• Title/Summary/Keyword: clinical grading

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A Study on Evaluation of Clinical Practice of Dept. of Dental Technology - Construction of items and grading of the evaluation table at clinical practice - (치기공과 임상실습평가에 관한 연구 - 임상실습평가표 항목구성내용과 배점을 중심으로 -)

  • Lee, Hwa-Sik;Bae, Bong-Jin;Chang, Ki-Whan
    • Journal of Technologic Dentistry
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    • v.29 no.2
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    • pp.65-77
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    • 2007
  • This study is for the purpose of studying the validity of the construction of items and grading of the evaluation table at clinical practice used as the method of evaluation when clinical practice of Dept. of Dental Technology. 205 dental technicians in 4 cities were questioned to analyze the relation between items of the evaluation table at clinical practice and its grading. The collected materials were inspected by SAS V8 for Windows. The results are as follows: 1. Making up all the items and grading seem to be appropriate because they had the marks more than midium(more than 3.28). 2. Making up detailed items and grading seem to be trusted because they had the marks more than 3.30. 3.The significance level of the relation between items of the evaluation at clinical practice and its grading by t-inspection is p<0.0001 and so it appears to be meaningful. 4. It proved to be meaningful in result of regression analysis of the influence on the construction of the evaluation at clinical practice and its grading. With this result, further study is needed for the better methods of the evaluation in its adjustment and graduated grading among the items.

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A Modified Length-Based Grading Method for Assessing Coronary Artery Calcium Severity on Non-Electrocardiogram-Gated Chest Computed Tomography: A Multiple-Observer Study

  • Suh Young Kim;Young Joo Suh;Na Young Kim;Suji Lee;Kyungsun Nam;Jeongyun Kim;Hwan Kim;Hyunji Lee;Kyunghwa Han;Hwan Seok Yong
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.284-293
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    • 2023
  • Objective: To validate a simplified ordinal scoring method, referred to as modified length-based grading, for assessing coronary artery calcium (CAC) severity on non-electrocardiogram (ECG)-gated chest computed tomography (CT). Materials and Methods: This retrospective study enrolled 120 patients (mean age ± standard deviation [SD], 63.1 ± 14.5 years; male, 64) who underwent both non-ECG-gated chest CT and ECG-gated cardiac CT between January 2011 and December 2021. Six radiologists independently assessed CAC severity on chest CT using two scoring methods (visual assessment and modified length-based grading) and categorized the results as none, mild, moderate, or severe. The CAC category on cardiac CT assessed using the Agatston score was used as the reference standard. Agreement among the six observers for CAC category classification was assessed using Fleiss kappa statistics. Agreement between CAC categories on chest CT obtained using either method and the Agatston score categories on cardiac CT was assessed using Cohen's kappa. The time taken to evaluate CAC grading was compared between the observers and two grading methods. Results: For differentiation of the four CAC categories, interobserver agreement was moderate for visual assessment (Fleiss kappa, 0.553 [95% confidence interval {CI}: 0.496-0.610]) and good for modified length-based grading (Fleiss kappa, 0.695 [95% CI: 0.636-0.754]). The modified length-based grading demonstrated better agreement with the reference standard categorization with cardiac CT than visual assessment (Cohen's kappa, 0.565 [95% CI: 0.511-0.619 for visual assessment vs. 0.695 [95% CI: 0.638-0.752] for modified length-based grading). The overall time for evaluating CAC grading was slightly shorter in visual assessment (mean ± SD, 41.8 ± 38.9 s) than in modified length-based grading (43.5 ± 33.2 s) (P < 0.001). Conclusion: The modified length-based grading worked well for evaluating CAC on non-ECG-gated chest CT with better interobserver agreement and agreement with cardiac CT than visual assessment.

The Relationship between Clinical Grading of Carpal TunnelSyndrome and Sensory nerve Conduction Velocity (수근관 증후군의 임상증상정도와 감각신경전도검사와의 관계)

  • Kwak, Jae-Hyuk;Lee, Dong-Kuck
    • Annals of Clinical Neurophysiology
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    • v.6 no.2
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    • pp.98-102
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    • 2004
  • Background: Carpal tunnel syndrome (CTS) is a common condition characterized by entrapment neuropathy of the median nerves. Clinical manifestations are the most important findings for diagnosis and assessment of therapeutic effects. But, objective indicators, such as electrophysiological findings, are also valuable supplementary tools. This study investigated the relationship between clinical grading and sensory nerve conduction velocity (SNCV) of median proper palmar digital nerve (MPPDN) in CTS patients. Method: This study was done on 90 upper limbs of 53 patients with CTS (men: 6, women: 47, age: 26~69 years, mean age; 52 years). Each SNCV of MPPDN was recorded with bar electrode using antidromic method. Each SNCV was compared with clinical grading of CTS. The clinical grades of CTS were designated as follows; group 1 is mild symptoms, 2 is moderate symptoms, and 3 is severe and longstanding symptoms. Result: In thumb, the SNCV of MPPDN was not different significantly between 3 groups (p=0.817). In the index finger, the SNCV was the fastest in the group 1, but faster in group 3 than in group 2 (p=0.001). In the middle and ring fingers, SNCV was decreased in higher clinical grading groups (middle finger: p=0.015, ring finger: p=0.044). Conclusion: SNCV of MPPDN of middle and ring finger correlated with the clinical grading of CTS. SNCV of index finger was the fastest in group 1. But SNCV of thumb did not correlate with the clinical grading of CTS.

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Correlation of Habits and Clinical Findings with Histopathological Diagnosis in Oral Submucosal Fibrosis Patients

  • Ara, Syeda Arshiya;Arora, Vini;Zakaullah, Syed;Raheel, Syed Ahmed;Rampure, Prakash;Ashraf, Sajna
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7075-7080
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    • 2013
  • Background: Oral submucosal fibrosis (OSMF) is one of the most prevalent premalignant conditions in India which is easy to diagnose but difficult to manage. At present it is considered as irreversible and incurable. It has also been referred to as an epidemic in India. Aims and Objectives: To correlate the frequency and duration of habits with clinical staging, functional staging and histopathological grading and to correlate the clinical and functional staging with histopathological grading. Materials and Methods: The study included a total of 90 subjects, 80 with OSMF in the experimental group and 10 patients in the control group. Patient personal history was recorded with chewing habits, including frequency and duration of chewing. The site of keeping the quid, time duration and whether he/she swallows it or spits it were also noted. Clinical staging was done on the presence of palpable fibrous bands. Functional staging was accomplished by measuring mouth opening. Incisional biopsy was done for all the patients for histopathological examination. Histopathological grading was according to Pindborg and Sirsat. Results: The experimental group comprised 71 males and 9 females, the majority of which were in the age group of 21-30 years. Correlation of habits with clinical staging, functional staging and histopathological grading were significant (p<0.05). Clinical and functional staging did not correlate with histopathological grading, but the correlation of clinical and functional staging was highly significant (p<0.01). Conclusions: The widespread habit of chewing gutkha is a major risk factor for OSMF, especially in the younger age group. In this study, it was found that with increase in the duration and frequency of the habit the severity of the disease increased.

Clinical Observation of Effect on Severity of Symptoms and Safety of Auto-microneedle Therapy in Patients with Peripheral Facial Paralysis (자동 미세침이 말초성 안면마비 환자의 증상 정도 및 안전성에 미치는 영향에 대한 임상 관찰)

  • Lee, Ung-In;Kwon, You-Jung;Kim, Hyun-Ho;Yoo, Je-Hyuk;Kim, Kyung-Wook;Kang, Jung-Won;Lee, Sang-Hoon
    • Journal of Acupuncture Research
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    • v.29 no.4
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    • pp.35-42
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    • 2012
  • Objectives : This study was to observe clinical application of auto-microneedle therapy system (AMTS) in patients with peripheral facial paralysis. Methods : 27 peripheral facial paralysis patients were observed after taking AMTS at Facial Palsy Center, Kyung Hee University Oriental Medicine Hospital from March 1, 2011 to January 9, 2012. We assessed the symptoms of facial paralysis with Yanagihara unweighted grading system, Sunnybrook facial grading system(SBGS) and facial disability index(FDI), and observed adverse events and total safety of the treatment. Results : The scores of facial palsy scales increased after AMTS in Yanagihara grading system and Sunnybrook facial grading system. AMTS-related adverse events were mild pain(5.9%) and fatigue(3.5%), which needed no extra treatment. The total safety evaluation was between 'safe' and 'nearly safe' level. There were no other serious adverse events. In addition, patients were satisfied with subjective improvement including facial tingling and numbness. Conclusions : AMTS can be applied as an adjunctive treatment for patients with peripheral facial paralysis due to its safety and clinical usefulness. It is easier to stimulate wide skin area in a short time. Further clinical research is required to investigate the effectiveness of ATMS in a more rigorous RCTs.

Suggestion for a New Grading Scale for Radiation Induced Pneumonitis Based on Radiological Findings of Computerized Tomography: Correlation with Clinical and Radiotherapeutic Parameters in Lung Cancer Patients

  • Kouloulias, Vassilios;Zygogianni, Anna;Efstathopoulos, Efstathios;Victoria, Oikonomopoulou;Christos, Antypas;Pantelis, Karaiskos;Koutoulidis, Vassilios;Kouvaris, John;Sandilos, Panagiotis;Varela, Maria;Aytas, Ilknur;Gouliamos, Athanasios;Kelekis, Nikolaos
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.2717-2722
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    • 2013
  • Background: The objective of this research is the computed axial tomography (CT) imaging grading of radiation induced pneumonitis (RP) and its correlation with clinical and radiotherapeutic parameters. Materials and Methods: The chest CT films of 20 patients with non-small cell lung cancer who have undergone threedimensional conformal radiation therapy were reviewed. The proposed CT grading of RP is supported on solely radiological diagnosis criteria and distinguishes five grades. The manifestation of RP was also correlated with any positive pre-existing chronic obstructive pulmonary disease (COPD) history, smoking history, the FEV1 value, and the dosimetric variable V20. Results: The CT grading of RP was as follows: 3 patients (15%) presented with ground glass opacity (grade 1), 9 patients (45%) were classified as grade 2, 7 patients (35%) presented with focal consolidation, with or without elements of fibrosis (grade 3), and only one patient (5%) presented with opacity with accompanying atelectasis and loss of pulmonary volume (grade 4). Both univariate and multivariate analysis revealed as prognostic factors for the radiological grading of RP the reduction of FEV1 and the V20 (P=0.026 and P=0.003, respectively). There was also a significant (P<0.001) correlation of radiological grading of RP with FEV1 and V20 (spearman rho 0.92 and 0.93, respectively). Conclusions: The high correlation of the proposed radiological grading with the FEV1 and the V20 is giving a satisfactory clinical validity. Although the proposed grading scale seems relevant to clinical practice, further studies are needed for the confirmation of its validity and reliability.

A Case Report of Korean Medical Treatment on a Left Pontine Hemorrhage with a Cavernous Malformation (해면상 혈관 기형에 병발한 뇌교 출혈로 인한 좌측 내사시 환자 치험 1례)

  • Yim, Tae-Bin;Jeon, Gyu-Ri;Lee, Hye-Jin;Lee, Kyeong-Hwa;Cho, Seung-Yeon;Park, Jung-Mi;Ko, Chang-Nam;Park, Seong-Uk
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.929-939
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    • 2022
  • This case report determines the effects of Korean medicine treatment on a pontine hemorrhage with a cavernous malformation. In this study, Korean medicine treatments, such as herbal medicine, acupuncture, electro-acupuncture, and moxibustion, were administered for 30 days. During the hospitalization period, evaluations were performed using the Scott and Kraft Scale, eye movement, 9-gaze photography, the House-Brackmann grading system, and Yanagihara's unweighted grading system on days 1, 12, and 30. The Scott and Kraft Scale increased from -4 to -2, while eye movement increased from 43.1% to 72.3%. The House-Brackmann grading system improved from 4 to 2, and Yanagihara's unweighted grading system increased from 13 to 31. We also discovered that the movement of the left eye was improved by 9-gaze photography. Our findings suggest that Korean medicine treatment has potential effects on esotropia and facial palsy caused by a pontine hemorrhage with a cavernous malformation.

Magnetic Resonance Imaging Grading Systems for Central Canal and Neural Foraminal Stenoses of the Lumbar and Cervical Spines With a Focus on the Lee Grading System

  • Jiwoon Seo;Joon Woo Lee
    • Korean Journal of Radiology
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    • v.24 no.3
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    • pp.224-234
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    • 2023
  • Magnetic resonance imaging (MRI) is a standard imaging modality for diagnosing spinal stenosis, which is a common degenerative disorder in the elderly population. Standardized interpretation of spinal MRI for diagnosing and grading the severity of spinal stenosis is necessary to ensure correct communication with clinicians and to conduct clinical research. In this review, we revisit the Lee grading system for central canal and neural foraminal stenosis of the cervical and lumbar spine, which are based on the pathophysiology and radiologic findings of spinal stenosis.

Study on the Validity of Surface Electromyography as Assessment Tools for Facial Nerve Palsy

  • Ryu, Hye-Min;Lee, Seung-Jeong;Park, Eun-Jin;Kim, Su-Gyeong;Kim, Kyeong Han;Choi, Yoo Min;Kim, Jong Uk;Song, Beom Yong;Kim, Cheol Hong;Yoon, Hyun-Min;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.21 no.4
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    • pp.258-267
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    • 2018
  • Objectives: The purpose of this study was to find out validity of Surface Electromyography(sEMG) compared with Nerve Conduction Study and clinical assessment scale as assessment factors for facial palsy. Methods: We investigated 50 cases of patients with peripheral facial palsy who had records of sEMG and NCS to check. Then we analyzed the correlation between sEMG and NCS that carried out around 1 week after onset. And we analyzed the correlation between sEMG and clinical assessment scales that were measured three times around 1 week, 3-4 weeks and 5-6 weeks after onset. Clinical assessment scales used in this study were House-brackmann grade, Yanagihara unweighted grading scale and Sunnybrook facial grading system. We used Pearson's correlation for statistical analysis. Results: sEMG and NCS, measured at similar times, were statistically correlated. Especially, the correlation with the forehead region was high. And sEMG and clinical assessment scale, measured at same time, were statistically correlated, especially after 5 weeks from onset. Conclusion: According to this study, sEMG is expected to be useful to assessment facial palsy.

Clinical assessment and grading of back pain in horses

  • Mayaki, Abubakar Musa;Razak, Intan Shameha Abdul;Adzahan, Noraniza Mohd;Mazlan, Mazlina;Rasedee, Abdullah
    • Journal of Veterinary Science
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    • v.21 no.6
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    • pp.82.1-82.10
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    • 2020
  • Background: The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance. Objectives: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP. Methods: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse. Results: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases. Conclusions: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.