• Title/Summary/Keyword: Medical audit

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Reporting Quality of Research Studies on AI Applications in Medical Images According to the CLAIM Guidelines in a Radiology Journal With a Strong Prominence in Asia

  • Dong Yeong Kim;Hyun Woo Oh;Chong Hyun Suh
    • Korean Journal of Radiology
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    • v.24 no.12
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    • pp.1179-1189
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    • 2023
  • Objective: We aimed to evaluate the reporting quality of research articles that applied deep learning to medical imaging. Using the Checklist for Artificial Intelligence in Medical Imaging (CLAIM) guidelines and a journal with prominence in Asia as a sample, we intended to provide an insight into reporting quality in the Asian region and establish a journal-specific audit. Materials and Methods: A total of 38 articles published in the Korean Journal of Radiology between June 2018 and January 2023 were analyzed. The analysis included calculating the percentage of studies that adhered to each CLAIM item and identifying items that were met by ≤ 50% of the studies. The article review was initially conducted independently by two reviewers, and the consensus results were used for the final analysis. We also compared adherence rates to CLAIM before and after December 2020. Results: Of the 42 items in the CLAIM guidelines, 12 items (29%) were satisfied by ≤ 50% of the included articles. None of the studies reported handling missing data (item #13). Only one study respectively presented the use of de-identification methods (#12), intended sample size (#19), robustness or sensitivity analysis (#30), and full study protocol (#41). Of the studies, 35% reported the selection of data subsets (#10), 40% reported registration information (#40), and 50% measured inter and intrarater variability (#18). No significant changes were observed in the rates of adherence to these 12 items before and after December 2020. Conclusion: The reporting quality of artificial intelligence studies according to CLAIM guidelines, in our study sample, showed room for improvement. We recommend that the authors and reviewers have a solid understanding of the relevant reporting guidelines and ensure that the essential elements are adequately reported when writing and reviewing the manuscripts for publication.

An Audit of 204 Histopathology Reports Over Three Years of Carcinoma of Cervix: Experience from a Tertiary Referral Centre

  • Pradhan, Anuja Prakash;Menon, Santosh;Rekhi, Bharat;Deodhar, Kedar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5643-5645
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    • 2015
  • Background: The aim was to see compliance to minimum data set information in carcinoma cervix histopathology reports from a team of 13 pathologists; and also to analyse the distribution of parameters like tumor size, grade, depth of cervical stromal invasion, lymph node yield and pTNM stage. Materials and Methods: All pathology reports of radical hysterectomy for carcinoma cervix operated in house within a three year duration (2010-2012), (n=204) were retrieved from medical records and analyzed for the above parameters. Results: In 2010- 59 cases, in 2011- 67 cases and in 2012- 78 cases of carcinoma cervix underwent operations in our hospital. The median age was 50.5 years and the maximum T diameter was 2.8 cms in the reports of three years. Squamous carcinoma was the commonest subtype amongst all the tumors. It was noted that 60.8% of cases had cervical stromal involvement more than half the thickness of the cervical stroma. Parametrial involvement was seen in 4.82% of cases. pTNM Staging was not mentioned in 65.06% of the cases. The mean bilateral pelvic lymph node yield count in our study was 16.6 inclusive of all the three years. Conclusions: Compliance with provision of a minimum dataset in our team of 13 pathologists was generally good. Lymph node yield in our hands is reasonable, but constant striving for greater numbers should be made. pTNM staging should be more meticulously documented. Use of proformas /checklists is recommended.

Effects of Vicarious Trauma on Mental Health in Firefighters (소방 공무원에서 간접 외상이 정신 건강에 미치는 영향)

  • Baik, Jun-Hyuck;Jung, Young-Eun;Chae, Jung-Mi;Myong, Jun-Pyo;Yim, Hyeon-Woo;Cha, Jeong-Ho
    • Anxiety and mood
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    • v.6 no.1
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    • pp.65-70
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    • 2010
  • Objectives : Indirect contact with trauma may occur when a person empathically listens to detailed descriptions, exposing the person to intense emotional pain from trauma victims. Although less severe than direct trauma, indirectly traumatized persons may experience the same fear, rage, and despair as direct trauma victims. This phenomenon has been variously termed vicarious trauma, traumatic countertransference, burnout, compassion fatigue, and secondary traumatic stress. Using a psychiatric symptoms questionnaires, this study investigated the effects of indirect exposure to co-worker's trauma on the mental health of firefighters who had not directly experienced traumatic events in the previous year. Methods : We administered self-report questionnaires, such as the Impact of Event Scale-Revised (IESR) and Alcohol Use Disorder Identification Test (AUDIT), to firefighters working at two fire stations in a metropolitan city. We analyzed 188 of 232 collected surveys, after excluding falsely entered data (28 cases) and questionnaires by directly-traumatized victims (16 cases). Results : Alcohol consumption and posttraumatic stress disorder (PTSD) symptoms, as determined by the AUDIT and IES-R, were significantly higher in the indirectly-traumatized group. The ratio of high-risk members scoring higher than 23 in IES-R was larger in the indirectly traumatized group, although this was not statistically significant. Conclusion : Alcohol consumption was significantly higher in the indirectly traumatized group. This group also included more members at high risk for PTSD. Further research, with a larger group of indirectly traumatized firefighters and ongoing investigation of PTSD development and other psychiatric symptoms, is needed.

Characteristics Associated with Survival in Patients Receiving Continuous Deep Sedation in a Hospice Care Unit

  • Ahn, Hee Kyung;Ahn, Hong Yup;Park, So Jung;Hwang, In Cheol
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.254-260
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    • 2021
  • Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.

Mission and Operation of Institutional Review Board (임상시험심사위원회의 임무와 운영)

  • Kim, Yong-Jin
    • Journal of Yeungnam Medical Science
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    • v.30 no.2
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    • pp.73-78
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    • 2013
  • An institutional review board (IRB) should independently safeguard the right, safety, and well-being of all clinical trial subjects. It should consist of members who are qualified and experienced to review and evaluate the science, medical aspects, and ethics of the proposed trial. They have to pursue continuing efforts to improve the standards of review. The levels of review include the full board review, expedited review, continuing review, or exempt from review, while the levels of decision-making include approval, conditional approval, deferred approval, and disapproval. Investigators must follow the approved protocols and regulations honestly, and it is the IRB's mission to audit clinical trial sites as well.

Good manufacturing practice of radiopharmaceuticals in Korea

  • Oh, Seung Jun
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.2
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    • pp.98-103
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    • 2015
  • Good manufacturing Practice (GMP) regulation for diagnostic and therapeutic radiopharmaceuticals was prepared at 2014. The mandatory GMP regulation becomes effective on $1^{st}$, July 2015,with two years of grace periods. Korean radiopharmaceuticals GMP regulation was consisted of quality management, personnel, premise and facility, documentation, production, quality control and self-audit and they have a very similar structure to European Union and PIC/S GMP regulation. Here, we describe detailed description of GMP regulation each part and application to radiopharmaceuticals production. And we also compare Korea, Japan and USA radiopharmaceuticals GMP regulation. GMP is a method to maintain quality of radiopharmaceuticals in daily production and it must be embedded on the manufacturing operation and management.

OHDSI OMOP-CDM Database Security Weakness and Countermeasures (OHDSI OMOP-CDM 데이터베이스 보안 취약점 및 대응방안)

  • Lee, Kyung-Hwan;Jang, Seong-Yong
    • 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.

Why Screening Rates Vary between Korea and Japan-Differences between Two National Healthcare Systems

  • Goto, Rei;Hamashima, Chisato;Mun, Sunghyun;Lee, Won-Chul
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.395-400
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    • 2015
  • Both Japan and Korea provide population-based screening programs. However, screening rates are much higher in Korea than in Japan. To clarify the possible factors explaining the differences between these two countries, we analyzed the current status of the cancer screening and background healthcare systems. Population-based cancer screening in Korea is coordinated well with social health insurance under a unified insurer system. In Japan, there are over 3,000 insurers and coordinating a comprehensive strategy for cancer screening promotion has been very difficult. The public healthcare system also has influence over cancer screening. In Korea, public healthcare does not cover a wide range of services. Almost free cancer screening and subsidization for medical cost for cancers detected in population-screening provides high incentive to participation. In Japan, on the other hand, a larger coverage of medical services, low co-payment, and a lenient medical audit enables people to have cancer screening under public health insurance as well as the broad range of cancer screening. The implementation of evidence-based cancer screening programs may be largely dependent on the background healthcare system. It is important to understand the impacts of each healthcare system as a whole and to match the characteristics of a particular health system when designing an efficient cancer screening system.

A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges

  • Omeje, Kelvin;Efunkoya, Akinwale;Amole, Ibiyinka;Akhiwu, Benjamin;Osunde, Daniel
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.6
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    • pp.272-277
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    • 2014
  • Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions. Materials and Methods: A retrospective review of medical records and patient case files from January 2012 to December 2013 was undertaken. All case files and other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed reconstruction were selected for review. Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients' (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean $26.0{\pm}10.6years$). Indications for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmental resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients' postoperative reviews and radiographs revealed good facial profile and continued bone stability up to 1 year following NVIBG. Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.

A Study on the Responses to the Change of Health and Medical Finance and Sustainability of the Influencing Foreigners (외국인 유입에 따른 보건의료재정 변화 및 지속가능성 제고를 위한 대응방안 연구)

  • Jung, YongJu
    • Korea Journal of Hospital Management
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    • v.25 no.4
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    • pp.38-47
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    • 2020
  • Purposes: The problem in the recent immigration policy and social policy changes for foreigners is that the preliminary analysis or research on the actual impact of the influx of foreigners has not been done enough in Korea yet.. This study is to examine the impact of the Korean health insurance finances on the influx of foreigners. Approach: This study analyzed the health insurance statistics for foreigners and overseas Koreans of the Health Insurance Corporation from 2013 to 2017. The data is the "Status of Health Insurance Premiums for Nationals, Foreigners, and Overseas Koreans from 2013 to 2017" submitted by the National Health Insurance Service to the Health and Welfare Committee during the 2018 National Audit Period. Findings: To summarize the analysis, first, the proportion of foreigners was only 1% of all subscribers (1.7% at work, 1.9% in regions) until 2017. Second, employees at work have a lower pay-to-pay ratio, and local subscribers have a higher pay-to-pay rate, regardless of nationality. Third, as immigrants are mostly concentrated in younger ages, they are healthy and use of hospitals is relatively low. Fourth, in terms of gender distribution, there are many women of childbearing age due to marriage immigration among foreign local subscribers, and more men use hospitals than workers who have a high proportion of males due to childbirth. In conclusion, the impact of immigration on health insurance finances is not large, and has a positive effect on finances. Practical Implications: If we simply consider the financial aspect, encouraging foreigners to subscribe to health insurance has a positive effect on finances. In particular, the more foreign workers are enrolled, the greater the financial gain. In particular, increasing the employment of foreign women through language education, vocational training, and employment support will help finance health insurance. One of the reasons foreign subscribers have a positive impact on health insurance finance is the low medical utilization rate. It can be said that young and healthy foreigners use fewer hospitals and clinics, but another aspect means that foreigners have difficulty using health insurance for various reasons. Therefore, various supports must be accompanied so that foreign subscribers can use medical services when necessary.