• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• Tuberculosis and Respiratory Diseases
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• 제73권5호
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• pp.282-287
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• 2012

Broncholiths are defined as calcified materials that occur in a tracheobronchial tree or in a cavity communicating with that. Broncholith has variable clinical features. The therapeutic options to remove broncholiths are so variable that clinicians need to select the most safe and effective methods by mass size, mobility, and location. As yet, there is no consistent guideline removing a broncholith. We report 2 successful cases of removing a fixed broncholith by flexible bronchoscopy guided cryoadhesion. With repeated technique of thawing and freezing with cryoprobe, we could extract the fixed broncholith safely. This method is promising as a way to remove broncholith in the future.

• 한국의료질향상학회지
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• 제8권2호
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• pp.186-207
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• 2001

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

• 한국보육지원학회지
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• 제16권5호
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• pp.69-86
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• 2020

Objective: The purpose of this research was to examine the prediction models of conflict and intimacy in teacher-child relationships based on decision tree analysis. Methods: The participants were 297 preschool children from ages three to five including 166 boys and 131 girls. Teacher-child relationships were measured by the Student-Teacher Relationship Scale(STRS). Physical aggression, relational aggression, social withdrawal, and prosocial behaviors were measured by teacher ratings. Moreover, ADHD-RS(Attentive Deficit Hyperactivity Disorder Rating Scale) was used to measure ADHD. The data was analyzed with decision tree analysis. Results: According to the prediction model for teacher-child conflict, the significant predictors were physical aggression and social withdrawal. According to the prediction model for teacher-child intimacy, the significant predictors were prosocial behaviors and relational aggression. However, children's age, gender and ADHD were not significant predictors. Conclusion/Implications: The findings suggest that social behaviors may be closely related with teacher-child relationships for preschool children. Based on the results of this study, intervention suggestions were made.

• 대한방사선기술학회지:방사선기술과학
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• 제43권6호
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• pp.495-502
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• 2020

In this study, the prevalence of osteoporosis was predicted based on 10 independent variables such as age, weight, and alcohol consumption and 4 tree-based machine-learning models, and the performance of each model was compared. Also the model with the highest performance was used to check the performance by clearing the independent variable, and Area Under Curve(ACU) was utilized to evaluate the performance of the model. The ACU for each model was Decision tree 0.663, Random forest 0.704, GBM 0.702, and XGBoost 0.710 and the importance of the variable was shown in the order of age, weight, and family history. As a result of using XGBoost, the highest performance model and clearing independent variables, the ACU shows the best performance of 0.750 with 7 independent variables. This data suggests that this method be applied to predict osteoporosis, but also other various diseases. In addition, it is expected to be used as basic data for big data research in the health care field.

• Parasites, Hosts and Diseases
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• 제60권6호
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• pp.429-432
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• 2022

Inflammatory eyelid symptoms are common in primary care and there have been several reports on Demodex blepharitis. In the present study, we evaluate the 9 patients with Demodex blepharitis, who showed inflammation of the eyelids, dry eye, and cylindrical dandruff at the base of the eyelashes. The causative species from all patients was Demodex folliculorum of either the adult or nymph stage. Two patients had recurrent chalazion and 3 patients had keratitis. Weekly lid scrubs with 50% tee tree oil were performed for 6 weeks. After treatment, the symptoms of blepharitis and keratitis had improved in all patients. This case report provides clinical reference source for the proper treatment of ocular demodicosis.

• 가정∙방문간호학회지
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• 제5권
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• pp.32-46
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• 1998

Cancer is a leading cause of death, and the number of cancer patients is increasing in Korea. The needs for the home care of cancer patients are increasing recently, but the standardized home care protocols are not developed yet. This study was designed to develop nursing assessment -intervention algorithms for the cancer chemotherapy patients at home. These algorithms suggest guidelines when we assess the patient's condition, and find appropriate nursing interventions, so that standardization and quality control of home care can be attained. The algorithms were processed by yes-no tree. Eleven common problems of cancer chemotherapy patients were identified by the literature review and oncology nurses' experience. These were digestive dysfunction, pain, fatigue, infection, respiratory difficulties, activity intolerance, hemorrhage, sensory disorder, edema, skin problem, and mucosal problem. The algorithm needs to be validated and modified by using for the cancer chemotherapy patients at home.

• 전기의세계
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• 제28권6호
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• pp.61-77
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• 1979

This paper is concerned with minimization process of the binary logic function. This paper describes an algorithm called the SIMPLE TABLE METHOD that well suited to minimization a switching function of any number of variables. For the Simple Table construction, a theorem based upon the numerical properties of the logic function is derived from the relationships governing minterms of the given function. Finally the minimal sum of products can be obtained in terms of the Direct Method or the Indirect Method from the table and table characteristics derived from the Simple Table. The properties and table characteristics used in this paper are described. All the minterms of a switching function are manipulated only by decimal numbers, not binary numbers. Some examples are used as a vehicle to guide the readers who are familiar with the Karnaugh map and Quine-McCluskey tabular method to this New method. These examples not only treat how to handle Don't Care miterms but also show the multiple output functions.

• 대한치과의료관리학회지
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• 제6권1호
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• pp.1-10
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• 2018

Prior to the end of the 20th century, microorganism research was limited to culture and has since been revolutionized by genetic analysis. Microorganisms, including bacteria, can cause disease, but most of them are commensal microorganisms in our bodies. This knowledge changes the pathological approach to infectious diseases and lends to a new perspective on the effects of gut and oral microorganisms on disease and health. The oral cavity, particularly the periodontal pocket, is considered to be a reservoir of microbes that cause disease, and oral microbial control is becoming more important. In this review, I will examine the changes in the microbiological revolution and the meaning of oral healthcare management based on those changes.

• Tuberculosis and Respiratory Diseases
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• 제54권1호
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• pp.45-56
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• 2003

배경 : M. abscessus는 rapidly growing mycobacteria에 의한 폐질환의 가장 흔한 원인균으로 기존의 항결핵제에 대한 치료반응이 매우 낮아 정확한 진단이 중요하다. 본 연구는 M. abscessus 폐질환 12례의 임상상을 알아보고자 하였다. 대상 및 방법 : 1997년 1월부터 2002년 6월까지 5.5년간 진단된 12명의 M. abscessus 폐질환 환자의 임상적 특징과 방사선학적 특징을 후향적으로 분석하였다. 모든 환자는 1997년 미국흉부학회 진단기준을 만족하였다. 결과 : 12명의 환자 중 여자가 11명(92%)이었다. 진단시 연령의 중앙값은 49세(범위 22-73세)였다. 모든 환자가 비흡연자였다. Anti-HIV 항체 양성자는 없었다. 증상은 기침(83%), 객담(83%), 객혈(83%)이 흔하였으며, 방문전 증상기간은 3.5년(2개월-10년)이었다. 증상 발생부터 진단까지 6.5년(14개월-11년)이 소요되었다. 11명(92%)의 환자는 과거 폐결핵 치료력을 가지고 있었다. 모든 환자가 방문 후 객담 도말 양성을 보여 초기에는 폐결핵을 의심하고 일차 항결핵치료를 시행받았고, 항결핵치료 이후에도 지속적인 객담도말 양성을 보여 다제내성 폐결핵을 의심하고 2차 항결핵치료를 시행받은 환자가 6명(50%)이었다. 단순흉부방사선촬영에서 망상결절성 병변(11/12, 92%)이 가장 흔히 관찰되었으며, 공동은 5명(42%)에서 관찰되었다. 전산화단층촬영에서는 중심소엽성 결절과 tree-in-bud 소견을 보이는 세기관지염(9/10, 90%) 그리고 기관지확장증(9/10, 90%), 소결절(7/10, 70%) 등이 흔히 관찰되었다. 결론 : M. abscessus 폐질환은 비결핵성 마이코박테리아에 의한 만성 폐질환으로 기저질환이 없는 중년여성에서 흔히 발생하며, 증상 발생부터 진단까지 많은 시간이 소요되고 있다. 폐결핵이 의심되는 환자에서 M. abscessus가 분리되었을 때 정확한 진단과 적절한 치료를 위한 세심한 평가가 필요할 것으로 사료된다.