for early glottic cancers. We used the National Cancer Database (NCDB) to identify predictors of IMRT use and effect on outcome in these patients. Materials and Methods: We queried the NCDB from 2004-2015 for squamous cell carcinoma of the glottic larynx staged Tis-T2N0 treated with radiation alone. Logistic regression was used to identify predictors of IMRT. Cox regression was used to identify factors predictive of overall survival. Propensity matching was conducted to account for indication bias. Results: We identified 15,627 patients, of which 11% received IMRT. IMRT use rose from 2% in 2004 to 16% in 2015. Predictors of IMRT include: increased comorbidity, T2 stage, urban location, chemotherapy, treatment at an academic center, and later treatment year. Predictors of improved survival were female gender, higher income, lower stage, no chemotherapy, academic facility, and more remote year. There was no difference in survival between 3D-CRT and IMRT across all stages. Conclusions: The rate of IMRT use for early stage glottic laryngeal cancer has increased over time. There was no difference in outcome in patients receiving IMRT versus 3D-CRT across the cohort.

Trends in intensity-modulated radiation therapy use for rectal cancer in the neoadjuvant setting: a National Cancer Database analysis

  • Wegner, Rodney E.;Abel, Stephen;White, Richard J.;Horne, Zachary D.;Hasan, Shaakir;Kirichenko, Alexander V.
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.276-284
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    • 2018
  • Purpose: Traditionally, three-dimensional conformal radiation therapy (3D-CRT) is used for neoadjuvant chemoradiation in locally advanced rectal cancer. Intensity-modulated radiation therapy (IMRT) was later developed for more conformal dose distribution, with the potential for reduced toxicity across many disease sites. We sought to use the National Cancer Database (NCDB) to examine trends and predictors for IMRT use in rectal cancer. Materials and Methods: We queried the NCDB from 2004 to 2015 for patients with rectal adenocarcinoma treated with neoadjuvant concurrent chemoradiation to standard doses followed by surgical resection. Odds ratios were used to determine predictors of IMRT use. Univariable and multivariable Cox regressions were used to determine potential predictors of overall survival (OS). Propensity matching was used to account for any indication bias. Results: Among 21,490 eligible patients, 3,131 were treated with IMRT. IMRT use increased from 1% in 2004 to 22% in 2014. Predictors for IMRT use included increased N stage, higher comorbidity score, more recent year, treatment at an academic facility, increased income, and higher educational level. On propensity-adjusted, multivariable analysis, male gender, increased distance to facility, higher comorbidity score, IMRT technique, government insurance, African-American race, and non-metro location were predictive of worse OS. Of note, the complete response rate at time of surgery was 28% with non-IMRT and 21% with IMRT. Conclusion: IMRT use has steadily increased in the treatment of rectal cancer, but still remains only a fraction of overall treatment technique, more often reserved for higher disease burden.

A Precise Trajectory Prediction Method for Target Designation Based on Cueing Data in Lower Tier Missile Defense Systems (큐잉 데이터 기반 하층방어 요격체계의 초고속 표적 탐지 방향 지정을 위한 정밀 궤적예측 기법)

  • Lee, Dong-Gwan;Cho, Kil-Seok;Shin, Jin-Hwa;Kim, Ji-Eun;Kwon, Jae-Woo
    • Journal of the Korea Institute of Military Science and Technology
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    • v.16 no.4
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    • pp.523-536
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    • 2013
  • A recent air defense missile system is required to have a capability to intercept short-range super-high speed targets such as tactical ballistic missile(TBMs) by performing engagement control efficiently. Since flight time and distance of TBM are very short, the missile defense system should be ready to engage a TBM as soon as it takes an indication of the TBM launch. As a result, it has to predict TBM trajectory accurately with cueing information received from an early warning system, and designate search direction and volume for own radar to detect/track TBM as fast as it can, and also generate necessary engagement information. In addition, it is needed to engage TBM accurately via transmitting tracked TBM position and velocity data to the corresponding intercept missiles. In this paper, we proposed a method to estimate TBM trajectory based on the Kepler's law for the missile system to detect and track TBM using the cueing information received before the TBM arrives the apogee of the ballistic trajectory, and analyzed the bias of prediction error in terms of the transmission period of cueing data between the missile system and the early warning system.

Full-Endoscopic versus Minimally Invasive Lumbar Interbody Fusion for Lumbar Degenerative Diseases : A Systematic Review and Meta-Analysis

  • Son, Seong;Yoo, Byung Rhae;Lee, Sang Gu;Kim, Woo Kyung;Jung, Jong Myung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.539-548
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    • 2022
  • Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.