• 제목/요약/키워드: diagnostic categories

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Comparison of Core Needle Biopsy and Repeat Fine-Needle Aspiration in Avoiding Diagnostic Surgery for Thyroid Nodules Initially Diagnosed as Atypia/Follicular Lesion of Undetermined Significance

  • Leehi Joo;Dong Gyu Na;Ji-hoon Kim;Hyobin Seo
    • Korean Journal of Radiology
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    • 제23권2호
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    • pp.280-288
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    • 2022
  • Objective: To compare core needle biopsy (CNB) and repeat fine-needle aspiration (rFNA) to reduce the rate of diagnostic surgery and prevent unnecessary surgery in nodules initially diagnosed as atypia/follicular lesions of undetermined significance (AUS/FLUS). Materials and Methods: This study included 231 consecutive patients (150 female and 81 male; mean age ± standard deviation, 51.9 ± 11.7 years) with 235 thyroid nodules (≥ 1 cm) initially diagnosed as AUS/FLUS, who later underwent both rFNA and CNB. The nodules that required diagnostic surgery after the biopsy were defined using three different scenarios according to the rFNA and CNB results: criterion 1, surgery for low-risk indeterminate (categories I and III); criterion 2, surgery for high-risk indeterminate (categories IV and V); and criterion 3, surgery for all indeterminate nodules (categories I, III, IV, and V). We compared the expected rates of diagnostic surgery between CNB and rFNA in all 235 nodules using the three surgical criteria. In addition, the expected rates of unnecessary surgery (i.e., surgery for benign pathology) were compared in a subgroup of 182 nodules with available final diagnoses. Results: CNB showed significantly lower rates of nondiagnostic, AUS/FLUS, and suspicious for malignancy diagnoses (p ≤ 0.016) and higher rates of follicular neoplasm or suspicious for a follicular neoplasm (p < 0.001) and malignant diagnoses (p = 0.031). CNB showed a significantly lower expected rate of diagnostic surgery than rFNA for criterion 1 (29.8% vs. 48.1%, p < 0.001) and criterion 3 (46.4% vs. 55.3%, p = 0.029), and a significantly higher rate for criterion 2 (16.6% vs. 7.2%, p = 0.001). CNB showed a significantly lower expected rate of unnecessary surgery than rFNA for criterion 1 (18.7% vs. 29.7%, p = 0.024). Conclusion: CNB was superior to rFNA in reducing the rates of potential diagnostic surgery and unnecessary surgery for nodules initially diagnosed as AUS/FLUS in a scenario where nodules with low-risk indeterminate results (categories I and III) would undergo surgery.

협동유우진료소(協同乳牛診療所)를 중심(中心)한 서울근교(近郊) 유우질환(乳牛疾患)의 연간조사보고(年間調査報告) (A One-Year Analysis of Dairy Cow Diseases of Seoul Area at Hyup Dong Large Animal Clinic)

  • 정창국;남정현;김정배;서정순;최중범;박근영
    • 대한수의학회지
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    • 제6권1호
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    • pp.53-56
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    • 1966
  • Number of dairy cow patients treated at Hyup Doug Large Animal Clinic during the year July 1,1965, through June 30, 1966, were amounted to 485 cases and the result of analysis of disease incidence during one year period were us follows; 1. In the etiologic diagnostic categories, diseases caused by static mechanical abnormality were most productive and 28.1% of all diagnoses involved in this category. 2. In the topographic diagnostic categories, 39.4% of all diagnoses involved the urogenital system and were obeserved most productive. 3. As a result of each topographic diagnostic categories were subdivided into disease entities, 13.4% of all diagnoses involved the retained placenta and this were observed most productive in the miscellaneous disease enties. Next productive diseases were miscellaneous ovarian disease (10.9%), indigestion (10.3%), mastitis (8.0%) and metritis (6.8%) chronologically.

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협동유우진료소(協同乳牛診療所)를 중심(中心)한 서울근교(近郊) 유우질환(乳牛疾患)의 연간조사보고(年間調査報告) (II) (A One-Year Analysis of Dairy Cow Diseases of Seoul Area at Hyup Dong Large Animal Clinic)

  • 정창국;남정현;김정배;서정순;최중범;박근영;차종상
    • 대한수의학회지
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    • 제7권2호
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    • pp.56-59
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    • 1967
  • Number of dairy cow patients diagnosed and treated at Hyup Dong Large Animal Clinic during the year, October 1, 1966, through September 30, 1967, were amounted to 1,119 cases and the result of analysis of disease incidence during one year period were as follow: 1. In the etiologic diagnostic categories, diseases cause by infection with lower organism were most productive and 43.3% of all diagnosis involved in this category. 2. In the topographic diagnostic categories, 37.3% of all diagnosis involved the urogenital system and were observed most productive. 3. As a result of each topographic diagnostic categories were subdivided into disease entities, 21.4% of all diagnosis involved the mastitis and this were observed most productive in the miscellaneous disease entities. Next productive disease were indigestion (11.9%), endometritis(11.5%), miscellaneousl ovarian disease(11.1%) and retained placenta(81.1%) chronologicaly.

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현재 불안 장애의 분류 : 타당한가? (DSM-IV Diagnostic Criteria for Anxiety Disorder: Discriminant Validity)

  • 유범희;이인수
    • 대한불안의학회지
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    • 제1권1호
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    • pp.18-24
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    • 2005
  • The Diagnostic and Statistical Manual 4th edition (DSM-IV) has been widely accepted and used for international classification of mental disorder. The DSM has been changed to improve diagnostic reliability and validity through descriptive and categorical approaches which was undertaken atheoretically. The authors reviewed current studies about the DSM-IV classification system and the diagnostic issues of representative categories of anxiety disorder. The authors concluded that the anxiety disorder classification system in DSM-IV has limitations such as a lack of empirical consideration for overlapping features of anxiety disorders and a lack of discriminant validity. To improve diagnostic validity and revise the current DSM-IV classification system, the authors suggested 1) more longitudinal studies for collecting empirical evidence, 2) decreasing the dependence upon operational criteria, 3) deceasing diagnostic boundary blurring, 4) developing disease specific biological diagnostic techniques and 5) continued collaboration between the DSM and International Classification of Diseases (ICD) systems.

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장애 아동·청소년 독서역량 진단도구 개발을 위한 구성요인 연구 (Research on Components for Developing a Reading Competency Diagnostic Tool for Children and Adolescents with Disabilities)

  • 김수경;최승숙;황정현;윤성은
    • 한국도서관정보학회지
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    • 제54권3호
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    • pp.129-163
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    • 2023
  • 본 연구의 목적은 장애 아동·청소년의 독서역량 강화를 위해 독서역량과 독서역량 개념에 따른 구성요인을 파악하고 진단 문항을 개발하여 장애 아동·청소년의 독서역량 진단도구 개발의 기초자료를 제공하기 위함이다. 연구 방법은 문헌연구, 브레인스토밍, 델파이조사 및 예비조사를 실시한다. 연구 결과 독서역량 진단도구 구성요인은 크게 2개 영역(정의적 영역, 환경적 영역), 4개 범주(독서동기, 독서태도, 인적 환경, 물적 환경), 4개 범주별 총 13개 구성요인(독서 흥미, 독서가치, 독서인정, 독서기대, 독서습관, 독서효능감, 독서몰입, 독서불안(회피), 가정/가족, 학교/교사, 또래, 독서환경, 매체환경)을 도출하고, 그에 따른 문항을 개발하였다. 이 결과를 토대로 장애 아동·청소년 독서역량 진단도구 개발 방향을 제시하였다.

EVALUATION OF DIAGNOSTIC TESTS WITH MULTIPLE DIAGNOSTIC CATEGORIES

  • Birkett N.J.
    • 대한예방의학회:학술대회논문집
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    • 대한예방의학회 1994년도 교수 연수회(역학)
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    • pp.154-157
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    • 1994
  • The evaluation of diagnostic tests attempts to obtain one or more statistical parameters which can indicate the intrinsic diagnostic utility of a test. Sensitivity. specificity and predictive value are not appropriate for this use. The likelihood ratio has been proposed as a useful measure when using a test to diagnose one of two disease states (e.g. disease present or absent). In this paper, we generalize the likelihood ratio concept to a situation in which the goal is to diagnose one of several non-overlapping disease states. A formula is derived to determine the post-test probability of a specific disease state. The post-test odds are shown to be related to the pre-test odds of a disease and to the usual likelihood ratios derived from considering the diagnosis between the target diagnosis and each alternate in turn. Hence, likelihood ratios derived from comparing pairs of diseases can be used to determine test utility in a multiple disease diagnostic situation.

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미만성 침윤성 폐질환; 고해상 전산화 단층촬영상 병변의 유형에 따른 방사선학적 진단접근 (DILD (diffuse infiltrative lung disease); Radiologic Diagnostic Approach According to High-Resolution CT Pattern)

  • 이기남
    • Tuberculosis and Respiratory Diseases
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    • 제58권2호
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    • pp.111-119
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    • 2005
  • The introduction of high-resolution CT (HRCT) in recent years has improved the ability of radiologists to detect and characterize the diffuse infiltrative lung disease (DILD). The detection and diagnosis of diffuse lung disease using HRCT are based on the recognition of specific abnormal findings. In this article, pattern recognition of HRCT findings is reviewed in the differential diagnosis of diffuse infiltrative lung disease. In general, HRCT findings of lung disease can be classified into four categories based on their appearances. These categories consist of (1) nodules and nodular opacities, (2) linear and reticular opacities, (3) increased lung opacity, and (4) decreased lung opacity, including cystic lesions.

만성 요통 한의진단 도구 개발을 위한 변증 항목 번역 적합성에 관한 연구 (The Study about the suitability of the translations of categories in the Questionnaire for Pattern Identification of Chronic Low Back Pain)

  • 박창현;강용중;고성규;송윤경
    • 척추신경추나의학회지
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    • 제11권2호
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    • pp.45-56
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    • 2016
  • Objectives : The aim of this study is to verify if the translation of chronic low back pain questionary is done properly. Methods : We used pattern identification of chronic low back pain in the guideline suggested by Ministry of Food and Drug Safety when making the questionnaire. And we used expressions which four native korean speakers who have bachelor's degree on chinese and teach related subjects in university have agreed on for two times. Results : We examined translated sentences about 40 symptoms according to 9 large categories on the questionnaire and corrected them into agreed expressions. Conclusions : In this study, we carried out evaluations on the suitability of the translations of categories which identify symptoms of low back pain. From now on, it is necessary to verify the degree of accuracy of question items that have been subjected to translation verification in clinical diagnosis. Furthermore considering the characteristics of patients with low back pain, we think diagnostic tools which reflects objective diagnosis results other than diagnostic identification are needed in the clinical field.

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Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

  • Yeeji Sung;Soon-Beom Hong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제34권4호
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    • pp.236-241
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    • 2023
  • Objectives: According to the 10th revision of the International Classification of Diseases, the main categories of tic disorders (F95.0, F95.1, and F95.2) follow a diagnostic hierarchy based on the duration and diversity of tic symptoms. The present study investigated the use of this diagnostic hierarchy in real-world clinical practice. Methods: Based on the National Health Insurance Service-National Health Information Database, the diagnosis of transient tic disorder (F95.0) made after a diagnosis of chronic motor or vocal tic disorder (F95.1) or Tourette's syndrome (F95.2) and diagnosis of chronic motor or vocal tic disorder (F95.1) made after a diagnosis of Tourette's syndrome (F95.2) were referred to as type A errors. The diagnosis of transient tic disorder (F95.0) repeated after a period of >12 months was referred to as type B error. Demographic and clinical differences according to the diagnostic error types were analyzed using analysis of variance, Student's t-tests, and chi-squared tests. Results: Most participants (96.5%) were without errors in the diagnosis of tic disorders. Higher proportions of males (p=0.005) and antipsychotic prescriptions (p<0.001) were observed in patients with type A or B diagnostic errors. A higher proportion of health insurance holders was observed among those with type A errors (p=0.027). Conclusion: Errors were absent in majority of the tic diagnoses in real-world clinical practice in terms of the diagnostic hierarchy.

갑상선 세침흡인세포검사 2023년 베데스다 시스템, 3판의 하이라이트 (Highlights of the 2023 Bethesda System for Reporting Thyroid Cytopathology, 3rd Edition)

  • 송동은
    • 대한두경부종양학회지
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    • 제40권1호
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    • pp.1-5
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    • 2024
  • The Bethesda System for Reporting Thyroid Cytopathology (TBSRCT) is crucial for cytopathologists to use a standardized, category-based reporting system for thyroid fine needle aspirations and is effective for clear communication with the referring physicians. The new Bethesda System for Reporting Thyroid Cytopathology, the third edition in 2023, provides several key updates. The most important update is the assignment of only single name for each of the six diagnostic categories: (I) nondiagnostic; (II) benign; (III) atypia of undetermined significance; (IV) follicular neoplasm; (V) suspicious for malignancy; and (VI) malignant. An implied risk of malignancy (ROM) for each of six categories has been updated based on extensively published data since the second edition of TBSRTC in 2017 and offers both an average ROM for each category and the expected range of cancer risk. Estimated final ROM after excluding "Noninvasive Follicular Thyroid Neoplasm with Papillary Like Nuclear Features (NIFTP)" for each of six categories has been updated based on the reported mean decreases in the ROM if excluding NIFTP. For atypia of undetermined significance (AUS) category, the subcategorization is simplified and more formalized into 2 subgroups, AUS-nuclear atypia or AUS-other, based on the implied ROM and molecular profiling. For the pediatric thyroid disease, pediatric ROMs and management algorithms are newly added for the same six reporting categories for this age group. New or revised disease nomenclatures including high-grade follicular-derived carcinoma has been updated according to the recently published 2022 World Health Organization Classification of Thyroid Neoplasms. Brand new two chapters are added including clinical perspectives and imaging studies (Chap. 13) and the use of molecular and other ancillary tests (Chap. 14). The atlas is updated with new images to illustrate more effectively for new disease entity and diagnostic criteria.