• Title/Summary/Keyword: risk scoring

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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.

Stratifying Patients with Haematuria into High or Low Risk Groups for Bladder Cancer: a Novel Clinical Scoring System

  • Tan, Guan Hee;Shah, Shamsul Azhar;Ann, Ho Sue;Hemdan, Siti Nurhafizah;Shen, Lim Chun;Abdul Galib, Nurudin Al-Fahmi;Singam, Praveen;Kong, Ho Chee Christopher;Hong, Goh Eng;Bahadzor, Badrulhisham;Zainuddin, Zulkifli Md
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6327-6330
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    • 2013
  • Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross-sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low r isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.

Scoring System and Management Algorithm Assessing the Role of Survivin Expression in Predicting Progressivity of HPV Infections in Precancerous Cervical Lesions

  • Indarti, Junita;Aziz, M. Farid;Suryawati, Bethy;Fernando, Darrell
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1643-1647
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    • 2013
  • Background: To identify the risk factors and assess the role of survivin in predicting progessivity precancerous cervical lesions. Materials and Methods: This case-control study was conducted from October 2009 until May 2010. We obtained 74 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 19 samples for CIN 1, 18 samples for CIN 2, 18 samples for CIN 3, and 19 samples as controls. Demographic profiles and risk factors assesment, histopathologic examination, HPV DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples. Data was analyzed with bivariate and multivariate analysis. Results: Multivariate analysis revealed significant risk factors for developing precancerous cervical lesions are age <41 years, women with ${\geq}2$ sexual partners, course of education ${\geq}13$ years, use of oral contraceptives, positive high-risk HPV DNA, and high survivin expression by ICC or IHC staining. These factors were fit to a prediction model and we obtained a scoring system to predict the progressivity of CIN lesions. Conclusions: Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of CIN lesions. Application of this scoring system may be beneficial in determining the action of therapy towards the patient.

Risk Factors and Preoperative Risk Scoring System for Shunt-Dependent Hydrocephalus Following Aneurysmal Subarachnoid Hemorrhage

  • Kim, Joo Hyun;Kim, Jae Hoon;Kang, Hee In;Kim, Deok Ryeong;Moon, Byung Gwan;Kim, Joo Seung
    • Journal of Korean Neurosurgical Society
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    • v.62 no.6
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    • pp.643-648
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    • 2019
  • Objective : Shunt-dependent hydrocephalus (SdHCP) is a well-known complication of aneurysmal subarachnoid hemorrhage (SAH). The risk factors for SdHCP have been widely investigated, but few risk scoring systems have been established to predict SdHCP. This study was performed to investigate the risk factors for SdHCP and devise a risk scoring system for use before aneurysm obliteration. Methods : We reviewed the data of 301 consecutive patients who underwent aneurysm obliteration following SAH from September 2007 to December 2016. The exclusion criteria for this study were previous aneurysm obliteration, previous major cerebral infarction, the presence of a cavum septum pellucidum, a midline shift of >10 mm on initial computed tomography (CT), and in-hospital mortality. We finally recruited 254 patients and analyzed the following data according to the presence or absence of SdHCP : age, sex, history of hypertension and diabetes mellitus, Hunt-Hess grade, Fisher grade, aneurysm size and location, type of treatment, bicaudate index on initial CT, intraventricular hemorrhage, cerebrospinal fluid drainage, vasospasm, and modified Rankin scale score at discharge. Results : In the multivariate analysis, acute HCP (bicaudate index of ${\geq}0.2$) (odds ratio [OR], 6.749; 95% confidence interval [CI], 2.843-16.021; p=0.000), Fisher grade of 4 (OR, 4.108; 95% CI, 1.044-16.169; p=0.043), and an age of ${\geq}50years$ (OR, 3.938; 95% CI, 1.375-11.275; p=0.011) were significantly associated with the occurrence of SdHCP. The risk scoring system using above parameters of acute HCP, Fisher grade, and age (AFA score) assigned 1 point to each (total score of 0-3 points). SdHCP occurred in 4.3% of patients with a score of 0, 8.5% with a score of 1, 25.5% with a score of 2, and 61.7% with a score of 3 (p=0.000). In the receiver operating characteristic curve analysis, the area under the curve (AUC) for the risk scoring system was 0.820 (p=0.080; 95% CI, 0.750-0.890). In the internal validation of the risk scoring system, the score reliably predicted SdHCP (AUC, 0.895; p=0.000; 95% CI, 0.847-0.943). Conclusion : Our results suggest that the herein-described AFA score is a useful tool for predicting SdHCP before aneurysm obliteration. Prospective validation is needed.

A Study on the Scoring Method for the Insurance Underwriting Using Generalized Linear Model (보험사 언더라이팅 기준 설정을 위한 스코어링 기법에 관한 연구)

  • Lee, Chang-Soo;Kwon, Hyuk-Sung;Kim, Dong-Kwang
    • The Korean Journal of Applied Statistics
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    • v.22 no.3
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    • pp.489-498
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    • 2009
  • Underwriting is the first step for the administration of an insurance contract, which may result in stable profitability or unexpected loss for insurance company. Adequacy of underwriting criteria determines underwriting result. Generally, quantitative scoring system is used for underwriting. Method of evaluating risk for the scoring system is summing up scores for risk factors of a potential policyholder in consideration. Scores for each risk factor is predetermined. Current business environment for insurance companies makes underwriting profit more important, which means that insurance companies need more efficient underwriting method. This study suggests a reasonable approach to estimate risk relativities based on generalized linear model. Real data were used to quantify risk levels of groups of insureds for the design of underwriting model. Finally, effects in business volume and profitability of reflecting estimated underwriting scoring system are explained.

Building credit scoring models with various types of target variables (목표변수의 형태에 따른 신용평점 모형 구축)

  • Woo, Hyun Seok;Lee, Seok Hyung;Cho, HyungJun
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.1
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    • pp.85-94
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    • 2013
  • As the financial market becomes larger, the loss increases due to the failure of the credit risk managements from the poor management of the customer information or poor decision-making. Thus, the credit risk management also becomes more important and it is essential to develop a credit scoring model, which is a fundamental tool used to minimize the credit risk. Credit scoring models have been studied and developed only for binary target variables. In this paper, we consider other types of target variables such as ordinal multinomial data or longitudinal binary data and suggest credit scoring models. We then apply our developed models to real data and random data, and investigate their performance through Kolmogorov-Smirnov statistic.

External Validation of a Clinical Scoring System for Hematuria

  • Lee, Seung Bae;Kim, Hyung Suk;Kim, Myong;Ku, Ja Hyeon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6819-6822
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    • 2014
  • Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

Comparative Study of Exposure Potential and Toxicity Factors used in Chemical Ranking and Scoring System (화학물질 우선순위선정 시스템에서 고려되는 노출.독성인자 비교연구)

  • An, Youn-Joo;Jeong, Seung-Woo;Kim, Min-Jin;Yang, Chang-Yong
    • Environmental Analysis Health and Toxicology
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    • v.24 no.2
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    • pp.95-105
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    • 2009
  • Chemical Ranking and Scoring (CRS) system is a useful tool to screen priority chemicals of large body of substances. The relative ranking of chemicals based on CRS system has served as a decision-making support tools. Exposure potential and toxicity are significant parameters in CRS system, and there are differences in evaluating those parameters in each CRS system. In this study, the parameters of exposure potential, human toxicity, and ecotoxicity were extensively compared. In addition the scoring methods in each parameter were analyzed. The CRS systems considered in this study include the CHEMS-1 (Chemical Hazard Evaluation for Management Strategies), SCRAM (Scoring and Ranking Assessment Model), EURAM (European Union Risk Ranking Method), ARET (Accelerated Reduction/Elimination of Toxics), and CRS-Korea. An comparative analysis of the several CRS systems is presented based on their assessment parameters and scoring methods.

A Study on the Safety Improvement of Buried Pipeline Using Scoring Model (Scoring Model을 이용한 매설배관 안전성 개선에 관한 연구)

  • Son, Myoung-Duck;Kim, Sung-Keun
    • KSCE Journal of Civil and Environmental Engineering Research
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    • v.37 no.1
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    • pp.175-185
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    • 2017
  • As the gas is manufactured, handled and used more often due to the continuous increase of gas, the related facility gets expanded and more complex causing small and big accident which causes economic loss including damage for humans and materials. The gas pipeline, the most common gas facility, has the biggest risk of accidents. Especially in the urban area and densely populated areas, the accident due to the high pressure pipeline may cause even more serious damages. To prevent the accident caused by the buried pipeline, it is required for the relevant authorities to evaluate the damage and risk of the whole pipeline system effectively. A risk is usually defined as a possibility or probability of an undesired event happening, and there is always a risk even when the probability of failure is set low once the pipeline is installed or under operation. It is reported that the accident caused by the failure of the pipeline rarely happens, however, it is important to minimize the rate of accidents by analyzing the reason of failure as it could cause a huge damage of humans and property. Therefore, the paper rated the risk of pipelines with quantitative numbers using the qualitative risk analysis method of the Scoring Model. It is assumed that the result could be effectively used for practical maintenance and management of pipelines securing the safety of the pipes.

Risk Scoring System for Software Vulnerability Using Public Vulnerability Information (공개 취약점 정보를 활용한 소프트웨어 취약점 위험도 스코어링 시스템)

  • Kim, Min Cheol;Oh, Sejoon;Kang, Hyunjae;Kim, Jinsoo;Kim, Huy Kang
    • Journal of the Korea Institute of Information Security & Cryptology
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    • v.28 no.6
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    • pp.1449-1461
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    • 2018
  • As the number of software vulnerabilities grows year by year, attacks on software are also taking place a lot. As a result, the security administrator must identify and patch vulnerabilities in the software. However, it is important to prioritize the patches because patches for all vulnerabilities are realistically hard. In this paper, we propose a scoring system that expands the scale of risk assessment metric by taking into consideration attack patterns or weaknesses cause vulnerabilities with the vulnerability information provided by the NIST(National Institute of Standards and Technology). The proposed scoring system is expanded based on the CWSS and uses only public vulnerability information to utilize easily for any company. In this paper, we applied the automated scoring system to software vulnerabilities, and showed the expanded metrics with consideration for influence of attack pattern and weakness are meaningful.