• Journal of Korea Entertainment Industry Association
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• v.4 no.4
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• pp.72-76
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• 2010

Clinical nomogram is a graphical representation of numeric formula, constructed from clinical cases database of followed patients' treatment, which is used for medical predication. For a clinical nomogram to contribute patient care, it is required to accumulate as many as clinical cases and to extract medical prediction knowledge. It needs to be equipped with an effective method to build medical nomogram with high predication accuracy. It is desirable for medical nomogram to be accessible at patient care point. This paper proposes a medical nomogram service system architecture which takes into account the above-mentioned issues. The proposed system architecture includes a web-based database subsystem to maintain and keep track of clinical cases. On the periodic basis, a new clinical nomogram is reconstructed for the updated clinical database. For the convenient use of patient care practice environment, an app-based program is provided which makes prediction based on the most recent clinical nomogram constructed in the service system. The proposed method has been applied to a clinical nomogram service system development for recurrence and survival prediction in bladder cancer patients.

• Journal of Gastric Cancer
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• v.17 no.3
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• pp.204-211
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• 2017

Purpose: Recently, a nomogram predicting overall survival after gastric resection was developed and externally validated in Korea and Japan. However, this gastric cancer nomogram is derived from large-volume centers, and the applicability of the nomogram in smaller centers must be proven. The purpose of this study is to externally validate the gastric cancer nomogram using a dataset from a medium-volume center in Korea. Materials and Methods: We retrospectively analyzed 610 patients who underwent radical gastrectomy for gastric cancer from August 1, 2005 to December 31, 2011. Age, sex, number of metastatic lymph nodes (LNs), number of examined LNs, depth of invasion, and location of the tumor were investigated as variables for validation of the nomogram. Both discrimination and calibration of the nomogram were evaluated. Results: The discrimination was evaluated using Harrell's C-index. The Harrell's C-index was 0.83 and the discrimination of the gastric cancer nomogram was appropriate. Regarding calibration, the 95% confidence interval of predicted survival appeared to be on the ideal reference line except in the poorest survival group. However, we observed a tendency for actual survival to be constantly higher than predicted survival in this cohort. Conclusions: Although the discrimination power was good, actual survival was slightly higher than that predicted by the nomogram. This phenomenon might be explained by elongated life span in the recent patient cohort due to advances in adjuvant chemotherapy and improved nutritional status. Future gastric cancer nomograms should consider elongated life span with the passage of time.

• Journal of Breast Disease
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• v.6 no.2
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• pp.52-59
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• 2018

Purpose: This study aimed to determine whether clinicopathological factors are potentially associated with successful breast-conserving surgery (BCS) after neoadjuvant chemotherapy (NAC) and develop a nomogram for predicting successful BCS candidates, focusing on those who are diagnosed with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative tumors during the pre-NAC period. Methods: The training cohort included 239 patients with an HR-positive, HER2-negative tumor (${\geq}3cm$), and all of these patients had received NAC. Patients were excluded if they met any of the following criteria: diffuse, suspicious, malignant microcalcification (extent >4 cm); multicentric or multifocal breast cancer; inflammatory breast cancer; distant metastases at the time of diagnosis; excisional biopsy prior to NAC; and bilateral breast cancer. Multivariate logistic regression analysis was conducted to evaluate the possible predictors of BCS eligibility after NAC, and the regression model was used to develop the predicting nomogram. This nomogram was built using the training cohort (n=239) and was later validated with an independent validation cohort (n=123). Results: Small tumor size (p<0.001) at initial diagnosis, long distance from the nipple (p=0.002), high body mass index (p=0.001), and weak positivity for progesterone receptor (p=0.037) were found to be four independent predictors of an increased probability of BCS after NAC; further, these variables were used as covariates in developing the nomogram. For the training and validation cohorts, the areas under the receiver operating characteristic curve were 0.833 and 0.786, respectively; these values demonstrate the potential predictive power of this nomogram. Conclusion: This study established a new nomogram to predict successful BCS in patients with HR-positive, HER2-negative breast cancer. Given that chemotherapy is an option with unreliable outcomes for this subtype, this nomogram may be used to select patients for NAC followed by successful BCS.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.30 no.1
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• pp.48-58
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• 2023

Purpose: The purpose of this study was to construct a nomogram for predicting difficulty in peripheral intravenous cannulation (DPIVC) for adult inpatients. Methods: This study conducted a secondary analysis of data from the intravenous cannulation cohort by intravenous specialist nurses at a tertiary hospital in Seoul. Overall, 504 patients were included; of these, 166 (32.9%) patients with failed cannulation in the first intravenous cannulation attempt were included in the case group, while the remaining 338 patients were included in the control group. The nomogram was built with the identified risk factors using a multiple logistic regression analysis. The model performance was analyzed using the Hosmer-Lemeshow test, area under the curve (AUC), and calibration plot. Results: Five factors, including vein diameter, vein visibility, chronic kidney disease, diabetes, and chemotherapy, were risk factors of DPIVC. The nomogram showed good discrimination with an AUC of 0.81 (95% confidence interval: 0.80-0.82) by the sample data and 0.79 (95% confidence interval: 0.74-0.84) by bootstrapping validation. The Hosmer-Lemeshow goodness-of-fit test showed a p-value of 0.694, and the calibration curve of the nomogram showed high coherence between the predicted and actual probabilities of DPIVC. Conclusion: This nomogram can be used in clinical practice by nurses to predict DPIVC probability. Future studies are required, including those on factors possibly affecting intravenous cannulation.

• Communications for Statistical Applications and Methods
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• v.28 no.4
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• pp.339-350
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• 2021

In medical research, the risk factors associated with human diseases need to be identified to predict the incidence rate and determine the treatment plan. Logistic regression analysis is primarily used in order to select risk factors. However, individuals who are unfamiliar with statistics outcomes have trouble using these methods. In this study, we develop a nomogram that graphically represents the numerical association between the disease and risk factors in order to identify the risk factors for delirium and to interpret and use the results more effectively. By using the logistic regression model, we identify risk factors related to delirium, construct a nomogram and predict incidence rates. Additionally, we verify the developed nomogram using a receiver operation characteristics (ROC) curve and calibration plot. Nursing home, stroke/epilepsy, metabolic abnormality, hemodynamic instability, and analgesics were selected as risk factors. The validation results of the nomogram, built with the factors of training set and the test set of the AUC showed a statistically significant determination of 0.893 and 0.717, respectively. As a result of drawing the calibration plot, the coefficient of determination was 0.820. By using the nomogram developed in this paper, health professionals can easily predict the incidence rate of delirium for individual patients. Based on this information, the nomogram could be used as a useful tool to establish an individual's treatment plan.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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• pp.3773-3777
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• 2015

Background: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. Materials and Methods: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. Results: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. Conclusions: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.3
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• pp.1481-1488
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• 2014

Background: To avoid performing axillary lymph node dissection (ALND) for non-sentinel lymph node (SLN)-negative patients with-SLN positive axilla, nomograms for predicting the status have been developed in many centers. We created a new nomogram predicting non-SLN metastasis in SLN-positive patients with invasive breast cancer and evaluated 14 existing breast cancer models in our patient group. Materials and Methods: Two hundred and thirty seven invasive breast cancer patients with SLN metastases who underwent ALND were included in the study. Based on independent predictive factors for non-SLN metastasis identified by logistic regression analysis, we developed a new nomogram. Receiver operating characteristics (ROC) curves for the models were created and the areas under the curves (AUC) were computed. Results: In a multivariate analysis, tumor size, presence of lymphovascular invasion, extranodal extension of SLN, large size of metastatic SLN, the number of negative SLNs, and multifocality were found to be independent predictive factors for non-SLN metastasis. The AUC was found to be 0.87, and calibration was good for the present Ondokuz Mayis nomogram. Among the 14 validated models, the MSKCC, Stanford, Turkish, MD Anderson, MOU (Masaryk), Ljubljana, and DEU models yielded excellent AUC values of > 0.80. Conclusions: We present a new model to predict the likelihood of non-SLN metastasis. Each clinic should determine and use the most suitable nomogram or should create their own nomograms for the prediction of non- SLN metastasis.

• The Korean Journal of Applied Statistics
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• v.32 no.4
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• pp.619-630
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• 2019

Dyslipidemia is a representative chronic disease affecting Koreans that requires continuous management. It is also a known risk factor for cardiovascular disease such as hypertension and diabetes. However, it is difficult to diagnose vascular disease without a medical examination. This study identifies risk factors for the recognition and prevention of dyslipidemia. By integrating them, we construct a statistical instrumental nomogram that can predict the incidence rate while visualizing. Data were from the Korean National Health and Nutrition Examination Survey (KNHANES) for 2013-2016. First, a chi-squared test identified twelve risk factors of dyslipidemia. We used a naïve Bayesian classifier model to construct a nomogram for the dyslipidemia. The constructed nomogram was verified using a receiver operating characteristics curve and calibration plot. Finally, we compared the logistic nomogram previously presented with the Bayesian nomogram proposed in this study.

• Journal of Korea Multimedia Society
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• v.13 no.5
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• pp.722-729
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• 2010

Prediction problems are widely used in medical domains. For example, computer aided diagnosis or prognosis is a key component in a CDSS (Clinical Decision Support System). SVMs with nonlinear kernels like RBF kernels, have shown superior accuracy in prediction problems. However, they are not preferred by physicians for medical prediction problems because nonlinear SVMs are difficult to visualize, thus it is hard to provide intuitive interpretation of prediction results to physicians. Nomogram was proposed to visualize SVM classification models. However, it cannot visualize nonlinear SVM models. Localized Radial Basis Function (LRBF) was proposed which shows comparable accuracy as the RBF kernel while the LRBF kernel is easier to interpret since it can be linearly decomposed. This paper presents a new tool named VRIFA, which integrates the nomogram and LRBF kernel to provide users with an interactive visualization of nonlinear SVM models, VRIFA visualizes the internal structure of nonlinear SVM models showing the effect of each feature, the magnitude of the effect, and the change at the prediction output. VRIFA also performs nomogram-based feature selection while training a model in order to remove noise or redundant features and improve the prediction accuracy. The area under the ROC curve (AUC) can be used to evaluate the prediction result when the data set is highly imbalanced. The tool can be used by biomedical researchers for computer-aided diagnosis and risk factor analysis for diseases.

• Journal of the Korean Institute of Intelligent Systems
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• v.19 no.6
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• pp.796-801
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• 2009

In medical practice, the diagnosis or prediction models requiring complicated computations are not widely recognized due to difficulty in interpreting the course of reasoning and the complexity of computations. Medical personnel have used the nomograms which are a graphical representation for numerical relationships that enables to easily compute a complicated function without help of computation machines. It has been widely paid attention in diagnosing diseases or predicting the progress of diseases. A nomogram is constructed from a set of clinical data which contain various attributes such as symptoms, lab experiment results, therapy history, progress of diseases or identification of diseases. It is of importance to select effective ones from available attributes, sometimes along with parameters accompanying the attributes. This paper introduces a nomogram construction method that uses a naive Bayesian technique to construct a nomogram as well as a genetic algorithm to select effective attributes and parameters. The proposed method has been applied to the construction of a nomogram for a real clinical data set.