• Journal of Korean Neurosurgical Society
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• v.57 no.3
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.19
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• pp.8209-8213
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• 2014

Background: Cervical cancer is a common, preventable and manageable disease in women worldwide. Objectives: This study was conducted to determine the cost of follow-up for suspicious precancerous cervical lesions within a screening program using Pap smear or HPV DNA test through the decision tree. Materials and Methods: Patient follow-up processes were determined using standard guidelines and consultation with specialists to design a decision tree model. Costs of treatment in both public and private sectors were identified according to the national tariffs in 2010 and determined based on decision tree and provided services (visits to specialists, colposcopy, and conization) with two modalities: Pap smear and HPV DNA test. The number of patients and the mean cost of treatment in each sector were calculated. The prevalence of lesions and HPV were obtained from literature to estimate the cost of treatment for each woman in the population. Results: Follow-up costs were determined using seven processes for Pap smear and 11 processes for HPV DNA test. The total cost of using Pap smear and HPV DNA process for each woman in the population was 36.1$ and 174$ respectively. Conclusions: The follow-up process for patients with suspicious cervical lesions needs to be included in the existing screening program. HPV DNA test is currently more expensive than Pap smear, it is suggested that we manage precancerous cervical lesions with this latter test.

• Journal of Convergence for Information Technology
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• v.11 no.1
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• pp.45-53
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• 2021

This study was a retrospective descriptive study to identify frequency and change of palliative care provided for older patients with terminal stage of cardiopulmonary disease before and after life-sustaining treatment (LST) decision making. As a result of chart review of 124 older patients in a university hospital, oral analgesics medication, cold and hot therapy for pain management, antibiotics medication and urine culture for urinary infection, oral care, hair wash, and partial bath were provided significantly less after LST decision making. Provision of praying and relaxation therapy for pain control, oral and nasal care, and emotional care were not changed before and after LST decision making. Spiritual care was the least provided care. Therefore, non-pharmacological pain management, emotional care, and spiritual care need to be improved for older patients with terminal cardiopulmonary disease at the end of life.

• Korean Journal of Adult Nursing
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• v.22 no.5
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• pp.488-498
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• 2010

Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

• The Journal of the Korean dental association
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• v.43 no.5 s.432
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• pp.334-343
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• 2005

• The Journal of the Korean dental association
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• v.43 no.8 s.435
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• pp.540-547
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• 2005

• International Journal of Computer Science & Network Security
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• v.24 no.9
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• pp.97-104
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• 2024

Leukemia induced death has been listed in the top ten most dangerous mortality basis for human being. Some of the reason is due to slow decision-making process which caused suitable medical treatment cannot be applied on time. Therefore, good clinical decision support for acute leukemia type classification has become a necessity. In this paper, the author proposed a novel approach to perform acute leukemia type classification using sequential neural network classifier. Our experimental result only covers the first classification process which shows an excellent performance in differentiating normal and abnormal cells. Further development is needed to prove the effectiveness of second neural network classifier.

• Journal of Sasang Constitutional Medicine
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• v.27 no.2
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• pp.222-230
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• 2015

Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.3
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• pp.239-245
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• 2003

The occurrence and pattern of tooth wear are related to cultural, dietary, occupational, and geographic factors, Excessive occlusal wear can result in pulpal exposure, occlusal disharmony, functional inability. Surface loss can be differentiated into 3 general causal categories: i) mechanical loss, which includes attrition, ii) abrasion chemical loss including erosion, and finally iii) a proposed biomechanical category described as abfraction. Considering that mechanical wear is frequently asymptomatic, patients may have parafunctional habit. Structured clinical decision analysis in fixed prosthodontics, as other branches of dentistry do, allows the practitioner to consider the patient's problems more thoroughly based on the clinical data and extenuation factors. This discipline of decision making is intended to complement the experience level and educational background of the clinician in assisting the patient through the decision process. Additionally, CDA helps the clinician define not only the pre-existing condition of the patient prior to irreversible therapy, but also better treatment strategies for the patient over an extended period. The systematic nature of decision analysis stimulates the dentists to pay further attention to those factors, which is germane to the overall complexity of the case, and exclude factors, which have little influence on its final outcome. Further implementation of computerized databases, procedural outcome probabilities based on clinical and laboratory studies and the clinical experience of those who use it, may provide quite a promising future in the field of structured and formalized clinical decision analysis.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.29-34
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• 2010

To examine the attitude of students toward animals and its relation to veterinary ethical decision making, 302 pre-veterinary and veterinary students of three national universities (Seoul, Chungbuk and Kyungsang National University) were requested to answer the Animal Attitude Scale Test, an indicator of one's pro-animal attitude. A significant gender difference in the AAS scores was found with higher scores in females (female vs. male, 65.27 vs. 57.40; p < 0.0001). The students who have companion animals had higher AAS scores (62.55) than those who donot (58.03, p < 0.0001). However, years of study and experience with animal protection activities did not affect the AAS scores. The correlation between the attitude toward animals and ethical decision making was found in the investigation with two cases of a veterinary ethical dilemma: the medical treatment of a cow in its last gestation stage with ocular squamous cell carcinoma and the euthanizing of a 12 year-old dog with urinary incontinence. The students tend to support for veterinarians to influence clients' decisions in treatment by using their power as medical professionals, even if doing so could partly damage the interests of the clients or patients. The significant correlations between the AAS scores and veterinary ethical decision making were found in this study, which implies that the attitude toward animals should be considered as one of the major factors in making ethical decisions in veterinary practice.