The purpose of this study is to develop a diagnostic screening tool for the early detection of osteoporosis in persons with a predisposition for this condition and to facilitate effective management of the disease. Data are collected using questionnaires. The subjects are 120 women in a small city OB-GY clinic in South Korea, who are 6 months or more post menopausal and who have been examined for BMD. Two items in general syndrome of kidney vacuity(Shin Hur) : hears noises like streaming water or the sound of shrill chirrups of a cicada (OR=3.34, p<0.1), feels twinges in the back and knee(OR=4.10, p<0.05), one item in kidney yin vacuity: feels thirst and gets sore throat(OR=8.5, p<0.01) were proven as statistically significant risk factors in the identification of osteoporosis (Odds Ratio). The predictability score was 86.36%, and ROC curve was 0.84. This study attempted to identify risk factors in female osteoporosis so as to develop a screening tool for the purposes of early diagnosis, the effective management of osteoporosis patients and to modify the progress of their disease. Further studies are needed to elaborate this tool's ability to identify contributing factors in osteoporosis as defined by diagnostic evidence predicted by Oriental Medicine Theory.
Saengow, Udomsak;Chongsuwiwatvong, Virasakdi;Geater, Alan;Birch, Stephen
Asian Pacific Journal of Cancer Prevention
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제16권6호
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pp.2269-2276
/
2015
Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.
This is an underlying study for expanding child growth and developmental screening program, which had been implemented as a part of maternal child health service in a certain public health center located in P City. This study attempted to develop system model to discover, consult and follow-up developmental disabilities in children in early stage. For the purpose of providing groundwork for further development of screening program, the system model was analyzed and evaluated. One of the focuses of this study was developing practical tool that can aid small number staffs of public health center to handle large number of patients. 9 types of developmental checklist by key month was developed to support understaffed public health center. These checklists were also supplied to other public health centers, greatly improving qualitative and quantitative development of screening project. Also, the 4-step program of operating and managing child growth and developmental screening was proved to be quite effective. Total 632 children were evaluated and 21 of them were suspected to have developmental problem. Among these children, 8 children were determined to receive regular supervision of public health center. Other 13 children were recommended to visit professional institution, but only 7 of them actually visited institution. Four of these children who visited professional institution are currently receiving treatment, while the other 3 children were determined to require close observation. Five times of screening education were provided to the staffs in public health center and personnel in charge of children in every district public center in P City. The purpose of this training was to improve individuals' capability to implement project and to establish basis for expanding child growth and developmental screening program. The participants were guided to have continuous attention for the project, and their knowledge, skill and recognition were greatly improved through educational training. Also, professional child consulting and education, including lecture for baby food and baby food menu exhibition, were given to parents. Through this opportunity, parents acquired higher understanding about baby food while the local residents' recognition for maternal child health service was greatly improved.
Agostino, Pozzi;Angelo, Della Corte;el Lakis, Mustapha A;Heon-Jae, Jeong
Asian Pacific Journal of Cancer Prevention
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제17권7호
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pp.3521-3526
/
2016
Digital breast tomosynthesis (DBT) as a breast cancer screening modality, through generation of three-dimensional images during standard mammographic compression, can reduce interference from breast tissue overlap, increasing conspicuity of invasive cancers while concomitantly reducing false-positive results. We here conducted a systematic review on previous studies to synthesize the evidence of DBT efficacy, eventually 18 articles being included in the analysis. The most commonly emerging topics were advantages of DBT screening tool in terms of recall rates, cancer detection rates and cost-effectiveness, preventing unnecessary burdens on women and the healthcare system. Further research is needed to evaluate the potential impact of DBT on longer-term outcomes, such as interval cancer rates and mortality, to better understand the broader clinical and economic implications of its adoption.
Chorionic villus sampling has gained importance as a tool for early cytogenetic diagnosis with a shift toward first trimester screening. First trimester screening using nuchal translucency and biomarkers is effective for screening. Chorionic villus sampling generally is performed at 10-12 weeks by either the transcervical or transabdominal approach. There are two methods of analysis; the direct method and the culture method. While the direct method may prevent maternal cell contamination, the culture method may be more representative of the true fetal karyotype. There is a concern for mosaicism which occurs in approximately 1% of cases, and mosaic results require genetic counseling and follow-up amniocentesis or fetal blood sampling. In terms of complications, procedure-related pregnancy loss rates may be the same as those for amniocentesis when undertaken in experienced centers. When the procedure is performed after 9 weeks gestation, the risk of limb reduction is not greater than the risk in the general population. At present, chorionic villus sampling is the gold standard method for early fetal karyotyping; however, we anticipate that improvements in noninvasive prenatal testing methods, such as cell free fetal DNA testing, will reduce the need for invasive procedures in the near future.
The purpose of this study was to develop and evaluate psychometrically the Korean version of the Primary Care Posttraumatic Stress Disorder Screen for the Diagnostic and Statistical Manual-fifth edition (K-PC-PTSD-5). In total, 252 participants were interviewed with the Structured Clinical Interview for Diagnostic and Statistical Manual-fifth edition-research version (SCID-5-RV). The K-PC-PTSD-5 showed good internal consistency (${\alpha}=0.872$), test-retest reliability (r = 0.89), and concurrent validity (r = 0.81). A score of 3 was identified as the threshold for clinically significant posttraumatic stress disorder (PTSD) symptoms. Overall, the results indicate that the K-PC-PTSD-5 is a useful, timesaving instrument for screening PTSD symptoms.
Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.
Purpose: The purpose of this study was to develop a Korean Adult Patients Delirium Screening Tool (K-APDS) for those admitted to general wards, and to verify its reliability and validity. Methods: For the development of the tool, 12 items were derived through the results of literature review and focus group interviews with general ward nurses, and the content validity was confirmed by experts. To verify the reliability and validity of the developed tool, 317 adult patients who were admitted to general wards of three tertiary general hospitals from October to November 2022 were evaluated by the attending nurse and data were collected. Results: After factor analysis for construct validity verification, two factors were extracted, which explained 60.1% of the total variance. After the validation of the control group, the difference in the delirium incidence scores calculated using the K-APDS between the delirium group and non-delirium group was very significant (Z=-10.82, p<.001). To verify the criterion validity, K-APDS, Delirium Observation Screening, and Pearson's correlation coefficient were checked and found to be .94 (p<.001). The predictive validity test reported that the sensitivity was 91.1%, specificity was 82.4%, positive predictive value was 52.6%, and negative predictive value was 97.8%. The reliability of K-APDS was found to be high with Cronbach's ⍺=.91. Conclusion: K-APDS can screen for delirium with 2 or more points, excellent validity and reliability have been verified. Therefore, this tool could be applied immediately in the clinical field, and will contribute to the early detection of delirium, enabling rapid interventions.
This study aimed to screen for anal cancer and to determine its cytomorphology using liquid-based cytology (LBC) with specimens preserved in 95% ethyl alcohol. Anal swabs were collected for cytological examination from 177 adult, HIV-infected patients. After collection, sample slides were reviewed and classified according to their cytomorphology using the modified Bethesda 2001 system. An abnormal anal Pap smear was found in 26.0% of the patients. The diagnoses were: 66.7% negative for intraepithelial lesions (NIL), 14.1% with atypical squamous cells of undetermined significance (ASC-US), 10.7% (19) with low-grade squamous intraepithelial lesions (LSIL), and 1.13% with high-grade squamous intraepithelial lesions (HSIL). The cytological evaluation was an unsatisfactory result only with 6.67%. The present modified LBC using 95% ethyl alcohol as the preservative could thus be used for anal cancer screening. The number of SILs in Thai HIV-infected patients is lower than that in Western countries. We found anal cytology a satisfactory tool for early screening and detection of anal dysplasia commonly found in high-risk, HIV-infected patients.
The develop a simple screening test for identifying Korean elderly at risk of undernutrition, the data of the health-related habits, dietary behaviors and nutrient intakes of the elderly in Chongju were analyzed. Two risk indicators, mean adequacy ratio (MAR) and the respondents perceived health, were used to detect the undernutrition risk of the elderly. In order to select a list of questions for the test, factors a affecting nutritional status and items investigated in previous nutrition surveys of the elderly were considered, and 21 questions were primarily selected. A multiple regression and stepwise regression analysis were used to take out the weak predictors of poor nutrient intake, and to give item weights to the strong predictors, and a list of 17 questions was finally adopted. To determine the cut-point of the test score, sensitivity, and positive predictive values were calculated. The Simple Screening Test developed in this study is a brief, easily scored tool to predict poor nutrient intake and the perceived health status of the elderly. The test may provide a basis of further comprehensive nutritional assessment or intervention planning, if necessary, for those who are diagnosed ad "high risk". The test, however, needs to be independently validated by other groups of individuals.dividuals.
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