• Title/Summary/Keyword: Patient Outcome Assessment

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Development of a Tele-Rehabilitation System for Outcome Evaluation of Physical Therapy

  • Park, Hyung-Soon;Lee, Jeong-Wan
    • Journal of Biomedical Engineering Research
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    • v.29 no.3
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    • pp.179-186
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    • 2008
  • This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals (요양병원의 서비스 질 평가를 위한 요실금 결과 지표 개발)

  • Yoon, Ju-Young;Lee, Ji-Yun
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.110-118
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    • 2010
  • Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

Results of Ludloff Osteotomy in Hallux Valgus (무지외반증에 대한 Ludloff 절골술의 결과)

  • Moon, Hyung-Tae;Jang, Suk-Hwan;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.64-68
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    • 2005
  • Purpose: The purpose of this study was to evaluate the outcome of Ludloff osteotomy for treatment of hallux valgus with regard to patient satisfaction and clinical and radiological results. Materials and Methods: 43 feet of 28 patients underwent Ludloff osteotomy between January 2003 and August 2003. 21 patients (32 feet) who were available for follow up for more than one year were enrolled in this study. Average follow up period was 16 months. All patients were female and the average age was 51 years ranging 28 years to 72 years. Patient satisfaction was assessed and VAS (Visual Analogue Scale) was used for subjective outcome, AOFAS (American Orthopaedic Foot and Ankle Society) score and presence of metatarsalgia were used for clinical outcome, and hallux valgus angle and intermetatarsal angle were used for radiological outcome assessment. Results: Patient satisfaction regarding cosmesis was excellent in 6 cases, good in 21 cases, fair in 4 cases and poor in 1 case. VAS was improved from preoperative 6 points to postoperative 2 points and AOFAS score was improved from preoperative 53 points to postoperative 82 points. Metatarsalgia was observed in 18 cases preoperatively and 9 cases postoperatively. HVA and IMA were 35.8 and 15.2 degrees preoperatively, 12.5 and 6.6 degrees at 3 months follow up, and 13.2 and 7.1 degrees at last follow up respectively. At the last follow up, loss of angle of correction for HVA was 0.7 degrees and for IMA was 0.5 degrees. Conclusion: Ludloff osteotomy is an appropriate surgery of moderate to severe hallux valgus.

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Sharing Experiences in Selecting Clinical Outcome and Approving Validated Questionnaires : Insights from an Elderly Registry Study (노인등록연구 사례를 통한 임상평가지표 선정 과정 및 검증된 설문도구 승인 경험의 공유)

  • Nahyun Cho;Hyungsun Jun;Won-Bae Ha;Junghan Lee;Mi Mi Ko;Young-Eun Kim;Jeeyoun Jung;Jungtae Leem
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.17-43
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    • 2024
  • Objectives: Underpinned by the context of a Korean traditional medicine cohort study on healthy aging, this research primarily aims to guide the selection of Clinical Outcome Assessments (COAs) for elderly healthy aging patient registry research, offering insights into the selection process; and secondly, to streamline the resource-intensive process of obtaining permissions for validated COAs, benefiting future traditional Korean medicine clinical researchers. Methods : In this study, we identified outcomes through a review of previous studies, followed by a process involving expert consultations to select the final outcomes. Subsequently, for the selected outcomes that were Clinical Outcome Assessments (COAs) developed tools, we searched in commercial databases to confirm the availability of Korean versions and the necessity of obtaining permissions. Finally, we obtained permissions for their utilization and, when needed, acquired the original instrument questionnaire through payment. Results: Through a literature review of existing observational studies, a total of 57 outcomes were selected, with 19 of them identified as COA instruments. Upon verifying usage permissions for these 19 instruments, it was found that 17 required author-specific permissions, and among these, 2 needed a purchase as they were commercially available. Conclusion: This study provides a detailed overview of outcome selection and permission acquisition for elderly patient registry research. It underscores the importance of Clinical Outcome Assessment (COA) tools and the rigorous approval process, aiming to enhance research reliability. Continuous verification of COA information is essential, and future research should explore Core Outcome Set (COS) development through consensus-building approaches like Delphi studies.

Three Case Study of Primary Insomnia Patient Diagnosed with Cold-related Diarrhea Accompanied by Abdominal Pain (신한복통(身寒腹痛) 망음증(亡陰證) 원발성 불면증 환자 3례 보고)

  • Hong, Seung-Min;Hwang, Min-Woo
    • Journal of Sasang Constitutional Medicine
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    • v.28 no.4
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    • pp.350-360
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    • 2016
  • Objective The aim of this study was to report significant improvement of primary insomnia in a Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatic pattern Patient. Methods The patients were diagnosed with Soyangin Cold-related diarrhea accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證) and treated with Hyungbangjihwang-tang(荊防地黃湯). The primary outcome measures for this study were condition of sleep using a questionnaire with Pittsburgh Sleep Quality Index (PSQI) Secondary outcome assessment included change of original symptoms such as patient's digestion, sweating and feces. Result The symptoms of primary insomnia improved by the end of the a treatment period without side effect. original symptoms were also changed. Conclusions This result show Hyungbangjihwang-tang(荊防地黃湯) can be used to treat primary insomnia in a Soyangin Cold related Mangeum Symptomatic Pattern accompanied by abdominal pain Symptomatology(身寒腹痛亡陰證). Meaning and process of primary insomnia are different according to Sasang Constitutions.

How we should approach and manage older patients with cancer (노인 암 환자의 접근과 관리 원칙)

  • Kim, Jee Hyun
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.1-8
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    • 2017
  • Cancer is the disease of aging and Korea is one of the fastest aging country in the world. Older patients have decreased organ function and stress tolerance, therefore are at high risk of functional decline and developing complication from cancer and cancer treatment. Before beginning cancer treatment, it is important to assess patients' life expectancy, whether the patient is likely to die of cancer or of other comorbidity, and also the risks with cancer treatment. In order to estimate patient's physiologic age, it is recommended to perform geriatric assessment and implement appropriate geriatric intervention together with meticulous supportive care, when planning cancer treatment for older patients. In a resource limited country such as Korea, two step approach of applying screening tool followed by geriatric assessment can be more efficient. Geriatric assessment is used to predict toxicity from cancer treatment such as surgery, radiotherapy, and chemotherapy, predict survival, and also to aid treatment decision. Number of randomized trials are ongoing to compare usual care versus oncogeriatric care, and with these results we expect to improve outcome of older patients with cancer.

Statistical evaluation of the cleft lip nose deformity image (구순열 환자 코변형(cleft lip nose deformity) 영상의 통계적 평가)

  • Nam, Ki-Chang;Kim, Jin-Tae;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
    • Proceedings of the KIEE Conference
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    • 2005.05a
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    • pp.45-47
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    • 2005
  • Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity. Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed on quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three greatly experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis.

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Statistical Evaluation of the Cleft Lip Nose Deformity Image (구순열 환자 코변형(Cleft Lip Nose Deformity) 영상의 통계적 평가)

  • Kim, Jin-Tae;Nam, Ki-Chang;Hong, Hyun-Ki;Rah, Dong-Kyun;Kim, Deok-Won
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.54 no.8
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    • pp.517-520
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    • 2005
  • Cleft lip is a congenital deformity condition with separation of the two sides of the lip and results in nose deformity Evaluation of surgical corrections and outcome assessments in nose deformity resulting from the cleft lip depend mainly on doctor's objective judgment. Development of an objective assessment tool in evaluation of the condition and surgical outcome of cleft lip nose deformity patients will help in advancement and evaluation of surgical techniques of cleft lip. Hence, our study aimed at quantitative assessment of a cleft lip nose deformity condition by comparing following parameters gathered from a photographic image of a cleft lip patient: (1) angle difference between two nostril axis, (2) center of the nostril and distance between two centers, (3) overlapped area of two nostrils and (4) the overlapped area ratio of two nostrils. Assessment results of the nose deformity were determined by statistical analysis of evaluation results from three experienced plastic surgeons. In addition, regression model was developed using correlation relationship and factor analysis of parameters from results of the image analysis

Effects of Trunk Stability Exercise by using PNF on Trunk Control Ability and Balance, Gait in a Patient with Hemiplegia: A Single Case Study (PNF를 이용한 체간안정화운동이 뇌졸중 환자의 체간조절능력과 균형, 보행에 미치는 영향: 단일사례연구)

  • Jung, Du-Kyo
    • PNF and Movement
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    • v.13 no.4
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    • pp.203-213
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    • 2015
  • Purpose: Deficits in lower-extremity function and trunk control ability have a negative impact on individuals with hemiplegia. This case report aimed to describe the effect of trunk stability exercises using proprioceptive neuromuscular facilitation (PNF) on trunk control ability, balance, and gait in a patient with hemiplegia. Methods: A 77-year-old man with hemiplegia and trunk and lower extremity impairment participated in this four-week training intervention. Results: The patient demonstrated improvements in trunk control ability, balance, and gait performance. Outcome measures (Fugl-Meyer Assessment Lower Extremity (FMA-LE), Trunk Control Test, Berg Balance Scale, Timed Up and Go test, 10 Meter Walk test) were measured before and after the training program. Conclusion: The results of this case suggest that a trunk stability exercise using a PNF program may improve trunk control ability, balance, and gait in a patient with hemiplegia.

Association between Optic Nerve Sheath Diameter/Eyeball Transverse Diameter Ratio and Neurological Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage

  • Jinsung Kim;Hyungoo Shin;Heekyung Lee
    • Journal of Korean Neurosurgical Society
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    • v.66 no.6
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    • pp.664-671
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    • 2023
  • Objective : The optic nerve sheath diameter (ONSD)/eyeball transverse diameter (ETD) ratio is a more reliable marker of intracranial pressure than the ONSD alone. We aimed to investigate the predictive value of the ONSD/ETD ratio (OER) for neurological outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods : Adult patients with aSAH who visited the emergency department of a tertiary hospital connected to a South Korean university between January 2015 and December 2021 were included. Data on patient characteristics and brain computed tomography scan findings, including the ONSD and ETD, were collected using a predefined protocol. According to the neurological outcome at hospital discharge, the patients were divided into the unfavorable neurological outcome (UNO; cerebral performance category [CPC] score 3-5) and the favorable neurological outcome (FNO; CPC score 1-2) groups. The primary outcome was the association between the OER and neurological outcomes in patients with aSAH. Results : A total of 171 patients were included in the study, of whom 118 patients (69%) had UNO. Neither the ONSD (p=0.075) nor ETD (p=0.403) showed significant differences between the two groups. However, the OER was significantly higher in the UNO group in the univariate analysis (p=0.045). The area under the receiver operating characteristic curve of the OER for predicting UNO was 0.603 (p=0.031). There was no independent relationship between the OER and UNO in the multivariate logistic regression analysis (adjusted odds ratio, 0.010; p=0.576). Conclusion : The OER was significantly higher in patients with UNO than in those with FNO, and the OER was more reliable than the ONSD alone. However, the OER had limited utility in predicting UNO in patients with aSAH.