• Title/Summary/Keyword: Preventive Diagnostic Criteria

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A Registry Program for Familial Gastric Cancer Patients Referred to Cancer Institute of Iran

  • Etemadi, Mehrnoosh;Pourian, Mandana;Shakib, Asyeh;Sabokbar, Tayebeh;Peyghanbari, Vahideh;Shirkoohi, Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2141-2144
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    • 2014
  • Background: Gastric cancer is the second most common cause of cancer death. It has a poor prognosis with only 5-10% of hereditary etiology. If it is diagnosed, it could be helpful for screening the other susceptible members of a family for preventive procedures. Usually it is identified by symptoms such as presence of cancer in different members of family, some special type of pathology such as diffused adenocarcinoma, having younger age and multiple cancer syndromes. Hence, designing a registry program can be a more practical way to screen high risk families for a preventive program. Materials and Methods: Based on the inclusion criteria, a questionnaire was prepared. After pilot on a small number of patients, the actual data was collected from 197 patients and processed in SPSS 16.0. Results: Totally, 11.8% of the patients were younger than 45 years old. Blood type 'A' was dominant and males had a higher risk behavior with higher consumption of unhealthy food. Adenocarcinoma was reported in majority of cases. 21.8% of the patients had the including criteria for familial gastric cancer (FGC). Conclusions: The high percentage of FGC population compared to the other studies have revealed a need to design an infrastructural diagnostic protocol and screening program for patients with FGC, plus preventive program for family members at risk which could be done by a precise survey related to frequency and founder mutations of FGC in a national registry program.

Investigation on Status of Musculoskeletal Disorders for Industrial Safety Managers (우리나라 근골격계질환의 추이와 산업체 안전담당자의 인식 실태 조사)

  • Gi, Do-Hyeong
    • Journal of the Ergonomics Society of Korea
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    • v.22 no.4
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    • pp.79-90
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    • 2003
  • The purposes of this study are to compare data for work-related musculoskeletal disorders(WMSDs) between Korea and USA, and to investigate status of WMSDs for industrial safety managers. The first part of this study was based on statistical data annually published by Minister of Labor of Korea and Bureau of Labor Statistics of USA. The latter was performed by using questionnaire survey for industrial safety managers in two regions. The results showed that the WMSDs incidence rate was significantly lower in Korea than in USA, and that there is big difference in the distribution of occupational illness by category of illness between Korea and USA. The questionnaire survey revealed that knowledge level about WMSDs was significantly affected depending upon corresponding companies' location and size, and that the low back pain was the most prevalent illness among varying WMSDs symptoms, followed by tendonitis/tenosynovitis, carpal tunnel syndrome, and tennis elbow. Based on this study, it is recommended that the future education/training for WMSDs focus on their preventative measures, methods/tools for identifying their risk factors, and diagnostic criteria for judging suspicious symptoms for industrial accidents, and that the governmental policy for WMSDs be changed towards financial supporting for preventive facilities, establishing objective diagnostic criteria and training for WMSDs.

Estimation of Disease Code Accuracy of National Medical Insurance Data and the Related Factors (의료보험자료 상병기호의 정확도 추정 및 관련 특성 분석 -법정전염병을 중심으로-)

  • Shin, Eui-Chul;Park, Yong-Mun;Park, Yong-Gyu;Kim, Byung-Sung;Park, Ki-Dong;Meng, Kwang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.471-480
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    • 1998
  • This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

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A Study on the Establishment of Management Methods about Occupational Dermatoses (직업성 피부질환에 대한 현황 파악 및 관리 대책 수립을 위한 연구)

  • Lim, Hyun-Sul;Cheong, Hae-Kwan;Choi, Byung-Soon;Kim, Ji-Yong;Sung, Yeol-Oh;Kim, Yang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.3 s.54
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    • pp.617-637
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    • 1996
  • Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

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Physicians' behavior and attitude toward Review system of National Health Insurance claim in Korea (진료비 심사제도에 대한 개원의 들의 태도 및 만족도)

  • Jo, Heui-Sug;Jeong, Heon-Jae;Hwang, Moon-Sun
    • Korea Journal of Hospital Management
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    • v.10 no.2
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    • pp.45-63
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    • 2005
  • The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

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Prevalence of Dementia in the Elderly of an Urban Community in Korea (도시지역 노인들의 치매유병률에 관한 단면조사연구)

  • Na, Duk-L.;Yeon, Byeon-Gil;Kang, Yeon-Wook;Min, Kyung-Bok;Lee, Soo-Hyun;Lee, Sang-Suk;Lee, Mi-Ra;Pyo, Ok-Jung;Park, Chan-Byung;Kim, Sun-Mean;Bae, Sang-Soo;Kim, Dong-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.32 no.3
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    • pp.306-316
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    • 1999
  • Objectives: In Korea, as in most countries, there will be a sharp increase in the number of dementia patients in the near future. However basic data on dementia prevalence, which is important in defining epidemiologic characteristics and in implementing preventive strategy, are limited. This study was conducted to estimate the prevalence rate of dementia in the urban elderly aged 65 or older in Kwangmyung, Korea. Methods: A two phase design was used for case finding and case identification. In phase I, a representative sample aged 65 or older was selected and interviewed by door-to-door survey with a Korean version of the Mini-Mental State Examination (K-MMSE). In phase II, Of the 946 subjects interviewed in phase 1,356 elderly were randomly selected disproportionately according to K-MMSE score. Of these elderly, 223 (61.5%) underwent standardized clinical evaluations, including psychiatric interview, neurological examination, and neuropsychological assessment. Dementia was diagnosed by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. The diagnosis of Alzheimer's disease (AD) was made by National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and feinted Disorders Association(NINCDS-ADRDA) criteria and vascular dementia (VD) by DSM-IV. Results: The overall weighted prevalence rate of all dementia among Kwangmyung residents aged 65 or older was 12,8%(age-adjusted rate: 13,0%, 95% Confidence Interval[CI]: 10.6-15.3%). Women had much higher prevalence rate than men even when age was controlled(15.9%[95% CI 12.6-19.2%] vs 7.5%[95% CI 4.0-10.4%]), The rates of dementia were 5.2%, 12.2%, 17.0%, and 34.3% for the age groups of 65-69, 70-74, 75-79 and 80 and over, respectively. The rate of AD appeared to be slightly higher than that of VD(5.2% vs 4.8%), though not statistically significant. Most of the cases(69%) were mild dementia according to CDR(<1) in these subjects. Conclusions : These results showed that the prevalence rate of dementia among urban elderly in Korea appears to be higher than those of other Asian countries.

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Current Research Status of National Health Insurance Database Studies in Korea Related to Parkinson's Disease and Future Research Proposals for Integrative Therapies (국민건강보험공단 청구자료를 활용한 파킨슨병과 관련된 코호트 연구 디자인 분석 및 향후 한의중재 관련 파킨슨 후향적 코호트 연구를 위한 제언)

  • Ye-Chae Hwang;Jungtae Leem
    • Journal of Society of Preventive Korean Medicine
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    • v.28 no.1
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    • pp.69-87
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    • 2024
  • Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

A Critical Review on the Epilepsy-related Classification Systems Delineated in the Literatures both Western and East Asian Medicine : A Suggestion to Develope a New Classification (간질의 분류법에 대한 동서의학적 문헌고찰 및 새로운 제안)

  • Son, Kwang-Hyun;Kim, Moon-Ju
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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    • pp.135-148
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    • 2010
  • The major purpose of this study is to evaluate the classification of epileptic seizure types and epilepsy described in the literatures of both Western and East Asian medicine, especially based on the two criteria- a theoretical and a practical aspect of the classification systems. Currently, the 1981 classification of epileptic seizure types, and the 1989 classification of epilepsy syndromes and epilepsies which were proposed and approved by the International League Against Epilepsy(ILAE) have been generally accepted worldwide, although a variety of modifications have been consistently suggested. A large proportion of epilepsy cases cannot be easily classified as either 'focal' or 'generalized' or as either 'symptomatic' or 'idiopathic', so they fail to be precisely fallen into any of the ILAE categories. Terms and concepts used in the East Asian medicine are also inadequate to identify epileptic seizure types and epilepsy syndromes as discrete diagnostic entities because of ambiguities in definition and use. Therefore, this article suggests an alternative approach not only more helpful in understanding mechanism of epilepsy but also more easily applicable and effective in clinical value.

The Performance Improvement of Lightning Arrester Leakage Current Measuring Device for GIS (GIS용 피뢰기 누설전류 측정장치 성능개선)

  • Kim, Won-Gyu;Kim, Min-Soo;Baek, Young-Sik
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.63 no.12
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    • pp.1726-1731
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    • 2014
  • This paper shows the developed new lightning arrester LCM (Leakage Current Measuring device) which is important element of GIS (Gas Insulated Switchgear) Preventive & Diagnostic system and verify its performance though strengthened test standards. The existing lightning arrester LCM was modified to solve measuring errors which happened frequently. At first, we explained the principle of measuring leakage current. Through analyzing some problems which the existing LCM have. we got some improvable items. For the performance verification of the improved LCM, we manufactured prototype LCM which is applied some improvable items such as improving LCM circuit, adding protection circuit, optimizing inner structure of LCM and changing ground design. After then we carried out the performance test. Accredited testing laboratory carried out the performance verification test according to performance test criteria and procedure of reliability test standards, IEC-60225, 61000 and 60068 etc. We confirmed the test results which correspond with the performance test criteria. Also, we confirmed the performance of the improved LCM installed & being operated at G Substation through the immunity test against the normal noise and open/close surge etc.

Performance verification and improvement of the frequency analysis unit for GIS Preventive & Diagnostic Monitoring System (GIS 예방진단시스템 주파수 분석장치 성능개선 및 검증)

  • Kim, Won-Gyu;Kim, Min-Soo;Baek, Young-Sik
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.64 no.3
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    • pp.485-491
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    • 2015
  • This paper shows the design improvement and test model of FAU (Frequency Analysis Unit) in PDD (Partial Discharge Diagnosis system) for 800kV GIS (Gas Insulated Switchgear). We found some problems during operation of previous FAU, such as the aging of fiber-optic converter that can cause communication error, the malfunction of signal analysis circuit etc. And then we solved those problems by design improvement and verified the performance through type test. To monitor partial discharge, the performance of UHF sensor is important but the performance of frequency analysis unit is also very important. So we solved communication error, the malfunction of signal analysis circuit and then increased the operation reliability of FAU by improving fiber-optic converter and signal analysis circuit. Accredited testing laboratory carried out the performance verification test according to performance test criteria and procedure of reliability test standards, IEC-60225, 61000 and 60068 etc. We confirmed the test results which correspond with the performance test criteria.