• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.415-423
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• 2022

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6857-6862
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• 2015

Background: To identify the optimal cost effective strategy for the management of women having ASC-US who attended at King Chulalongkorn Memorial Hospital (KMCH). Design: An Economical Analysis based on a retrospective study. Subject: The women who were referred to the gynecological department due to screening result of ASC-US at King Chulalongkorn Memorial Hospital, a general and tertiary referral center in Bangkok Thailand, from Jan 2008 - Dec 2012. Materials and Methods: A decision tree-based was constructed to evaluate the cost effectiveness of three follow up strategies in the management of ASC-US results: repeat cytology, triage with HPV testing and immediate colposcopy. Each ASC-US woman made the decision of each strategy after receiving all details about this algorithm, advantages and disadvantages of each strategy from a doctor. The model compared the incremental costs per case of high-grade cervical intraepithelial neoplasia (CIN2+) detected as measured by incremental cost-effectiveness ratio (ICER). Results: From the provider's perspective, immediate colposcopy is the least costly strategy and also the most effective option among the three follow up strategies. Compared with HPV triage, repeat cytology triage is less costly than HPV triage, whereas the latter provides a more effective option at an incremental cost-effectiveness ratio (ICER) of 56,048 Baht per additional case of CIN 2+ detected. From the patient's perspective, the least costly and least effective is repeat cytology triage. Repeat colposcopy has an incremental cost-effectiveness (ICER) of 2,500 Baht per additional case of CIN2+ detected when compared to colposcopy. From the sensitivity analysis, immediate colposcopy triage is no longer cost effective when the cost exceeds 2,250 Baht or the cost of cytology is less than 50 Baht (1USD = 31.58 THB). Conclusions: In women with ASC-US cytology, colposcopy is more cost-effective than repeat cytology or triage with HPV testing for both provider and patient perspectives.

• Proceedings of the Korean Information Science Society Conference
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• 2002.10d
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• pp.352-354
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• 2002

최근 들어, 대용량의 데이터를 처리할 수 있는 결정 트리 생성 방법에 많은 관심이 집중되고 있다. 그러나, 대용량 데이터를 위한 대부분의 알고리즘은 일괄처리 방식으로 데이터를 처리하기 때문에 새로운 예제가 추가되면 이 예제를 반영한 결정 트리를 생성하기 위해 처음부터 다시 재생성해야 한다. 이러한 재생성에 따른 비용문제에 보다 효율적인 접근 방법은 결정 트리를 순차적으로 생성하는 접근 방법이다. 대표적인 알고리즘으로 BOAT와 ITI를 들 수 있다. BOAT는 대용량 데이터를 지원하는 순차적 알고리즘이 지만 분할 포인트가 노드에서 유지하는 신뢰구간을 넘어서는 경우와 분할 변수가 변경되면 그에 영향을 받는 부분은 다시 생성해야 한다는 문제점을 안고 있고, 이에 반해 ITI는 분할 포인트 변경과 분할 변수 변경을 효율적으로 처리하지만 대용량 데이터를 처리하지 못해 오늘날의 순차적인 트리 생성 기법으로 적합하지 못하다. 본 논문은 ITI의 기본적인 트리 재구조화 알고리즘을 기반으로 하여 대용량 데이터를 처리하지 못하는 ITI의 한계점을 극복하기 위해 전역적 범주화 기법을 이용한 접근방법을 제안한다.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8265-8270
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• 2016

Purpose: A cost-utility analysis was performed to assess the cost-utility of neoadjuvant chemotherapy regimens containing doxorubicin and cyclophosphamide (AC) versus paclitaxel and gemcitabine (PG) for locally advanced breast cancer patients in Iran. Materials and Methods: This cross-sectional study in Namazi hospital in Shiraz, in the south of Iran covered 64 breast cancer patients. According to the random numbers, the patients were divided into two groups, 32 receiving AC and 32 PG. Costs were identified and measured from a community perspective. These items included medical and non-medical direct and indirect costs. In this study, a data collection form was used. To assess the utility of the two regimens, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core30 (EORTC QLQ-C30) was applied. Using a decision tree, we calculated the expected costs and quality adjusted life years (QALYs) for both methods; also, the incremental cost-effectiveness ratio was assessed. Results: The results of the decision tree showed that in the AC arm, the expected cost was 39,170 US$ and the expected QALY was 3.39 and in the PG arm, the expected cost was 43,336 dollars and the expected QALY was 2.64. Sensitivity analysis showed the cost effectiveness of the AC and ICER=-5535 US$. Conclusions: Overall, the results showed that AC to be superior to PG in treatment of patients with breast cancer, being less costly and more effective.

• Journal of KIISE:Software and Applications
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• v.29 no.9
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• pp.654-668
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• 2002

In this paper, we present an empirical study for improving the Korean text chunking based on machine learning and feature set selection approaches. We focus on two issues: the problem of selecting feature set for Korean chunking, and the problem of alleviating the data sparseness. To select a proper feature set, we use a heuristic method of searching through the space of feature sets using the estimated performance from a machine learning algorithm as a measure of "incremental usefulness" of a particular feature set. Besides, for smoothing the data sparseness, we suggest a method of using a general part-of-speech tag set and selective lexical information under the consideration of Korean language characteristics. Experimental results showed that chunk tags and lexical information within a given context window are important features and spacing unit information is less important than others, which are independent on the machine teaming techniques. Furthermore, using the selective lexical information gives not only a smoothing effect but also the reduction of the feature space than using all of lexical information. Korean text chunking based on the memory-based learning and the decision tree learning with the selected feature space showed the performance of precision/recall of 90.99%/92.52%, and 93.39%/93.41% respectively.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.12
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• pp.5309-5314
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• 2016

Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.

• The Journal of Korean Institute of Next Generation Computing
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• v.13 no.4
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• pp.29-39
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• 2017

Various electronic warfare situations drive the need to develop an integrated electronic warfare simulator that can perform electronic warfare modeling and simulation on radar threats. In this paper, we analyze the components of a simulation system to reversely model the radar threats that emit electromagnetic signals based on the parameters of the electronic information, and propose a method to gradually maintain the reverse extrapolation model of RF threats. In the experiment, we will evaluate the effectiveness of the incremental model update and also assess the integration method of reverse extrapolation models. The individual model of RF threats are constructed by using decision tree, naive Bayesian classifier, artificial neural network, and clustering algorithms through Euclidean distance and cosine similarity measurement, respectively. Experimental results show that the accuracy of reverse extrapolation models improves, while the size of the threat sample increases. In addition, we use voting, weighted voting, and the Dempster-Shafer algorithm to integrate the results of the five different models of RF threats. As a result, the final decision of reverse extrapolation through the Dempster-Shafer algorithm shows the best performance in its accuracy.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.609-614
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• 2016

Background: Although breast cancer is the most common cancer in women, economic evaluation of breast cancer screening is not fully addressed in developing countries. The main objective of the present study was to analyze the cost-effectiveness of breast cancer screening using mammography in 35-69 year old women in an Iranian setting. Materials and Methods: This was an economic evaluation study assessing the cost-effectiveness of a population-based screening program in 35-69 year old women residing in rural areas of South east Iran. The study was conducted from the perspective of policy-makers of insurance. The study population consisted of 35- to 69-year old women in rural areas of Kerman with a population of about 19,651 in 2013. The decision tree modeling and economic evaluation software were used for cost-effectiveness and sensitivity analyses of the interventions. Results: The total cost of the screening program was 7,067.69 US$ and the total effectiveness for screening and no-screening interventions was 0.06171 and 0.00864 disability adjusted life years averted, respectively. The average cost-effectiveness ratio DALY averted US$ for screening intervention was 7,7082.5 US$ per DALY averted and 589,027 US $ for no-screening intervention. The incremental cost-effectiveness ratio DALY averted was 6,264 US$ per DALY averted for screening intervention compared with no-screening intervention. Conclusions: Although the screening intervention is more cost-effective than the alternative (noscreening) strategy, it seems that including breast cancer screening program in health insurance package may not be recommended as long as the target group has a low participation rate.

• Health Policy and Management
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• v.29 no.3
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• pp.357-367
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• 2019

Background: This study evaluated the cost-effectiveness of 21 different national dyslipidemia screening strategies according to total cholesterol (TC) cutoff and screening interval among 40 years or more for the primary prevention of coronary heart disease over a lifetime in Korea, from a societal perspective. Methods: A decision tree was used to estimate disease detection with the 21 different screening strategies, while a Markov model was used to model disease progression until death, quality-adjusted life years (QALYs) and costs from a Korea societal perspective. Results: The results showed that the strategy with TC 200 mg/dL and 4-year interval cost \4,625,446 for 16.65105 QALYs per person and strategy with TC 200 mg/dL and 3-year interval cost \4,691,771 for 16.65164 QALYs compared with \3,061,371 for 16.59877 QALYs for strategy with no screening. The incremental cost-effectiveness ratio of strategy with TC 200 mg/dL and 4-year interval versus strategy with no screening was \29,916,271/QALY. At a Korea willingness-to-pay threshold of \30,500,000/QALY, strategy with TC 200 mg/dL and 4-year interval is cost-effective compared with strategy with no screening. Sensitivity analyses showed that results were robust to reasonable variations in model parameters. Conclusion: In this study, revised national dyslipidemia screening strategy with TC 200 mg/dL and 4-year interval could be a cost-effective option. A better understanding of the Korean dyslipidemia population may be necessary to aid in future efforts to improve dyslipidemia diagnosis and management.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.2
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• pp.1-10
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• 2021

Objectives We aimed to examine health-related economic analysis of available interventions on idiopathic short stature (ISS). Methods Eight studies were reviewed from English, Korean, and Chinese databases which were published up to December 24, 2020. Effectiveness, utility, and cost data were extracted from the studies and descriptive analysis of the individual studies was conducted Results Five studies were chosen. In the two economic evaluation studies, the incremental cost-effectiveness ratio (ICER) of growth hormone (GH) treatment was presented by performing cost-effectiveness analysis based on the deterministic decision tree approach for the GH and untreated group. Final adult height and direct medical costs were analyzed as effectiveness and cost outcomes. In 1 review article, an ICER of GH was presented based on systematic review on the effects of the GH treatment. In the two clinical trials, the effectiveness and cost of the 12 months Oriental medicine combination treatment were presented in comparison with the GH treatment alone. There were no literatures that provided utility data of available intervention on ISS. Conclusions The results of this study will be used as basic data for the economic analysis of Oriental medicine treatment on ISS in the future.