• Progress in Medical Physics
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• v.31 no.2
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• pp.20-28
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• 2020

Purpose: The objective of this study is to perform Postal dosimetry audits for medical linear accelerators in radiation therapy institutions using glass dosimeters and Gafchromic film reading systems and postal dosimetry audit procedures, and to evaluate radiation therapy doses and mechanical accuracy in medical institutions. Methods: Photon output measured and analyzed using a standard phantom for measuring photon output dose using a glass dosimeter for medical linear accelerators. Mechanical accuracy was measured and analyzed using software for film measurement. Results: Measurement and analysis of photon beam output dose using a standard phantom glass dosimeter for photon beam output dose measurement was completed. All tolerance doses were within 5%. Mechanical accuracy measurement and analysis using a standard phantom for verifying the mechanical accuracy of linear accelerator (LINAC) using a Gafchromic film were completed, and all results were shown within tolerances (2 mm or less). Conclusions: In this study, Postal dosimetry audits were performed on the output dose and mechanical accuracy of photon beams (207 beams) for 106 LINACs from 48 institutions. As a result of corrective action and re-execution, it was confirmed that all engines met the acceptable standard within 2 mm in the linear accelerator.

• Progress in Medical Physics
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• v.32 no.4
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• pp.122-129
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• 2021

Purpose: This study aimed to design a multipurpose dose verification phantom for external audits to secure safe and optimal radiation therapy. Methods: In this study, we used International Atomic Energy Agency (IAEA) LiF powder thermoluminescence dosimeter (TLD), which is generally used in the therapeutic radiation dose assurance project. The newly designed multipurpose phantom (MPP) consists of a container filled with water, a TLD holder, and two water-pressing covers. The size of the phantom was designed to be sufficient (30×30×30 cm³). The water container was filled with water and pressed with the cover for normal incidence to be fixed. The surface of the MPP was devised to maintain the same distance from the source at all times, even in the case of oblique incidence regardless of the water level. The MPP was irradiated with 6, 10, and 15 MV photon beams from Varian Linear Accelerator and measured by a 1.25 cm³ ionization chamber to get the correction factors. Monte Carlo (MC) simulation was also used to compare the measurements. Results: The result obtained by MC had a relatively high uncertainty of 1% at the dosimetry point, but it showed a correction factor value of 1.3% at the 5 cm point. The energy dependence was large at 6 MV and small at 15 MV. Various dosimetric parameters for external audits can be performed within an hour. Conclusions: The results allow an objective comparison of the quality assurance (QA) of individual hospitals. Therefore, this can be employed for external audits or QA systems in radiation therapy institutions.

• The Journal of KAIRB
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• v.6 no.2
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• pp.48-55
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• 2024

Purpose: The purpose of this study is to introduce the Institutional Review Board (IRB) member-based internal audit method performed at A University Hospital, a secondary medical institution, and to identify the differences in audit results according to the characteristics of each auditor and the factors affecting the internal audit results. Furthermore, we will find out what needs to be improved in the internal audits to achieve Quality assurance (QA) objectives for human subject research conducted in medical institutions. Methods: The auditors were divided into group A (IRB member belonging to institution A) and group B (clinical trial QA administrator belonging to other institutions) and independently inspected the 2 studies using the same internal audit checklist (consisting of 11 domains, 130 items), and the differences in the internal inspection checklists written by each auditor were compared and analyzed. Results: In the case of audit for the study 1, the number of missing checklists is 1 for group A and 0 for group B, and the number of the matters to be pointed out is 1 for group A and 12 for group B. In the case of audit for the study 2, the number of missing checklists is 2 for both A and B, and the number of points is 5 for A and 4 for B. The differences in the internal audit results written by each auditor that the authors verified are summarized as follows. First, there were more comments from group B auditor than from group A auditor. Second, the results may vary because each auditor has different criteria for evaluating the appropriateness of an item. Third, there are cases where the questions on the checklist are vague or the definition is not clear, so they have the same opinion but check it with different answers. Fourth, if the auditors make a mistake when filling out the checklist, it causes to led to different the results. Conclusion: We propose the following items that should be improved in order to conduct consistent and efficient internal audits. First, it is necessary to test the tool in order to carry out reliable and consistent internal audits. Second, it is necessary to complete specialized training related to internal audit before conducting internal audit. Third, before notifying the audit results, it is necessary to have a procedure or a final review system to check whether the audit contents are appropriate. Fourth, Institutional support is needed to recruit specialized personnel for internal audits.

• Progress in Medical Physics
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• v.24 no.4
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• pp.315-322
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• 2013

The aim of this work is to verify the self-quality assurances in medical institutions in Korea through the external audits by the group of experts and have a mutual discussion of the systematic problems. In order to validate the external audits 30 of 80 medical institutions across the nation were picked out considering the regional distribution and the final 25 institutions applied voluntarily to take part in this work. The basic rules were setup that any information of the participants be kept secrete and the measurements be performed with the dosimetry system already verified through intercomparision. The outputs for 2 or more photon beams, the accuracy of gantry rotation and collimator rotation and the poistional accuracy of MLC movement were measured. The findings for the output measurement showed the differences of -0.8%~4.5%, -0.79%~3.01%, and -0.7%~0.07% with respect to that of the verified dosimetry system for the 6MV, 10MV, and 15MV, respectively. For the reference absorbed dose 8 (16%) of 50 photon beams in 25 medical institutions differed 2.0% or greater from the reference value. The coincidences of Field size with x-ray beam and radiation isocenters of Gantry roration and collimator rotation gave the results of within ${\pm}2$ mm for every institute except 2 institutions. The positional accuracy of MLC movement agreed to within ${\pm}1$ mm for every institute. For the beam qualities of 6 MV photon beams kQ values showed the distribution within 0.4% between maximum and minimum. For the protocols 21 institutions (84%) used absorbed dose to water based protocol while 4 insitutions (16%) used air kerma based one. 22 institutions employed the SSD technique while 3 institutions did the SAD one. External audit plays an important role in discovering the systematic problems of self-performing Quality Assurances and having in depth discussion for mutual complementation. Training experts of international level as well as national support system are required so that both the group of experts of medical physicists and government laboratory could perform together periodical and constant external audits.

• Korean Journal of Acupuncture
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• v.24 no.4
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• pp.13-24
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• 2007

Objectives : This article aims to give guidance on the conduct and reporting of case series and audits of acupuncture, based on common problems that have arisen in the past. This type of project, and particularly the prospective case series or pre- post-intervention study, may give valuable evidence of the overall effectiveness of acupuncture-for example in different situations and in different conditions- and provides one step in the research pathway before generating an hypothesis. Results & Discussion : The project should be designed with the aim of reducing bias as much as possible. Careful and detailed planning is essential for the project to produce worthwhile results that readers can evaluate and replicate. Ethical issues should be considered and formal approval may be necessary. The patient group should be recruited systematically and baseline data obtained. The treatment given should be systematic and decisions to change or end treatment made explicit. The outcome should be measured in ways that are known to be reliable and valid. Musculoskeletal problems can be evaluated with scales for pain and confirmed by measuring one other symptom such as stiffness or one other aspect such as bothersomeness. Global change scores also provide supporting information, and the MYMOP (Measure Yourself Medical Outcome Profile) measure is popular when patients with different conditions are included. The design of questionnaires for beliefs and attitudes is a specialised area that should not be attempted without expert help. Adverse events should also be recorded. Analysis of the data and the best way of summarising and presenting the results are also discussed.

• Safety and Health at Work
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• v.10 no.1
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• pp.54-60
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• 2019

Background: Increasing the establishment of integrated management systems (IMSs) is done with the purpose of leaving traditional management methods and replacing them with modern management methods. Thus, the present study sought to analyze the events and investigate the impact of IMS on health and safety performance indices in an Iranian combined cycle power plants. Methods: This case study was conducted in 2012 in all units of the Yazd Combined Cycle Power Plant on accident victims before and after the implementation of IMS. For data analysis and prediction of indices after the implementation of IMS, descriptive statistics and Kolmogorov-Smirnov test, Chi-square, linear regression, and Cubic tests were conducted using SPSS software. Results: The number of people employed in the power plant in an 8-year period (2004-2011) was 1,189, and 287 cases of work-related accidents were recorded. The highest accident frequency rate and accident severity rate were in 2004 (32.65) and 2008 (209), respectively. Safe T-score reached to below -3 during 2010-2011. In addition, given the regression results, the relation between all predictor variables with outcomes was significant (p < 0.05), except for the variable $X^1$ belonging to the accident severity rate index. Conclusion: The implementation of safety programs especially that of IMS and its annual audits has had a significant impact on reducing accident indices and improving safety within the study period. Accordingly, health and safety management systems are appropriate tools for reducing accident rate, and the use of regression models and accident indices is also a suitable way for monitoring safety performance.

• Journal of Information Technology Services
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• v.21 no.4
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• pp.63-74
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• 2022

Globally researchers at medical institutions are actively sharing COHORT data of patients to develop vaccines and treatments to overcome the COVID-19 crisis. OMOP-CDM, a common data model that efficiently shares medical data research independently operated by individual medical institutions has patient personal information (e.g. PII, PHI). Although PII and PHI are managed and shared indistinguishably through de-identification or anonymization in medical institutions they could not be guaranteed at 100% by complete de-identification and anonymization. For this reason the security of the OMOP-CDM database is important but there is no detailed and specific OMOP-CDM security inspection tool so risk mitigation measures are being taken with a general security inspection tool. This study intends to study and present a model for implementing a tool to check the security vulnerability of OMOP-CDM by analyzing the security guidelines for the US database and security controls of the personal information protection of the NIST. Additionally it intends to verify the implementation feasibility by real field demonstration in an actual 3 hospitals environment. As a result of checking the security status of the test server and the CDM database of the three hospitals in operation, most of the database audit and encryption functions were found to be insufficient. Based on these inspection results it was applied to the optimization study of the complex and time-consuming CDM CSF developed in the "Development of Security Framework Required for CDM-based Distributed Research" task of the Korea Health Industry Promotion Agency. According to several recent newspaper articles, Ramsomware attacks on financially large hospitals are intensifying. Organizations that are currently operating or will operate CDM databases need to install database audits(proofing) and encryption (data protection) that are not provided by the OMOP-CDM database template to prevent attackers from compromising.

• Annual Conference of KIPS
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• 2023.05a
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• pp.243-245
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• 2023

The care and quality provided to service users depend heavily on the documentation of medication administration. The results of medication management will be greatly impacted by the Medication Data Management (MDM) sheets, which will be examined during audits. Along with this impact, registered hospitals, care facilities, and residential homes will all be inspected by the healthcare industry. In order to deploy MDM sheets, it is proposed to create a blockchain prototype, or more specifically, to develop a blockchain-based Electronic Health Records (EHR) application. Confidentiality and confidence with the auditors are provided by the usage of permissioned blockchain technology (e.g., Care Quality Commission - CQC). Results from testing the prototype in two scenarios are positive. According to the findings, the use of EHR with permissioned blockchain can result in reminders being sent to medical practitioners as well as other effects.

• Journal of the Korea Society of Computer and Information
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• v.17 no.4
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• pp.173-184
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• 2012

As a result of the compulsory of information system audit and a rise in audit demand, the quality improvement of information system audit is being emphasized. However, since the current information system audit heavily depends on the auditor's experience, skill, and subjective judgments, it incurs distrust in the objectivity and reliability of audit results from audit interest person. Furthermore, so far research activities aimed at securing the objectivity and reliability of audits have not been adequately carried out. Therefore, this paper presents a quantitative method for information system audit evaluation in order to contribute to the quality improvement of overall information system audit through securing compliance, objectivity, and reliability of information system audit. The quantitative method is largely composed of two sectors, such as evaluation areas and items, scores calculation for evaluation items, and can generally apply the information system audit standard to information system audit evaluation.

• Journal of Korean Society of Transportation
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• v.25 no.5
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• pp.15-21
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• 2007

This paper proposes an improved methodology for estimating traffic accident cost savings in the transport appraisal. Four major problems from the existing framework are identified and their alternatives are suggested. First, casualties in the established approach are classified by just two types of 'killed' and 'injured'. This study supplies the indices of fatality further details. Namely, road victims are regrouped by 'killed', 'seriously injured', 'slightly injured', and 'accident reports'. Those of railways are similarly sorted by 'killed', 'seriously injured', and 'slightly injured'. Second, damage only accidents are not satisfactorily considered in the current arrangement. The accidents should be considered as one of the accident types and the social cost of them should also be evaluated. Third, the unit cost of accidents is given by the total value. The unit cost is consisted of several elements and each loss would be useful for a policy frame. This study breaks down the total figure into four pieces of costs, namely production loss, medical treatment, property loss, and administrative costs. Finally, there is inconsistency in the audit between roads and railways. Road accidents are analyzed by road types. On the other hand, patronage or others is the classification rule of rail accident costs. This paper suggests a way that the accident costs of two modes can be coherently estimated based on the level of services by each mode. The result of this study is expected to help frame more cautious social overhead capital investment policies.