• Title/Summary/Keyword: Medical measurement

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A Three-Dimensional Deep Convolutional Neural Network for Automatic Segmentation and Diameter Measurement of Type B Aortic Dissection

  • Yitong Yu;Yang Gao;Jianyong Wei;Fangzhou Liao;Qianjiang Xiao;Jie Zhang;Weihua Yin;Bin Lu
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.168-178
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    • 2021
  • Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion: The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

A Case Study of Six Sigma Project for Improving Measurement Method of Skin Elasticity (피부탄성 측정 문제점 개선을 위한 6시그마 프로젝트)

  • Lee, Hae-Jung;Kang, Nam-Sik;Jeon, Young-Ju;Kim, Keun-Ho;Kim, Hong-Gie;Kim, Jong-Yeol
    • Korean Journal of Oriental Medicine
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    • v.16 no.3
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    • pp.135-140
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    • 2010
  • The usefulness of constitutional diagnoses based on skin measurements has been established in oriental medicine. According to Sasang constitutional medicine, humans can be distinguished based on properties of skin's friction, thickness and elasticity. To quantify and standardize skin diagnosis, the present study designed an equipment for measuring skin elasticity of hand. But there were some noises in measuring skin elasticity such as measurement method, environment, operator and conditions of patient. So we considered a six sigma project for reducing the measurement errors. The project was followed to discipline process of five macro phases: Define, Measure, Analyze, Improve and Control(DMAIC). So, we could find the major factors which should be controled for stabilizing measurement system and we revised the SOP(Standard Operating Procedure) of the skin elasticity measurement.

Uncertainty Assessment: Relative versus Absolute Point Dose Measurement for Patient Specific Quality Assurance in EBRT

  • Mahmood, Talat;Ibrahim, Mounir;Aqeel, Muhammad
    • Progress in Medical Physics
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    • v.28 no.3
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    • pp.111-121
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    • 2017
  • Verification of dose distribution is an essential part of ensuring the treatment planning system's (TPS) calculated dose will achieve the desired outcome in radiation therapy. Each measurement have uncertainty associated with it. It is desirable to reduce the measurement uncertainty. A best approach is to reduce the uncertainty associated with each step of the process to keep the total uncertainty under acceptable limits. Point dose patient specific quality assurance (QA) is recommended by American Association of Medical Physicists (AAPM) and European Society for Radiotherapy and Oncology (ESTRO) for all the complex radiation therapy treatment techniques. Relative and absolute point dose measurement methods are used to verify the TPS computed dose. Relative and absolute point dose measurement techniques have a number of steps to measure the point dose which includes chamber cross calibration, electrometer reading, chamber calibration coefficient, beam quality correction factor, reference conditions, influences quantities, machine stability, nominal calibration factor (for relative method) and absolute dose calibration of machine. Keeping these parameters in mind, the estimated relative percentage uncertainty associated with the absolute point dose measurement is 2.1% (k=1). On the other hand, the relative percentage uncertainty associated with the relative point dose verification method is estimated to 1.0% (k=1). To compare both point dose measurement methods, 13 head and neck (H&N) IMRT patients were selected. A point dose for each patient was measured with both methods. The average percentage difference between TPS computed dose and measured absolute relative point dose was 1.4% and 1% respectively. The results of this comparative study show that while choosing the relative or absolute point dose measurement technique, both techniques can produce similar results for H&N IMRT treatment plans. There is no statistically significant difference between both point dose verification methods based upon the t-test for comparing two means.

Development of Performance Measurement Indicators in S Hospital (S병원 성과평가지표 개발에 관한 연구)

  • Lee, Hee-Won;Yu, Seung-Hum;Lee, Hae-Jong;Park, Chang-Il
    • Korea Journal of Hospital Management
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    • v.5 no.1
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    • pp.1-23
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    • 2000
  • This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

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The Advent of Cuffless Mobile Device Blood Pressure Measurement: Remaining Challenges and Pitfalls

  • Hae-Young Lee;Thilo Burkard
    • Korean Circulation Journal
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    • v.52 no.3
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    • pp.198-204
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    • 2022
  • Blood pressure measurement (BPM) is an essential part of medical examination, and therefore accuracy of BPM devices is crucial. Over the past few years, there has been a rise in new BPM techniques using photoplethysmographic (PPG) signals and complex algorithms for blood pressure estimation. Especially the combination of a mobile device or a smartphone with a camera using PPG may potentially revolutionize BPM in the future. The first-ever BPM application to be approved as a medical device was one by the Korean Ministry of Food and Drug Safety in 2020, despite the lack of robust scientific evidence proving its validity. While the prospect of using these novel BPM devices is an opportunity, there are also some critical issues around calibration and utility in different patient groups that need to be resolved before they can be incorporated into daily clinical practice.

Analysis of the Research Trends of Pelvic Malposition in Korean Clinical Research (골반부와 관련된 국내임상연구동향 고찰 -골반부의 변위를 중심으로-)

  • Park, Jaehyeon;Nam, Soohyeon;Kim, Donghoo;Kang, Jun-Hyuk;Heo, Woo-Young
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.2
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    • pp.81-88
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    • 2015
  • Objectives The purpose of this review was to analyze the research trends in clinical research related to pelvic malposition published in Korean medicine journals. Methods We searched articles in Korean databases (OASIS, NDSL, RISS, and KTKP), and sorted the articles by publishing date, pelvic malposition type, field of study, and measurement index. Results 1. 25 original articles and 9 case report articles were reviewed. 2. In recent years, this topic has been studied more frequently, with an increasing number of original articles published. 3. 16 articles analyzed pelvic malposition type. And half of the articles focused on ilium. 4. The original articles have figured out the correlation between pelvic malposition measurement indices and other measurement indices or diseases. 5. Treatment tools, such as chuna therapy, the mckenzie method, devices for correcting malposition, acupuncture were used in the case report articles. 6. 29 measurement indices, such as Ferguson's angle, Ilium shadow measurement, and Iliac height difference were used. Conclusions According to the literature, pelvic malposition is related to other diseases and measurement indices, and manual medicine on pelvic malposition can be effective. However, due to the lack of sufficient empirical evidence from medical articles to support this, further clinical research should be conducted.

Measurement of Dose Distribution in Small Fields of NEC LINAC 6 MVX Using Films and Tissue Equivalent Phantoms (필름 및 tissue equivalent 팬톰을 이용한 NEC LINAC 6 MVX 소조사면에 대한 선량분포 측정)

  • Suh, Tae-Suk;Park, Dong-Rak;Choe, Bo-Young;Yoon, Sei-Chul;Jang, Hong-Seok;Park, Il-Bong;Kim, Moon-Chan;Bahk, Yong-Whee;Shin, Kyung-Sub
    • Progress in Medical Physics
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    • v.4 no.2
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    • pp.9-17
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    • 1993
  • The purpose of this paper is to develop a simple system to measure dose distribution in small fields of NEC LINAC 6 MVX using film and solid water instead of ion chamber and water phantom. Specific quantities measured include percent depth dose (PDD), off-axis ratio (OAR). We produced square fields of 1 to 3cm in perimeter in 1cm steps measured at SAD of 80cm. The PDD and OAR measured by film was compared with measurement made with ion chamber. We calculated the TMR from the basic PDD data using the conversion formula. The trends of our measured beam data and philips LINAC are similar each other. The measurement for the small field using film and solid water was simple. Hand-made film phantom was especially useful to measure OARs for the stereotactic radiosurgery.

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Development of the Performance Measurement Model of Electronic Medical Record System - Focused on Balanced Score Card - (균형성과표를 활용한 전자의무기록시스템의 성과측정 모형개발)

  • Lee, Kyung Hee;Kim, Young Hoon;Boo, Yoo Kyung
    • Korea Journal of Hospital Management
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    • v.21 no.4
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    • pp.1-12
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    • 2016
  • The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

The Change of Blood Pressure according to the Number of Measurements and the Number of Visits (측정 횟수 및 방문 횟수에 따른 혈압 변화)

  • Park, Ji-Eun;Lee, Min-Hee;Ryu, Yeon-Hee;Liu, Yan;Jung, Hee-Jung;Hong, Sang-Hoon;Lee, Seung-Deok;Kim, Nam-Kwen;Choi, Sun-Mi
    • Korean Journal of Oriental Medicine
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    • v.18 no.3
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    • pp.111-118
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    • 2012
  • Objective : The aim of this study was to investigate the number of measurements and visits for blood pressure measurement. We also analyzed the change of blood pressure based on the measurement method and measurement interval. Methods : Data of three clinical trials evaluating the effect of acupuncture, moxibustion, and qigong for pre and mild essential hypertension were used. Blood pressure was measured 3 times each visit with 1 or 5 minutes interval, and it was checked until $3^{rd}$ visit. Two trials used sphygmomanometer and another one trial used automatic device for blood pressure measurement. Results : The mean difference between $1^{st}$ and $2^{nd}$, and $2^{nd}$ and $3^{rd}$ measurement were significant in systolic (p<0.001) and diastolic blood pressure (p<0.001). However, in automated measurement or measuring with 1 minute interval, the difference between $2^{nd}$ and $3^{rd}$ was not significant. The mean of $1^{st}$ and $2^{nd}$ measurements was also significantly different from the mean of all three measurements in both systolic (p<0.001) and diastolic blood pressure (p<0.001). While the difference between each visit was not significant in diastolic blood pressure, the systolic blood pressure difference was significant between $1^{st}$ and $2^{nd}$ visit in automated and manual measurement. Conclusion : The mean of two measurements and three measurements were significantly different. The change of blood pressure was different according to the method and interval of blood pressure measurement.

A Measurement System for Rounded Shoulder Posture using a Wearable Stretch Sensor

  • Nguyen, Manh Thang;Dang, Quoc Khanh;Kim, Younghoon;Chee, Youngjoon
    • Journal of Biomedical Engineering Research
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    • v.39 no.1
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    • pp.10-15
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    • 2018
  • In this paper, we present a wearable measurement system for monitoring rounded shoulders. The system contains a shoulder correction band and a stretch sensor that can correct and measure shoulder posture, respectively. The capacitance of the stretch sensor changes linearly according to changes in the shoulders. To verify measurement, a motion analysis system was used as the reference to compare the change in the rounded angles of the shoulders and the change in the stretch sensor's capacitance. The results indicated that there is a high correlation between the two changes and the system can be used as a monitoring device for rounded shoulders.