• Title/Summary/Keyword: cut-off point

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Minimal Clinically Important Difference of Berg Balance Scale scores in people with acute stroke

  • Song, Min-Jeong;Lee, Jae-Hyoung;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.7 no.3
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    • pp.102-108
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    • 2018
  • Objective: To investigate whether the Minimal Clinically Important Difference (MCID) clinically defines improvement of Berg Balance Scale (BBS) scores in people with acute stroke in response to rehabilitation. Design: Retrospective study. Methods: Seventy-three participants with acute stroke participated in the study. Balance evaluation was performed using the BBS. All patients received rehabilitation with physical therapy for 4 weeks, 5 times a week, for 2 hours and 20 minutes a day. An anchor-based approach using the clinical global impression was used to determine the MCID of the BBS. The MCID was used to define the minimum change in the BBS total score (postintervention-preintervention) that was needed to perceive at least a 3-point improvement on the global rating of change. Receiver operating characteristic (ROC) curves was used to define the cut-off values of the optimal MCID of the BBS in order to discriminate between improvement and no improvement groups. Results: The optimal MCID cut-off point for the BBS change scores was 12.5 points for males with a sensitivity (Sn) of 0.62 and a specificity (Sp) of 0.89, and 12.5 points for females with a Sn of 0.69 and Sp of 0.85. The area under the curve of the ROC curve for all participants were 0.84 (95% confidence interval [CI], 0.72; 0.95, p<0.001), and 0.89 (95% CI, 0.77; 1.00, p<0.001), respectively. Conclusions: The MCID for improvement in balance as measured by the BBS was 13.5 points, indicating that the MCID does clinically detect changes in balance abilities in persons with stroke.

Malignancy Risk Scoring of Hydatidiform Moles

  • Pradjatmo, Heru;Dasuki, Djaswadi;Dwianingsih, Ery Kus;Triningsih, Ediati
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2441-2445
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    • 2015
  • Background: Several risk factors leading to malignant transformation of hydatidiform moles have been described previously. Many studies showed that prophylactic chemotherapy for high risk hydatidiform moles could significantly decrease the incidence of malignancy. Thus, it is essential to discover a breakthrough to determine patients with high risk malignancy so that prophylactic chemotherapy can be started as soon as possible. Objectives: Development of a scoring system of risk factors as a predictor of hydatidiform mole malignant transformation. Materials and Methods: This research is a case control study with hydatidiform mole and choriocarcinoma patients as subjects. Multiple logistic regression was used to analyze the data. Odds ratios (OR), attributable at risk (AR : OR-1) and risk index ($ARx{\beta}$) were calculated for develoipment of a scoring system of malignancy risk. The optimal cut-off point was determined using receiver operating characteristic (ROC) curve. Results: This study analyzed 34 choriocarcinoma cases and 68 benign hydatidiform mole cases. Four factors significantly increased the risk of malignancy, namely age ${\geq}35$ years old (OR:4.41, 95%CI:1.07-16.09, risk index 5); gestational age ${\geq}$ 12weeks (OR:11.7, 95%CI:1.8-72.4, risk index 26); uterine size greater than the gestational age (OR:10.2, 95%CI:2.8-36.6, risk index 21); and histopathological grade II-III (OR:3.4, 95%CI:1.1-10.6, risk index 3). The lowest and the highest scores for the risk factors were zero and 55, respectively. The best cut-off point to decide high risk malignancy patients was ${\geq}31$. Conclusions: Malignant transformation of hydatidiform moles can be predicted using the risk scoring by analyzing the above four parameters. Score ${\geq}31$ implies high risk patients so that prophylactic chemotherapy can be promptly administered for prevention.

Is Mammography for Breast Cancer Screening Cost-Effective in Both Western and Asian Countries?: Results of a Systematic Review

  • Yoo, Ki-Bong;Kwon, Jeoung A;Cho, Eun;Kang, Moon Hae;Nam, Jung-Mo;Choi, Kui Son;Kim, Eun Kyung;Choi, Yun Jeong;Park, Eun-Cheol
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4141-4149
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    • 2013
  • Background: Mammography is considered the gold standard of breast cancer mass screening and many countries have implemented this as an established breast cancer screening strategy. However, although the incidence of breast cancer and racial characteristics are different between Western and Asian countries, many Asian countries adopted mammography for mass screening. Therefore, the objective of this research was to determine whether mammography mass screening is cost-effective for both Western and Asian countries. Materials and Methods: A systematic review was performed of 17 national mammography cost-effectiveness data sets. Per capita gross domestic product (GDP), breast cancer incidence rate, and the most optimal cost-effectiveness results [cost per life year saved (LYS)] of a mammography screening strategy for each data set were extracted. The CE/per capita GDP ratio is used to compare the cost-effectiveness of mammography by countries. Non-parametric regression was used to find a cut-off point which indicated the breast cancer incidence rate boundary line determining whether mammography screening is cost-effective or not. Results: We found that the cost-effective cut-off point of breast cancer incidence rate was 45.04; it exactly divided countries into Western and Asian countries (p<0.0014). Conclusions: Mammography screening is cost-effective in most of Western countries, but not in Asian countries. The reason for this result may be the issues of incidence rate or racial characteristics, such as dense breast tissue. The results indicate that mammography screening should be adopted prudently in Asian countries and other countries with low incidence rates.

A Study on the Pressure Ulcers in Neurological Patients in Intensive Care Units (신경계 중환자의 욕창발생에 관한 연구)

  • Im, Mi-Ja;Park, Hyoung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.2
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    • pp.190-199
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    • 2006
  • Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

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Analysis of the Accuracy and Related Factors of Self-Reported Smoking Status according to Urinary Cotinine Concentration in Adolescents: The KoNEHS Cycle (2015~2017) (소변 중 코티닌 농도에 따른 청소년의 자가보고 흡연 상태의 정확도 및 관련요인 분석: 제3기(2015~2017) 국민환경보건 기초조사)

  • Jung, Sunkyoung;Park, Sangshin
    • Journal of Environmental Health Sciences
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    • v.48 no.4
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    • pp.216-226
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    • 2022
  • Background: The amount of smoking in adolescence increases with a younger age of smoking initiation and affects physical health. To establish and evaluate smoking-related policies, it is important to determine actual smoking status. Validation of self-reported questionnaires can identify the accuracy of the questionnaire data reflecting smoking status. Objectives: The purpose of this study was to evaluate the validity of self-reported smoking status and identify factors affecting the accuracy of self-reported smoking in South Korean adolescents. Methods: This study investigated the consistency between cotinine concentrations and self-reported questionnaire data through the analysis of urine samples collected from 922 adolescents aged 13~18 among the participants of Cycle 3 of the Korean National Environmental Health Survey. Smoking status was classified using the cotinine cut-off point of 39.85 ㎍/L in adolescents, and factors affecting the accuracy were analyzed through multiple logistic regression analysis. Results: The smoking rates according to the self-reported questionnaire and cut-off point-based cotinine concentrations among adolescents were 3.1% and 5.1%, respectively. The results found 97.1% consistency between self-reported smokers and smokers according to cotinine concentration. Factors affecting the discrepancy showed a significant relationship, including gender, secondhand smoke, and use of e-cigarettes. Conclusions: The results can be used as basic data to establish a smoking policy for adolescents through continuous monitoring and improvement of questionnaire items of factors affecting the discrepancy.

Establishment of Methodology for Estimating an Emergency Water (국내 비상용수 확보량 산정 방법론에 관한 연구)

  • Lee, Tae-Kuk;Chae, Seon-Ha;Kim, Seong-Su;Seo, In-Seok;Kim, Jeong-Hyun;Park, No-Suk
    • Journal of Korean Society of Water and Wastewater
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    • v.26 no.3
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    • pp.361-372
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    • 2012
  • In order to establish the methodology for estimating an emergency drinking water supply in Korea, overseas cases and accidents history of cutting off water supply were investigated, and questionnaire was conducted. Investigating accidents history of cutting off water supply in Korea, actual cutting off times of most cases were less than 13hours. Also, cases related with water quality and facility failure have been not enough to derive useful information for estimating an emergency water. From the results of questionnaire and cross-tabulation analysis, about 1,066 lpcd(liter per capita${\cdot}$day) as an emergency water and 14 days as tolerable outages time could be estimated. The results of water quality simulation could tell us that it might take 5-16 days for pollutant matter to travel from 15 contamination points to source water intake point in the selected reservoir(D-dam). This travel time was in good accordance with the estimated tolerable outage time, 14days.

Medical Insurance and Health Education (의료보험과 보건교육)

  • 이규식;홍상진
    • Korean Journal of Health Education and Promotion
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    • v.10 no.2
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    • pp.11-21
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    • 1993
  • Recently the structure of disease is changing its form into chronic disease. Taking into consideration this, the health care system doesn't cope with this tendency. With the health care system for acute disease, it is difficult to decrease medical care cost. At this point, Health education like primary health care can reduce risk factors and possibilities of occurrence of disease. This can cut off the medical insurance finance further more cuts off the rates of insurance cost. This is why health education is the principle part of medical insurance service. Though the law shows health education must be executed in the field of Medical insurance, still it is not enough. In order to carry out health education in the medical insurance organization, the efforts we should make are as follows: 1. Recognize the importance of health education. 2. Set the clear goals in health education. 3. Organize health education system. 4. Train health workers. 5. Systematize health education service. 6. Reform the medical insurance system. 7. Evaluate the effect of health education and practice the model.

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Reinterpretation of the Perception of Place Cues in the Reduced Closure Duration of Stop Consonant Clusters (폐쇄자음군의 폐쇄구간 축소에 따른 위치성 지각에 대한 재해석)

  • 이석재
    • MALSORI
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    • no.45
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    • pp.1-14
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    • 2003
  • This paper criticizes S. Kim (1992), claiming that the perception of place cues in the reduced stop consonant clusters ('reducing' means 'cutting off' the acoustic silence in stop clusters) largely depends on the acoustic characteristics such as formant transition and noise frequency distribution of stop burst, rather than the closure duration time as advocated by S. Kim (1992). The claim is based on the perception test conducted upon 111 stimuli over 10 subjects. The finding is that, when the closure duration is cut off up to the point where only one stop is perceived, place of the second stop, not the first one, in the cluster is in most cases perceived regardless of the places of the first and second stops. It is likely that the place cues of the stop in the prevocalic position mask those in the postvocalic position.

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Application of Receiver Operating Characteristics (ROC) Curves for Clinical Diagnostic Tests (임상진단 검사에서 ROC 곡선의 응용)

  • Pak, Son-Il;Koo, Hee-Seung;Hwang, Cheol-Yong;Youn, Hwa-Young
    • Journal of Veterinary Clinics
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    • v.19 no.3
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    • pp.312-315
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    • 2002
  • Diagnostic tests often require the determination of cut-off values that discriminate uninfected from infected individuals. The receiver operating characteristic (ROC) curve has been frequently used to attain this purpose and gives a representation of diagnostic accuracy (sensitivity and specificity) of a prediction model when varying the cut-point of a decision rule on a whole spectrum. We have written and tested a visual basic application program in EXCEL for maximum likelihood estimation of a binormal ROC curve, which also computes univariate statistics of a diagnostic test employed. Examples applying for computed tomographic images in radiology and methicillin-resistant Staphylococcus aureus research are given to illustrate this approach. This stand-alone module is available from the first author on request.

Characteristics of Anchorage Length for Reinforced Concrete Beam Strengthened by CFRP Plate (탄소섬유보강판으로 보강된 철근콘크리트 보의 정착길이 특성)

  • 한상훈;최만용;조홍동;박중열;황선일;권용길
    • Proceedings of the Korea Concrete Institute Conference
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    • 2002.05a
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    • pp.405-410
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    • 2002
  • This paper deals with the flexural behavior of RC hems strengthened with CFRP plate and the estimation on anchorage length of CFRP Plate. Experimental variables included concrete strength, reinforcement ratio, cover thickness of concrete and length ratio of CFRP plate for a pure span. A failure load, failure mode, deflection and strain response at different distances from a cut-off point of CFRP plate were observed and anchorage length was determined through strain distribution of CFRP plate. Herein, anchorage length is defined the length between CFRP plate end and the beginning point of full composite behavior. Also, the anchorage length observed from the experiment was compared with Nguyen's equation and BS specification.

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