• Title/Summary/Keyword: Systematic diagnosis

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Accuracy of Digital Breast Tomosynthesis for Detecting Breast Cancer in the Diagnostic Setting: A Systematic Review and Meta-Analysis

  • Min Jung Ko;Dong A Park;Sung Hyun Kim;Eun Sook Ko;Kyung Hwan Shin;Woosung Lim;Beom Seok Kwak;Jung Min Chang
    • Korean Journal of Radiology
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    • v.22 no.8
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    • pp.1240-1252
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    • 2021
  • Objective: To compare the accuracy for detecting breast cancer in the diagnostic setting between the use of digital breast tomosynthesis (DBT), defined as DBT alone or combined DBT and digital mammography (DM), and the use of DM alone through a systematic review and meta-analysis. Materials and Methods: Ovid-MEDLINE, Ovid-Embase, Cochrane Library and five Korean local databases were searched for articles published until March 25, 2020. We selected studies that reported diagnostic accuracy in women who were recalled after screening or symptomatic. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. A bivariate random effects model was used to estimate pooled sensitivity and specificity. We compared the diagnostic accuracy between DBT and DM alone using meta-regression and subgroup analyses by modality of intervention, country, existence of calcifications, breast density, Breast Imaging Reporting and Data System category threshold, study design, protocol for participant sampling, sample size, reason for diagnostic examination, and number of readers who interpreted the studies. Results: Twenty studies (n = 44513) that compared DBT and DM alone were included. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.86-0.93) and 0.90 (95% CI 0.84-0.94), respectively, for DBT, which were higher than 0.76 (95% CI 0.68-0.83) and 0.83 (95% CI 0.73-0.89), respectively, for DM alone (p < 0.001). The area under the summary receiver operating characteristics curve was 0.95 (95% CI 0.93-0.97) for DBT and 0.86 (95% CI 0.82-0.88) for DM alone. The higher sensitivity and specificity of DBT than DM alone were consistently noted in most subgroup and meta-regression analyses. Conclusion: Use of DBT was more accurate than DM alone for the diagnosis of breast cancer. Women with clinical symptoms or abnormal screening findings could be more effectively evaluated for breast cancer using DBT, which has a superior diagnostic performance compared to DM alone.

Diagnostic Analysis on Oral Health Education of Primary School's Health Teacher (초등학교 보건교사의 구강보건교육 진단)

  • Kim, Ka-Young;Choi, Kyung-Hee
    • Journal of dental hygiene science
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    • v.11 no.3
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    • pp.189-197
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    • 2011
  • Objectives : The systematic health education to form the basic healthy lifestyle should be realized from elementary school, so oral health education at elementary school can determine the whole lifetime oral health. The elementary school health teacher's recognition and behavior who in charge of health promotion of students is important. Therefore, the study was conducted to enhance oral health education. Methods : Total 114 people among of 131 from health teacher Gwangju elementary school. Survey system is configured by referring to PRECEDE model. Results : In behavioral diagnosis the proportion of oral Health Education is less than 10%(58.8%), mostly educated in activity time (86.0%), the health teachers educate when it is needed(53.5%). In predisposing diagnosis in the eight areas of health education, the oral health education is ranked as fourth, fifth. Even in the next year project, the oral health education ratio was 21.9 percent. In enabling diagnosing every year the Oral health education training experienced rate is 13.2%, satisfaction rate is 33.3%. In reinforcing diagnosing disability element in the regular education course are the lack of oral health-related information (46.7%), lack of materials needed for education (30.6%), lack of training opportunities (21.4%). Conclusion : In further research, oral health education textbooks, materials and methods should be developed. At the foundation of there developments, the elementary oral health education program should be more fully developed and conducted and also the evaluation of its effectiveness will need.

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

  • Lee, Jun Haeng;Kim, Jae G.;Jung, Hye-Kyung;Kim, Jung Hoon;Jeong, Woo Kyoung;Jeon, Tae Joo;Kim, Joon Mee;Kim, Young Il;Ryu, Keun Won;Kong, Seong-Ho;Kim, Hyoung-Il;Jung, Hwoon-Yong;Kim, Yong Sik;Zang, Dae Young;Cho, Jae Yong;Park, Joon Oh;Lim, Do Hoon;Jung, Eun Sun;Ahn, Hyeong Sik;Kim, Hyun Jung
    • Journal of Gastric Cancer
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    • v.14 no.2
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    • pp.87-104
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    • 2014
  • Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase.

Diagnostic Value of Fluorescence in Situ Hybridization Assay in Malignant Mesothelioma: A Meta-analysis

  • Wan, Chun;Shen, Yong-Chun;Liu, Meng-Qi;Yang, Ting;Wang, Tao;Chen, Lei;Yi, Qun;Wen, Fu-Qiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4745-4749
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    • 2012
  • The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situ hybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed to establish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of English language studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MM were pooled using random-effects models. Summary receiver operating characteristic curves were applied to summarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificity for FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positive likelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), and the diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggest that the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limited studies and patients included, further large scale studies are needed to confirm these findings.

A Study of Brand Equity & Performance Diagnosis Model (브랜드자산 및 성과 진단 모델에 관한 실증 연구)

  • Mun, Dal-Ju
    • Journal of Global Scholars of Marketing Science
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    • v.9
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    • pp.77-99
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    • 2002
  • As current business environment is experiencing radical changes, interest in brands has increased theoretically and practically. The growing interest in brands creates the need for brand equity measurement and management models that help companies manage and fortify brands continuously. Given the situation, this study analyzes effects of brand equity on purchasing behavior of consumers. Outcomes of this study can be employed as integrated brand management system in order to satisfy corporate needs for systematic brand management. This model has been developed in an effort to transcend varied limitations of other previous studies and existing models. Consequently, the practical value of this model is highly expected. Beyond the mere concept of brand for establishing differentiated position against competitors, contents of the study cover extended forms of brand equity and brand performance. This model has been tested through practical applications of fifteen brands from three product categories. Despite several disparities among the categories, the study has revealed that the overall market performance of the brands is correlated with the brand power and other factors in the model. As the importance of brands is growing, brand management is an essential step for power branding. And brand management requires extensive brand diagnosis. The practical results of this study indicate that companies should put an emphasis on brand-oriented management as core strategy of their business.

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DEVELOPMENT OF THREE DIMENSIONAL MEASURING PROGRAM WITH FRONTAL AND LATERAL CEPHALOMETRIC RADIOGRAPHS -PART 2. 3-D VISUALIZATION AND MEASURMENT PROGRAM FOR MAXILLOFACIAL STRUCTURE- (정모 및 측모 두부 방사선 규격사진을 이용한 3차원 계측 프로그램의 개발 -2. 악안면 구조에 대한 3차원적 시각화 및 측정프로그램 개발-)

  • Lee, Sang-Han;Mori, Yoshihide;Minami, Katsuhiro;Lee, Geun-Ho;Kwon, Tae-Geon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.27 no.4
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    • pp.321-329
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    • 2001
  • To establish systematic diagnosis and treatment planning of dentofacial deformity patient including facial asymmetry or hemifacial microsomia patient, comprehensive analysis of three dimensional structure of the craniofacial skeleton is needed. Even though three dimensional CT has been developed, landmark identification of the CT is still questionable. In recent, a method for correcting cephalic malpositioning that enables accurate superimposition of the landmarks in different stages without using any additional equipment was developed. It became possible to compare the three-dimensional positional change of the maxillomandible without invasive procedure. Based on the principle of the method, a new program was developed for the purpose of diagnosis and treatment planning of dentofacial deformity patient via three dimensional visualization and structural analysis. This program enables us to perform following menu. First, visualization of three dimensional structure of the craniofacial skeleton with wire frame model which was made from the landmarks observed on both lateral and frontal cephalogram. Second, establishment of midsagittal plane of the face three dimensionally, with the concept of "the plane of the best-fit". Third, examination of the degree of deviation and direction of deformity of structure to the reference plane for the purpose of establishing surgical planning. Fourth, simulation of expected postoperative result by various image operation such as mirroring, overlapping.

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The Design of the Self-diagnosis Algorithm for the Efficient Control of Sudden Cancer Pain (효율적인 돌발성 암 통증 관리를 위한 자가 진단 알고리즘 설계)

  • Jung, Eun-Young;Eun, Sung-Jong;Jeong, Byoung-Hui;Lee, Yong-Joon;Park, Dong-Kyun
    • The Journal of the Korea Contents Association
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    • v.14 no.5
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    • pp.458-467
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    • 2014
  • Pain is one of the most common and painful symptoms that cancer patients suffer from. Pain seriously affects 30-50% of the patients at the early cancer diagnosis stage or who receive active anticancer treatments, 60-70% of the patients with progressive cancer, and 80-90% of the patients at the late stage of cancer. However, there is no systematic and easy pain control program for the cancer patients. In this study, an algorithm is proposed to provide quick pain relief service upon the occurrence of sudden pain, for the purpose of controlling the sudden pain that cancer operation survivors experience. In developing the algorithm, questionnaires, evaluation forms and National Comprehensive Cancer Network (NCCN) guideline were considered, and a trial service was provided to a group of 20 cancer patients for a month to evaluate the designed algorithm. The results of the trial service were examined by expert medical workers to evaluate the proposed algorithm, and a 90% compatibility decision was derived, which verified the effectiveness of the proposed algorithm. In the case of incompatibility decision, the management of the pain diary did not have compatible results. Therefore, the further study will additionally address the customized pain diary algorithm.

An Exploration of Career Competency Mobility Map (CCMM) Focusing on Engineering Students in K University (경력역량이동지도(CCMM) 적용사례 연구: K 대학을 중심으로)

  • Park, Jiwon;Woo, Heajung;Noh, Kyungwon;Yi, Yejih;Hwang, Seong-jun;Kim, Woocheol
    • Journal of Practical Engineering Education
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    • v.11 no.2
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    • pp.195-206
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    • 2019
  • Accelerated technological advances and the convergence of information and communication technologies have led to changes of career concepts from one of lifetime employment to that of lifetime career. Given the importance of continuous career development for workers these days, systematic supports for workers' career development at the national level is necessary. Accordingly, a conceptual model of career competency mobility map (CCMM) has been proposed to support the development of workers' career competencies. The purpose of this study is to identify key issues that we should consider for real implementation by applying to each stage of the CCMM conceptual model as a case study. Based on the procedure presented in the conceptual model, the research process which includes collecting user information, conducting self-diagnosis of NCS-based job competencies, deriving necessary training competency, offering the guidance of training programs and job information were conducted. The results of the case study showed our participants' scores of competencies required further development and ranged from 1.83 to 4.52. Sequentially, a personalized information profile was offered for competency development, including training, certificates, and job information. Participants stated that the diagnosis results and profiles were meaningful and helped to explore further career development. Based on the results, implications are suggested.

Development of a Tailored Mobile Application to Improve Elementary School Students' Competencies of Emotional Awareness and Empathy (초등학생들의 감정인식과 공감능력 향상을 위한 맞춤형 모바일 앱 개발)

  • Kim, EunJung;Lee, Yuna;Lee, Sangsoo
    • The Journal of Korean Association of Computer Education
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    • v.17 no.3
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    • pp.85-99
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    • 2014
  • Recently youth problems such as school violence and bullying are becoming increasingly lower age. In order to overcome this situation highlights the importance of education and the emotions, which in analyzing the existing mobile app, only the most fun-oriented approach has been made and the information presented. It focuses on the emotion awareness and empathy abilities of learners diagnosis, training, application can be made at the level of educational mobile app prototype was developed. First, self-understanding, self-expression, others-understanding, and empathy of emotional competency derived from review of emotional awareness skills training programs. Second, by analyzing the existing emotion recognition app macro-principles and micro-strategy of mobile app's designs were derived. Third, accordi was conducted on prototype of storyboard and app the completed prototype was completed. The proposed app is a fun and learning by doing, also Depending on students' level of performance can be customized. The proposed mobile app is efficient and effective, engaging learning space as a systematic training in the diagnosis and the emotions through the elementary students will be able to improve emotional awaeness competency.

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Breast Cancer Screening in Morocco: Performance Indicators During Two Years of an Organized Programme

  • Fakir, Samira El;Najdi, Adil;Khazraji, Youssef Chami;Bennani, Maria;Belakhel, Latifa;Abousselham, Loubna;Lyoussi, Badiaa;Bekkali, Rachid;Nejjari, Chakib
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6285-6288
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    • 2015
  • Background: Breast cancer is commonly diagnosed at late stages in countries with limited resources. In Morocco, breast cancer is ranked the first female cancer (36.1%) and screening methods could reduce the proportion presenting with a late diagnosis. Morocco is currently adopting a breast cancer screening program based on clinical examination at primary health facilities, diagnosis at secondary level and treatment at tertiary level. So far, there is no systematic information on the performance of the screening program for breast cancer in Morocco. The aim of this study was to analyze early performance indicators. Materials and Methods: A retrospective evaluative study conducted in Temara city. The target population was the entire female population aged between 45-70 years. The study was based on process and performance indicators collected at the individual level from the various health structures in Tamara between 2009 and 2011. Results: A total of 2,350 women participated in the screening program; the participation rate was 35.7%. Of these, 76.8% (1,806) were married and 5.2% (106) of this group had a family history of breast cancer. Of the women who attended screening, 9.3% (190) were found to have an abnormal physical examination findings. A total of 260 (12.7%) were referred for a specialist consultation. The positive predictive value of clinical breast examination versus mammography was 23.0%. Forty four (35.5%) of the lesions found on the mammograms were classified as BI-RADs 3; 4 or 5 category. Cancer was found in 4 (1.95%) of the total number of screened women and benign cases represented 0.58%. Conclusions: These first results of the programme are very encouraging, but there is a need to closely monitor performance and to improve programme procedures with the aim of increasing both the participation rate and the proportion of women eligible to attend screening.