• Title/Summary/Keyword: Quality of Medical

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Impact of Photon-Counting Detector Computed Tomography on Image Quality and Radiation Dose in Patients With Multiple Myeloma

  • Alexander Rau;Jakob Neubauer;Laetitia Taleb;Thomas Stein;Till Schuermann;Stephan Rau;Sebastian Faby;Sina Wenger;Monika Engelhardt;Fabian Bamberg;Jakob Weiss
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.1006-1016
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    • 2023
  • Objective: Computed tomography (CT) is an established method for the diagnosis, staging, and treatment of multiple myeloma. Here, we investigated the potential of photon-counting detector computed tomography (PCD-CT) in terms of image quality, diagnostic confidence, and radiation dose compared with energy-integrating detector CT (EID-CT). Materials and Methods: In this prospective study, patients with known multiple myeloma underwent clinically indicated whole-body PCD-CT. The image quality of PCD-CT was assessed qualitatively by three independent radiologists for overall image quality, edge sharpness, image noise, lesion conspicuity, and diagnostic confidence using a 5-point Likert scale (5 = excellent), and quantitatively for signal homogeneity using the coefficient of variation (CV) of Hounsfield Units (HU) values and modulation transfer function (MTF) via the full width at half maximum (FWHM) in the frequency space. The results were compared with those of the current clinical standard EID-CT protocols as controls. Additionally, the radiation dose (CTDIvol) was determined. Results: We enrolled 35 patients with multiple myeloma (mean age 69.8 ± 9.1 years; 18 [51%] males). Qualitative image analysis revealed superior scores (median [interquartile range]) for PCD-CT regarding overall image quality (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), edge sharpness (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), image noise (4.0 [4.0-4.0] vs. 3.0 [3.0-4.0]), lesion conspicuity (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]), and diagnostic confidence (4.0 [4.0-5.0] vs. 4.0 [3.0-4.0]) compared with EID-CT (P ≤ 0.004). In quantitative image analyses, PCD-CT compared with EID-CT revealed a substantially lower FWHM (2.89 vs. 25.68 cy/pixel) and a significantly more homogeneous signal (mean CV ± standard deviation [SD], 0.99 ± 0.65 vs. 1.66 ± 0.5; P < 0.001) at a significantly lower radiation dose (mean CTDIvol ± SD, 3.33 ± 0.82 vs. 7.19 ± 3.57 mGy; P < 0.001). Conclusion: Whole-body PCD-CT provides significantly higher subjective and objective image quality at significantly reduced radiation doses than the current clinical standard EID-CT protocols, along with readily available multi-spectral data, facilitating the potential for further advanced post-processing.

Study on the Evaluation of TRS-398 Quality Factors with Central Electrode Corrections for Small Cylindrical Chambers (소형 전리함에 대한 TRS-398 선질인자 계산과 중심전극 보정에 관한 연구)

  • Kang, Yeong-Rok;Lee, Chang-Yeol;Kim, Jin-Ho;Moon, Young-Min;Kwak, Dong-Won;Kang, Sang-Koo;Kim, Jeung-Kee;Yang, Kwang-Mo;Jeong, Dong-Hyeok
    • Progress in Medical Physics
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    • v.22 no.3
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    • pp.148-154
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    • 2011
  • The quality factors ($k_{Q,Q_0}$) were evaluated by appling the results recently studied for the effect of central electrode in TRS-398 protocol. The PTW-31010 and IBA-CC13 chambers were used in this study. The quality factors were calculated as a function of beam quality for high energy electron and photon beams and compared with data currently used in TRS-398 protocol. In the PTW-31010 chamber using aluminium electrode, appling the new central electrode collections, the quality factors were 0.4% and 0.9% higher than current TRS-398 data for high energy photon and electron beams respectively. In the IBA-CC13 chamber using C-552 electrode, there are no variations in quality factors compared to TRS-398 data currently used.

A Study on the Criteria for Selection of Medical Care Facilities (의료기관 선택기준에 관한 연구)

  • Cho, Woo-Hyun;Kim, Han-Joong;Lee, Sun-Hee
    • Journal of Preventive Medicine and Public Health
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    • v.25 no.1 s.37
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    • pp.53-63
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    • 1992
  • There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of health care consumer by the types of medical services on a sample of 1,500 population aged 20 years and above. Major findings are as follows ; 1. When considering the criteria for selection of medical facilities into two factors, namely, quality or convenience factors, convenience factor was the major contributor for outpatient and dental services whereas it was quality factor for inpatient services. 2. Females and those residing in large cities selected medical facilities based on convenience factor in the outpatient services. In the case of inpatient service, persons who considered their present health status to be good and whose ages were 50 years old and above choose medical facilities based on quality factor. 3. Persons who considered medical facilities to be profit-making tended to choose medical facilities based on convenience factor for outpatient services. There were no differences in the cases of inpatient and dental services. 4. There was no significant difference on the criteria for selection of medical facilities according to the decision maker for selection or trust on medical facilities. On the use of health service information, selection of medical facilities was based on quality factor for those who made more use of the information in the cases of outpatient and dental services. 5. Analysis using the logistic regression model on the criteria for the selection of medical facilities with the characteristics of health care consumer as independent variables was performed. The selection of medical facilities was significantly related with residential area, sex, and use of information on medical facilities for outpatient services and with age, average monthly income, and perception of health status for inpatient services. For dental services significant association with residential area and use of information on medical facilities was seen. The results of this study, despite some limitations, can be used as baseline data for marketing and strategic planning of hospital management.

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Quality of Life and Its Related Factors of Radiation Therapy Cancer Patients (방사선 치료를 받은 암환자의 삶의 질과 관련요인)

  • Shin, Ryung-Mi;Jung, Won-Seok;Oh, Byeong-Cheon;Jo, Jun-Young;Kim, Gi-Chul;Choi, Tae-Gyu;Lee, Sok-Goo
    • The Journal of Korean Society for Radiation Therapy
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    • v.23 no.1
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    • pp.21-29
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    • 2011
  • Purpose: The purpose of this master's thesis is to utilize basic data in order to improve the quality of life of cancer patients who received radiation therapy after analysing related factors that influence patient's quality of life and obtaining information about physical, mental problems of patients. Materials and Methods: By using a structured questionnaire about various characteristics and forms of support, I carried out a survey targeting 107 patients that experienced radiation therapy at a university hospital in the Daejeon metropolitan area from July 15 to August 15, 2010 and analysed the factors influencing quality of life. Results: In case of pain due to disease, 65.15 and painless 81.87 showed a high grade quality of life. As body weight decreases, the quality of life become lower. When the grade of quality of life according to economic characteristics was compared, all items except treatment period showed a difference (P=0.000). When the score of social support, family support, medical support and self-esteem was low, the mark of quality of life showed respectively 61.71, 68.77, 71.31, and 69.39 on the basis of 128 points. When the score of support form was high, the mark of quality of life showed 90.47, 83.29, 90.40, and 90.36 (P<0.05). When analyzing the correlation between social support, family support, medical support and self-esteem and the degree of quality of life, social support was 0.768, family support 0.596, medical support 0.434, self-esteem 0.516. They indicated the correlation of meaningful quantity statistically (P<0.01). The factors that improved the quality of life were married state, having a job and painless status. As monthly income increases, the quality of life was also much improved (P<0.05). Among the factors related to quality of life, social support and medical support and higher self-esteem scores of the quality of life score increased 0.979 point, 0.508 points and 1.667 point, respectively. Conclusion: In conclusion, the quality of life of cancer patients that received radiation treatment is related to social support, medical support and self esteem. Self-esteem is an important factor that influenced quality of life, so if government offers works that doesn't affect patient's health, they are a useful method that maximize self-esteem and lessen their financial burden at the same time. Along with these policies, the developments of the attention of medical and the program for cancer patient's family are needed for the purpose of improving quality of life of cancer patients. Lastly, medical team, patients and family have to cooperate in harmony to overcome difficulties of cancer patients.

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Difference in Health-related Quality of Life between Medical Aid Beneficiaries and Health Insurance Beneficiaries using the Community Health Survey (지역사회건강조사를 이용한 의료급여수급권자와 건강보험가입자의 건강관련 삶의 질 비교 연구)

  • Hong, Ju-youn;Kim, Gha-jung
    • The Journal of the Korea Contents Association
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    • v.16 no.5
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    • pp.477-487
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    • 2016
  • This study attempts to comprehensively evaluate differences in sociodemographic characteristics, health behavior, disease morbidity, medical care and health-related quality of life of medical aid beneficiaries and health insurance beneficiaries. To achieve this, this study analyzes primitive data of community health survey that each health center had recently conducted in 2013. Study socioeconomic characteristics, health behavior, disease morbidity, medical care showed that various factors affecting health-related quality of life. It was found that medical aid beneficiaries showed lower health related-quality of life than health insurance beneficiaries because not good socioeconomic characteristics, health behavior, disease morbidity, and medical care and even as a comparative result after controlling socioeconomic characteristics, it was found that medical aid beneficiaries health-related quality of life was lower because of not good health behavior, disease morbidity, and medical care. Therefore, to improve health-related quality of life in medical aid beneficiaries as effectively as possible, improving mental health including managing chronic disease and stress and depression and daily living activities is above all important and our national concern with developing systematic program and policies focusing on health promotion behaviors such as moderate drinking habits and regular exercise and eating habits is required.

Effects of Ellagic Acid on Oxidative Stress Index, Inflammatory Markers and Quality of Life in Patients With Irritable Bowel Syndrome: Randomized Double-blind Clinical Trial

  • Zahra Mirzaie;Ali Bastani;Ali Akbar Haji-Aghamohammadi;Mohammadreza Rashidi Nooshabadi;Bahman Ahadinezhad;Hossein Khadem Haghighian
    • Clinical Nutrition Research
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    • v.11 no.2
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    • pp.98-109
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    • 2022
  • Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Oxidative stress and inflammation play a major role in IBS. Considering the antioxidant properties of ellagic acid (EA), this study was designed to evaluate the effect of EA on oxidative stress index, inflammatory markers, and quality of life in patients with IBS. This research was conducted as a randomized, double-blind, placebo-controlled clinical trial; 44 patients with IBS were recruited. Patients who met the inclusion criteria were randomly allocated to consume a capsule containing 180 mg of EA per day (n = 22) or a placebo (n = 22) for 8 weeks. Serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), and interleukin-6 (IL-6) were measured at the beginning and the end of the study. Also, quality of life was assessed using a self-report questionnaire for IBS patients (IBS-QOL). At the end of the study, we saw a significant decrease and increase in the MDA and TAC in the intervention group, respectively (p < 0.05). Also, EA consumption reduced CRP and IL-6 levels, and these changes were significant in comparison with placebo group changes (p < 0.05). The overall score of IBS-QOL significantly decreased, and quality of life was increased (p < 0.05), but there were no significant changes in the placebo group. According to these findings, receiving polyphenols, such as EA, may help maintain intestinal health by modulating inflammation and oxidative stress and ultimately improving the quality of life in IBS patients.

The Effectiveness of Oriental Medical Treatments to Symptoms and Quality of Life in the Patients with Herniated Cervical Disc being Suggested Operation (경추 추간판 탈출증으로 수술 권유를 받은 환자에게 한의학적 치료가 임상증상 및 삶의 질 개선에 미치는 영향)

  • Park, Jong-Min;Lee, Myeong-Jong
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.6 no.1
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    • pp.35-42
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    • 2011
  • Objective : The purpose of this study is evaluated the effects of Oriental treatments to symptoms and quality of life in the patients with herniated cervical disc being suggested operation. Methods : 20 patients diagnosed with herniated cervical disc by MRI in hospital were treated by oriental medical treatments. Symptoms of the patients were assessed by analogue scale(VAS) and SF-36. Results : After 12 weeks treatments, the VAS of symptoms of herniated cervical disc and the score of SF-36 were significantly improved. Conclusions : It could be suggested that oriental medical treatments were effective for the patients with herniated cervical disc being suggested operation. Further study of the effect of oriental medical treatments on herniated cervical disc is needed.

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Improve the Quality of Public Medical Centers for the Static, Dynamic Efficiency Analysis (공공의료기관의 품질향상을 위한 정태적.동태적 분석)

  • Moon, Jae-Young;Kim, Yong-Tea
    • Journal of Korean Society for Quality Management
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    • v.38 no.3
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    • pp.393-407
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    • 2010
  • The purpose of this study is to analysis relative efficiency and efficiency in process of time. Thus we use panel data of 34 local public medical centers between 2003 and 2005 to use DEA and Malmquist analysis. The result of our this study is as flow; first, The results of static efficiency of 34 local public medical centers show 10 CCR model and 23 BCC model which is difference of efficiency by economic of scale. Second, a cause of increased efficiency is not only change of technology but also change of efficiency to management system index show between 2003 and 2005 by Malmquist analysis and contracting-out is higher than direct management between 2004 and 2005. That means efficiency of local public medical centers is their own effort and innovation not government subsidies.