• Title/Summary/Keyword: Validity Index

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Changes in Quality of Care for Cesarean Section after Implementation of Diagnosis-Related Groups/Prospective Payment System (DRG 지불제도 도입 후 제왕절개술에서의 의료의 질 변화)

  • Kwon, Young-Hun;Hong, Du-Ho;Kim, Chang-Yup;Kim, Yong-Ik;Shin, Young-Soo;Yim, Jun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.347-353
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    • 2001
  • Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

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Validation of self-reported height and weight in fifth-grade Korean children

  • Lee, Bora;Chung, Sang-Jin;Lee, Soo-Kyung;Yoon, Jihyun
    • Nutrition Research and Practice
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    • v.7 no.4
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    • pp.326-329
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    • 2013
  • Height and weight are important indicators to calculate Body Mass Index (BMI); measuring height and weight directly is the most exact method to get this information. However, it is ineffective in terms of cost and time on large population samples. The aim of our study was to investigate the validity of self-reported height and weight data compared to our measured data in Korean children to predict obese status. Four hundred twenty-two fifth-grade (mean age $10.5{\pm}0.5$ years) children who had self-reported and measured height and weight data were final subjects for this study. Overweight/obese was defined as a BMI of or above the 85th percentile of the gender-specific BMI for age in the 2007 Korean National Growth Charts or a BMI of 25 or higher (underweight : < 5th, normal : ${\geq}5th$ to < 85th, overweight : ${\geq}85th$ to < 95th). The differences between self-reported and measured data were tested using paired t-test. Differences based on overweight/obese status were tested using analysis of variance (ANOVA) and linear trends. Pearson's correlation and Cohen's kappa were tested to examine agreements between the self-reported and measured data. Although measured and self-reported height, weight and BMI were significantly different and children tended to overreport their height and underreport their weight, the correlation between the two methods of height, weight and BMI were high (r = 0.956, 0.969, 0.932, respectively; all P < 0.001), and both genders reported their overweight/non-overweight status accurately (Cohen's kappa = 0.792, P < 0.001). Although there were differences between the self-reported and our measured methods, the self-reported weight and height was valid enough to classify overweight/obesity status correctly, especially in non-overweight/obese children. Due to bigger underestimation of weight and overestimation of height in obese children, however, we need to be aware that the self-reported anthropometric data were less accurate in overweight/obese children than in non-overweight/obese children.

A Study on Determining the Prediction Models for Predicting Stock Price Movement (주가 운동양태 예측을 위한 예측 모델결정에 관한 연구)

  • Jeon Jin-Ho;Cho Young-Hee;Lee Gye-Sung
    • The Journal of the Korea Contents Association
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    • v.6 no.6
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    • pp.26-32
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    • 2006
  • Predictions on stock prices have been a hot issue in stock market as people get more interested in stock investments. Assuming that the stock price is moving by a trend in a specific pattern, we believe that a model can be derived from past data to describe the change of the price. The best model can help predict the future stock price. In this paper, our model derivation is based on automata over temporal data to which the model is explicable. We use Bayesian Information Criterion(BIC) to determine the best number of states of the model. We confirm the validity of Bayesian Information Criterion and apply it to building models over stock price indices. The model derived for predicting daily stock price are compared with real price. The comparisons show the predictions have been found to be successful over the data sets we chose.

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A Study of Adolescents' Status Offenses Based on General Strain Theory - Experiencing Child Abuse as a Strain Factor - (일반긴장이론에 근거한 청소년 지위비행에 관한 연구 - 긴장요인으로서의 자녀학대경험을 중심으로 -)

  • Kim, Jea-yob;Song, Ah-young;Park, Kyung-na
    • Korean Journal of Social Welfare Studies
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    • no.37
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    • pp.295-318
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    • 2008
  • The purpose of this study is to examine the validity of adolescent's status offenses model based on general strain theory. To perform this research, a survey was conducted to adolescents of mixed gender from middle and high schools in Seoul and Gyeonggi Province, who were 9th to 11th grade students. A total of 1167 cases were collected, and without 27 inappropriate cases, 1140 cases were used for the analysis. A structural equation model was applied to the child abuse experience with depression mediator and the adolescents status offense, and the calculation of model fit index reached to .986(TLI), .994(CFI), and .032(RMSEA). The result of Aroian test on the effectiveness of depression as a mediator demonstrates that depression has a prominent effect as a mediator to the model. However, the self control of an adolescent, which were presented in this research as a primary moderating variable, did not display any salient effect on the course of a depression developing to the level of status offense.

Exploring Occupational and Behavioral Risk Factors for Obesity in Firefighters: A Theoretical Framework and Study Design

  • Choi, Bong-Kyoo;Schnall, Peter;Dobson, Marnie;Israel, Leslie;Landsbergis, Paul;Galassetti, Pietro;Pontello, Andria;Kojaku, Stacey;Baker, Dean
    • Safety and Health at Work
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    • v.2 no.4
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    • pp.301-312
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    • 2011
  • Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US). However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupational and behavioral risk factors in the development of obesity in firefighters enrolled in the Orange County Fire Authority Wellness Fitness Program. The study plan will be described with emphasis on its methodological merits: adopting a participatory action research approach, developing a firefighter-specific work and health questionnaire, conducting both a cross-sectional epidemiological study using the questionnaire and a sub-study to assess the validity of the questionnaire with dietary intake and physical activity measures, and evaluating the strengths and weaknesses of the body mass index as an obesity measure in comparison to skinfold-based percent body fat. The study plan based on a theoretical framework can be an essential first step for establishing effective intervention programs for obesity among professional and voluntary firefighters.

Correction method for the Variation of the Image Plane Generated by Various Symmetric Error Factors of Zoom Lenses of Digital Still Cameras and Estimation of Defect Rate Due to the Correction (디지털 카메라용 줌렌즈에서 대칭성 오차요인에 의한 상면 변화의 보정과 이에 따른 불량률 예측)

  • Ryu, Jae-Myung;Kang, Geon-Mo;Lee, Hae-Jin;Lee, Hyuck-Ki;Jo, Jae-Heung
    • Korean Journal of Optics and Photonics
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    • v.17 no.5
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    • pp.420-429
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    • 2006
  • In the zoom lens of digital still cameras with the variation of the image plane generated by various symmetric error factors such as curvature, thickness and refractive index error of each lens surface about the optic axis, we induce a theoretical condition to fix constantly the image plane by translating the compensator group of the zoom lens by using the Gaussian bracket. We confirm the validity of this condition by using three examples of general zoom lens types with 3, 4, and 5 groups, respectively. When these error factors are randomly changed within the range of tolerance according to the Monte Carlo method, we verify that the distributions of the degree of moving of the compensator are normal distributions at three zoom lens types. From capability analysis using these results, we theoretically propose the method estimating the standard deviation, that is, sigma-level, as a function of the maximum movement of the compensator.

Efficacy of salivary versus subgingival bacterial sampling for the detection and quantification of periodontal pathogens

  • Lee, Yoonsub;Hong, Yoojin;Kim, Bome;Lee, Dajung;Kim, Sungtae;Rhyu, In-chul
    • Journal of Periodontal and Implant Science
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    • v.50 no.6
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    • pp.358-367
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    • 2020
  • Purpose: The aim of this study was to investigate the efficacy and validity of subgingival bacterial sampling using a retraction cord, and to evaluate how well this sampling method reflected changes in periodontal conditions after periodontal therapy. Methods: Based on clinical examinations, 87 subjects were divided into a healthy group (n=40) and a periodontitis group (n=47). Clinical measurements were obtained from all subjects including periodontal probing depth (PD), bleeding on probing (BOP), clinical attachment loss (CAL), and the plaque index. Saliva and gingival crevicular fluid (GCF) as a subgingival bacterial sample were sampled before and 3 months after periodontal therapy. The salivary and subgingival bacterial samples were analyzed by reverse-transcription polymerase chain reaction to quantify the following 11 periodontal pathogens: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythus (Tf), Treponema denticola (Td), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Pavimonas micra (Pm), Campylobacter rectus (Cr), Prevotella nigrescens (Pn), Eikenella corrodens (Ec), and Eubacterium nodatum (En). Results: Non-surgical periodontal therapy resulted in significant decreases in PD (P<0.01), CAL (P<0.01), and BOP (P<0.05) after 3 months. Four species (Pg, Tf, Pi, and Pm) were significantly more abundant in both types of samples in the periodontitis group than in the healthy group. After periodontal therapy, Cr was the only bacterium that showed a statistically significant decrease in saliva, whereas statistically significant decreases in Cr, Pg, and Pn were found in GCF. Conclusions: Salivary and subgingival bacterial sampling with a gingival retraction cord were found to be equivalent in terms of their accuracy for differentiating periodontitis, but GCF reflected changes in bacterial abundance after periodontal therapy more sensitively than saliva.

Research on Reimbursement of Therapeutic Medical Device through Delphi Method and Analytic Hierarchy Process (치료재료 별도산정 기준 개선을 위한 델파이 및 계층분석과정 조사)

  • Noh, Jin-Won;Lee, Yejin;Jang, Suk Yong;Kim, Mi Kyung;Cho, Kyoung Hee;Kim, Jae-Hyun;Yoo, Ki-Bong
    • Korea Journal of Hospital Management
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    • v.23 no.4
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    • pp.15-25
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    • 2018
  • Purposes: The objectives of this study present the direction of the criteria for the separately reimbursement of therapeutic medical device. Methodology: We summarized experts' opinion using Delphi survey and Analytic Hierarchy Process(AHP). 48 experts were gathered from Medical Insurance Review Nurses Association, medical device industry, academy and association, Medical Device Expert Evaluation Committee. Descriptive statistics, consistency index, content validity ratio were analyzed. Findings: Clinical utility, patient safety, infection control, cost-homogeneity, cost-effectiveness showed high feasibility and importance, but market contribution and functional utility showed low feasibility and importance in a relative sense. The results of functional utility differed between clinical and non-clinical experts. Measurability was low across the whole area. Among the criteria for the separately reimbursement of therapeutic medical device. Patient safety/infection control and clinical utility showed the highest relative importance values, analyzed using AHP. Practical Implications: Patient safety and infection control are needed to be considered as one of Value Assessment Criteria. It is important to find out how to improve the measurability of therapeutic medical device.

Development of Clinical Terminology System for Human Body : Convergence Research of SNOMED CT (인체 골격의 좌표형 임상용어체계 표준 개발 : SNOMED CT 기반의 융복합 연구)

  • Choi, Byung-Kwan;Choi, Eun-A;Nam, Moon-Hee
    • Journal of Digital Convergence
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    • v.17 no.4
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    • pp.177-185
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    • 2019
  • This is a methodological study to develop standards for human body coordinate clinical terminology system. The Standard was developed through four stages: Stage 1 - research plan was developed through literature review and data collection. Stage 2 - preliminary standard was created. Stage 3 - the standard was revised in accordance with the consultation of experts through seminars. Stage 4 - Final version of the standard was presented after verification of the content level. 2D human body images are expressed as x, y axes, and 3D images are expressed as x, y, z axes. Concepts and definitions of coordinates were preassembled into FSN, synonyms and preferred names of SNOMED CT. The latter combination was defined through 18 relationships. The average index was 4.01 for the content validity of the developed relationship standard. This research suggests that subsequent standards should be developed for other parts of the human body such as the brain, organs, and tissues. Also, it suggests that methodological research should be continued to increase the utilization of the standard in clinical practice.

Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis

  • Park, Seong-Hi;Kim, So-Young
    • Nutrition Research and Practice
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    • v.13 no.5
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    • pp.399-409
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    • 2019
  • BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were "obesity," "nutrition therapy," and "worksite." The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of -4.37 (95% confidence interval (CI): -6.54 to -2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of -1.26 (95% CI: -1.98 to -0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of -5.57 (95% CI: -9.07 to -2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: -4.90 mmHg) and diastolic (WMD: -2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).