• 제목/요약/키워드: Validity of diagnosis

검색결과 407건 처리시간 0.027초

내전형 연축성 발성장애 감별진단 문항 개발과 임상적 유용성 평가 (Development of Differential Diagnosis Scale Items for Adductor Spasmodic Dysphonia and Evaluation of Clinical Availability)

  • 조재경;최성희;이상혁;진성민
    • 대한후두음성언어의학회지
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    • 제30권2호
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    • pp.112-117
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    • 2019
  • Background and Objectives The purpose of this study was to develop the differential diagnosis scale containing items from adductor spasmodic dysphonia (ADSD) to muscle tension dysphonia (MTD) and the determine clinical utility of newly developed items. Materials and Method The four parts of pitch, redirected phonation, automatic speech and voiced sound were selected for analyzing the characteristics of ADSD in the literature. One part of tense voiceless sound was developed according to the Korean manner of articulation. The content validity was evaluated based on 5 scales (1-5 point) analysis from 30 experts. One hundred patients (50 ADSD and 50 MTD) were recorded in reading a sentence and sustained phonation. The two speech language pathologist evaluated recorded voices through a blind test using 4 scales (0-3 point) for newly developed items. Results As a result of verifying the content validity of items with experts, it was identified that the differentiated items were valid with 4.2 out of 5. Through the differential diagnosis between two groups according to the items, the correlation between sub-domains and total scores was shown as higher than 0.710. The result of analyzing the reliability on each diagnosis domain was 0.840-0.893, which showed the internal consistency of items was great. Newly developed five parts of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). The reliability among the evaluators was analyzed as high with 0.892. Conclusion In this study, the differential diagnosis scale of ADSD was revealed as having validity and reliability. It is considered that it will be useful for differentiating ADSD and MTD in the clinical field.

기능성소화불량의 식적설문지 개발과 신뢰도 및 타당도 검정 (Development of a Food Retention Questionnaire for Functional Dyspepsia and the Analysis of Its Reliability and Validity)

  • 황미니;하나연;고석재;박재우;김진성
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.390-408
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    • 2019
  • Objectives: Several pattern diagnosis questionnaires have been developed to objectify the process of pattern diagnosis in Korean medicine. In this context, this study aimed to develop a food retention questionnaire for functional dyspepsia (FRQ-FD) by modifying the previously developed food retention questionnaire (FRQ) and to verify its reliability and validity. Furthermore, this study aimed to identify the optimal cut-off value of the FRQ-FD for standardization and use in clinical situations. Methods: To develop the FRQ-FD, we extracted the major symptoms of food retention pattern for functional dyspepsia from Chinese/Korean medicine textbooks and requested an importance survey from experts using the Delphi method. The first draft of the FRQ-FD was composed of 25 questions comprising 8 questions from the textbooks and the Delphi method and 17 questions from the FRQ already developed in 2013. To analyze its reliability, validity, and optimal cut-off value, 60 subjects were enrolled in this study from June 25 to August 13, 2018. Thirty patients were diagnosed as both functional dyspepsia and food retention pattern, and 30 healthy participants were not. All participants were requested to fill up the FRQ-FD, Stomach Qi Deficiency Questionnaire (SQDQ), Scale for Stomach Qi Deficiency pattern (SSQD), visual analog scale (VAS) for dyspepsia, Nepean Dyspepsia Index-Korean version (NDI-K), and functional dyspepsia-related quality of life (FD-QoL). Results: No statistically significant differences were found in sex distribution, age, and body mass index between the patient group and the control group. As five questions affected the reliability negatively and three questions affected the clinical validity negatively, we decided to exclude the eight questions upon further investigation. The Cronbach's ${\alpha}$ coefficient of the revised FRQ-FD (17 items) was 0.899, and its clinical validity was verified. Construct validity was analyzed by factor analysis and produced five factors. Statistically significant positive correlations were found between the revised FRQ-FD and the other dyspepsia scales, namely, SQDQ, SSQD, VAS, NDI-K, and FD-QoL. VAS and NDI-K especially had strong positive correlations with FRQ-FD. Conclusions: The FRQ-FD developed in this study can provide fundamental reliability and validity for a pattern diagnosis questionnaire. FRQ-FD can help to diagnose food retention pattern in functional dyspepsia patients. Further studies are required to inspect several statistical factors.

Standardization of diagnosis of cold hypersensitivity of hands and feet by D.I.T.I.

  • Lee, Kyung-Sub
    • 대한한방체열의학회지
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    • 제3권1호
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    • pp.15-19
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    • 2004
  • Cold hypersensitivity means a condition feeling cold at a temperature when one should not feel so. Cold hypersensitivity has been diagnosed based on the patient's subjective complaints. But these days, cold hypersensitivity can be diagnosed by the help of D.I.T.I.(Digital Infrared Thermal Imaging) This study is designed to verify the validity of diagnosis of cold hypersensitivity by D.I.T.I. Thermographic findings of 100 outpatients who visited the Kangnam Korean Hospital, KyungHee University, Seoul, Korea, from June 2000 to November 2000 were analyzed. The experimental group consisted of 50 patients who complained cold hypersensitivity, and for the control group, 50 patients who did not complain cold hypersensitivity. For the diagnosis of cold hypersensitivity of the hands, thermographic measurements were performed on two pairs of areas(palm-upper arm and back of hand-upper arm). And for that of the feet, other two pairs of areas(anterior thigh-top of the feet and posterior thigh-heel). When the criterion for thermal deviation between the palm and the upper arm was appointed as higher than $0.3^{\circ}C$, the sensitivity was 94.0% and the specificity, 90.0%. And when the criterion for that between the anterior thigh and the top of feet was appointed higher than $2.0^{\circ}C$, the sensitivity was 94.0% and the specificity, 76.0%. Through this study, the diagnostic standard for cold hypersensitivity of hands and feet could be presented.

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회복실 성인 수술환자의 주요 간호진단, 간호결과 및 간호중재 연계검증 (Validation of Major Nursing Diagnosis-Outcome-Intervention(NANDA-NOC-NIC) Linkage for Adult Surgery Patients of Post Anesthetic Care Unit)

  • 조은장;김남초
    • 임상간호연구
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    • 제14권3호
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    • pp.141-151
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    • 2008
  • Purpose: This study aimed at applying a standardized nursing process to adult surgery patients of post anesthetic care unit, and examining the validity of linkages in the measuring index of nursing outcome by which nursing outcome was applied. Method: The subjects were 184 surgery adult patients admitted at the post anesthetic care unit of Y university hospital. This study was used the measured tool developed by Choi et al.(2004) and by Lee (2004) who had already verified a validity based on Johnson and Bulechek's study(2001). Results: The nursing diagnosis of an acute pain, an urinary retention, a nausea, a decreased cardiac output, an ineffective airway clearance and an ineffective airway clearance were used in taking care for patients. The related factors according to the main nursing diagnosis were as the following: an injurious physical factor in an acute pain, reflex are inhibition in an urinary retention, post surgical anesthesia in a nausea, stroke volume change in a decreased cardiac output, secretory stasis in an ineffective airway clearance, pain in an ineffective breathing pattern. Conclusion: The study results could be facilitated in nursing process application for nurses at post anesthetic care unit. Also this study would provide basic data to develop a computerized program for the improvement of nursing process application.

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한의 입원환자분류체계의 적정성 평가 (Assessment of Validity of Inpatient Classification System in Korean Medicine (KDRG-KM))

  • 김동수;류지선;이병욱;임병묵
    • 대한한의학회지
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    • 제37권3호
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    • pp.112-122
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    • 2016
  • Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.

웹기반 진단 보조 시스템의 진단 일치도 연구 (A Study for Diagnostic Agreement between Web-based Diagnosis Support System and Korean Medical Doctors' Diagnosis)

  • 이승엽;강민지;임현정;양웅모
    • 대한융합한의학회지
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    • 제6권1호
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    • pp.37-42
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    • 2024
  • Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

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한국어판 WHO-CIDI(Composite International Diagnostic Interview)-사회 공포증의 개발 : 타당도 및 신뢰도 검사 (Development of Korean Version of WHO-CIDI(Composite International Dignostic Interview)-Social Phobia : Its Validity and Reliability)

  • 서주원;오강섭;이시형
    • 정신신체의학
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    • 제8권2호
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    • pp.191-200
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    • 2000
  • 연구목적 : 본 연구의 목적은 한국어판 CIDI(Composite International Diagnostic Interview) 사회공포증의 타당도, 신뢰도를 알아보고자 하는 것이다. 방법 : DSM-IV 진단기준에 의하여 사회공포증으로 진단한 50명의 환자를 대상으로 한국어판 CIDI-사회공포증을 실시하여 임상진단과의 일치도를 보았고 이중 20명에 대하여서는 두 명의 면담자가 각각 실시하여 면담자간 일치도를 측정하였다. 결과 : 50명에 대한 임상진단과 일치도를 통한 타당도는 0.74로 나타났으며 두 명의 면담자간 일치도를 통한 신뢰도(kappa)는 0.75로 나타났다. 결론 : 한국어판 CIDI-사회공포증은 높은 신뢰도 및 타당도를 가지고 있었다. 따라서 일반인구 및 임상집단을 대상으로 사회공포증을 진단하기에 유용한 도구로 판명되었다.

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한의 임상 연구에 대한 국내외 제언 고찰 - 미래 임상 연구 전략 II - (Study on the Proposals for Clinical Research in Korean Medicine Worldwide - Future Clinical Research Strategy II -)

  • 정기용;이민혜;최유경;이충열;박종형;전찬용
    • 동의생리병리학회지
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    • 제29권2호
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    • pp.115-126
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    • 2015
  • The purpose of this paper is to explore the strategy of future Korean medicine(KM) clinical research through the study on the proposals for KM clinical research worldwide. In this study, the papers published in English through Pubmed were investigated mainly. Among them, we analyzed the methodological proposals from the clinical research papers that were published in the KM related fields. Various proposals for improving the problems in KM clinical studies are as follows. First, KM clinical research should be designed based on understanding for the theory, backgrounds, paradigms and worldviews of KM. In addition, considering the model validity, KM clinical research model should include the diagnosis, interventions and outcomes measurement methods reflecting the characteristics and real practice in KM. The internal validity and external validity should be also taken into account. One of the most important thing is to identify the contents about various and complex 'real practice' in KM. A prospective observational study was suitable for the purpose of this study. Finally, we suggested a few improvement directions for RCTs studies in KM. First, we would be able to improve the quality and the internal validity in KM clinical research using the checklists of CONSORT(Consolidated Standards for Reporting Trials) Statement and STRICTA(Standards for Reporting Interventions in Clinical Trials of Acupuncture). Second, we could use various clinical research methods and the modified research of RCTs such as PCT(pragmatic clinical trial) to reflect the characteristics of actual KM practice. Consequently, we would be able to improve the external validity. Third, the KM diagnosis and outcomes measurement methods should be developed based on an actual KM practice and it should reflect a real practice. The 'pattern identification(辨證)' is the core to KM diagnosis. But in order to be applied to the clinical research, the pattern identification(辨證) should be objectified and standardized. Future KM clinical research model should reflect the characteristics and a real practice in KM. In addition, it should include the advantage of rigorous RCTs research.Specially, the diagnosis, interventions and outcomes measurement methods in KM clinical research should reflect this view.

국제임상데이터표준(CDISC TA)기반 비약물성 치매진단콘텐츠(Co-Wis)의 신뢰도 및 타당도에 대한 연구 (A Study of the Reliability and the Validity of Clinical Data Interchange Standards Consortium(CDISC) based Nonphamacy Dementia Diagnosis Contents(Co-Wis))

  • 전지윤;송승일;박정필
    • 한국콘텐츠학회논문지
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    • 제19권7호
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    • pp.638-649
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    • 2019
  • 본 연구는 국제임상데이터표준(CDISC TAUG-Alzheimer's v 2.0, SDTMIG v3.3)의 내용을 전산화 기반으로 비약물성 치매 진단검사 콘텐츠(Co-Wis) 개발 후 노인 및 치매고위험군 대상자에게 임상 또는 여러 삶의 환경 속에서 인지기능 검사의 유용성과 타당도 및 신뢰도 검증을 하는 데 목적이 있다. 이를 위해 치매 진단과정에 대해 탐색하고 기존 지필 검사의 단점을 보완한 비약물성 치매 진단콘텐츠(Co-Wis)를 개발하였다. 만 60세 이상인 대상자 30명을 선발하여 한국형 간이정신상태검사(MMSE-K), 서울신경심리검사(SNSB-II)와 비약물성 치매 진단콘텐츠(Co-Wis)의 인지 영역별 공인 타당도 및 검사-재검사 신뢰도를 검증하였다. 그 결과, 모든 인지 영역에서 높은 상관관계와 신뢰도를 나타냈다. 하지만 부족한 연구 대상자 수와 지역적 분포에 대한 한계점이 파악되었다. 연구 결과를 바탕으로 다양한 타당도 및 신뢰도 방법 에 대한 추후 연구를 보완, 확대할 필요성이 있다.

한의 변증 설문지 개발 표준프로세스 제안 (Suggestion of Standard Process in Developing Questionnaire of Pattern Identification)

  • 장은수;이은정;윤용기;박양춘;정인철
    • 동의생리병리학회지
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    • 제30권3호
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    • pp.190-200
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    • 2016
  • The aim of this study was to suggest the standard process in developing Questionnaire of Pattern Identification (QPI). The process in developing QPI was researched from validated and developed questionnaire and the standard process in developing QPI was suggested through review of the experts in research, statistics and clinics. Check list was also provided. The number of QPI reviewed in this research was 17(4 in disease in Korea Medicine, 5 in Pathological symptoms, 6 in Sasang constitutional Diagnosis, and 2 in etc), The standard process in developing QPI consisted of 11 phage and 33 check lists. 1) Composition of Research Member(3check lists), 2)Set up of the Aim(5), 3) Review for advanced research(3), 4) Finding an Important Index(3), 5) Review of item selection(4), 6) Developing the questions using items(5), 7) Developing Draft of Questionnaire(2), 8) 1st Survey of Reliability and Validity(2), 9) Revision and Correction of Item(1), 10) 2st Survey of Reliability and Validity(2), 11) Completion and Application(3). This study suggests the standard process in developing QPI for the first time in Korea. This following step may help A new QPI development.