• YAKHAK HOEJI
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• v.59 no.6
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• pp.278-283
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• 2015

The computerized prospective Drug Utilization Review (DUR) program supported by the Korean government has provided alerts to physicians and pharmacists since December 2010. This study aims to propose and apply the tiering system in "drug combinations to avoid (DCA)" and "age-precaution" alerts based on severity to improve the compliance of users. To propose the severity and clinical importance of 647 DCA alerts and 140 age precautions, a Delphi evaluation survey was conducted. An expert panel comprising 5 clinical pharmacists and 5 physicians were participated in mail surveys. Based on the results of Delphi survey, DCA pairs were classified into 3 groups; group 1 (70.6%), 2 (26.9%), and 3 (2.8%). Drug-age precaution ingredients were also classified into three groups; group 1 (53.6%), group 2 (40.7%), and group 3 (5.7%). When this grouping was applied to claim data from 2011 to 2013, the majority of alerts had occurred in the groups of high severity. Presenting DUR alerts with severity level is expected to improve the compliance of clinicians. The implementation of tiering system in DUR criteria should be considered.

• The Korean journal of internal medicine
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• v.33 no.6
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• pp.1203-1209
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• 2018

Background/Aims: Adverse drug reaction (ADR) is an appreciably harmful or unpleasant reaction, resulting from an intervention related to the use of a medicinal product. The present study was conducted in order to monitor the frequency and severity of ADR during antimicrobial therapy of septicemia. Methods: A prospective, observational, and noncomparative study was conducted over a period of 6 months on patients of septicemia admitted at a university hospital. Naranjo algorithm scale was used for causality assessment. Severity assessment was done by Hartwig severity scale. Results: ADRs in selected hospitalized patients of septicemia was found to be in 26.5% of the study population. During the study period, 12 ADRs were confirmed occurring in 9, out of 34 admitted patients. Pediatric patients experienced maximum ADRs, 44.4%. Females experienced a significantly higher incidence of ADRs, 66.7%. According to Naranjo's probability scale, 8.3% of ADRs were found to be definite, 58.3% as probable, and 33.3% as possible. A higher proportion of these ADRs, 66.7% were preventable in nature. Severity assessment showed that more than half of ADRs were moderate. Teicoplanin was found to be the commonest antimicrobial agent associated with ADRs, followed by gemifloxacin and ofloxacin. Conclusions: The incidence and severity of ADRs observed in the present study was substantially high indicating the need of extra vigilant during the antimicrobial therapy of septicemia.

• Journal of the Korean Society of Marine Environment & Safety
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• v.23 no.3
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• pp.217-223
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• 2017

In order to assess risk as a basic step for securing safety, it requires to select risk factors and determine the frequency and the severity of the consequence of each risk factor. This research adopted common risk factors among well-known maritime risk assessment models, and proposed objective criteria to gauge the risk level of each risk factor. The starting points of risk evolution were chosen for criteria according to related studies and seafarers' experience. The rate of risk appearance over the criteria is named as the incidence of risk factor. Therefore, the total risk level is expressed as the combination of incidence of each risk factor and severity. This quantitative method would be applied to measuring and comparing the risk level of target maritime zones, and it would also be useful to survey which risk factor be focused for reducing the total risk of a certain maritime zone.

• Smart Structures and Systems
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• v.2 no.2
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• pp.127-140
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• 2006

In this study, a wavelet-based covariance-driven system identification technique is proposed for damage assessment of structures under ambient excitation. Assuming the ambient excitation to be a white-noise process, the covariance computation is shown to be able to separate the effect of random excitation from the response measurement. Wavelet transform (WT) is then used to convert the covariance response in the time domain to the WT magnitude plot in the time-scale plane. The wavelet coefficients along the curves where energy concentrated are extracted and used to estimate the modal properties of the structure. These modal property estimations lead to the calculation of the stiffness matrix when either the spectral density of the random loading or the mass matrix is given. The predicted stiffness matrix hence provides a direct assessment on the possible location and severity of damage which results in stiffness alteration. To demonstrate the proposed wavelet-based damage assessment technique, a numerical example on a 3 degree-of-freedom (DOF) system and an experimental study on a three-story building model, which are all under a broad-band excitation, are presented. Both numerical and experimental results illustrate that the proposed technique can provide an accurate assessment on the damage location. It is however noted that the assessment of damage severity is not as accurate, which might be due to the errors associated with the mode shape estimations as well as the assumption of proportional damping adopted in the formulation.

• Journal of Korean Society for Quality Management
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• v.41 no.4
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• pp.623-635
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• 2013

Purpose: The recent major recalls of hazardous products caused consumer product safety acts to be strengthen worldwide. Although the recall system of hazardous products in Korea has been operating based on Framework Act on Product Safety since 2011, the evaluation of product risk has been relied on not the results of objective incident data but the results of illegal product investigations. The purpose of this paper is to propose a product risk assessment model for Korea using injury data. Methods: The authors derived Korea's risk assessment method by analysing the advantages and disadvantages of the most widely used models in advanced countries such as EU's RAPEX RAG and Janpan's R-MAP. In this study, the level of relative frequency and severity of injury are determined based on the objective incident data and the length of hospitalization respectively. In addition, the injury data occurred during 2011 is applied to the proposed risk assessment model for case study. Results: The data analysed in this paper can be classified as high risk, medium risk, low risk, acceptable risk, and safe products through the matrix f rom the combination of the relative frequency and the severity derived. Conclusion: The proposed risk assessment model in this study has advantage obtaining reliable objective results because it uses actual injury data and redeems the drawbacks of the existing models used in advanced countries. Furthermore, because the proposed model shows the high risk products among many, it is expected to be useful especially for customs whose main job is inspecting the imported goods and the government when selecting the target product groups for safety investigation.

• Journal of Korean Academy of Nursing
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• v.44 no.5
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• pp.542-551
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• 2014

Purpose: This study was done to examine the incidence of oral mucositis in hematopoietic stem cell transplantation patients and to identify factors influencing oral mucositis and patient outcomes according to severity. Methods: In this retrospective study, data were collected from electronic medical records of 222 patients who had received hematopoietic stem cell transplantation. Oral mucositis was evaluated using WHO's assessment scale. Data were analyzed using Chi-square test, Fisher exact test, Spearman's correlation, Ordinal logistic regression, ANOVA and Kruskal-Wallis test. Results: A total of 69.8% of the patients evaluated developed oral mucositis (grade II and over). As a results of ordinal regression, factors influencing oral mucositis severity were found to be diagnosis, type of transplantation, oxygen inhalation and the number of antiemetics administration before transplantation. The severity of oral mucositis was found to increase the days of hospitalization, days of TPN administration, days of using antibiotics and the number and dosage of analgesics. Conclusion: The results would help predict severity of oral mucositis in hematopoietic stem cell transplantation patients and suggest that provision of appropriate nursing assessment and oral care would improve patient outcomes.

• Proceedings of the KSR Conference
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• 2007.11a
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• pp.1529-1532
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• 2007

Failure Mode, Effects, and Criticality Analysis (FMECA) is an extension of FMEA which includes a criticality analysis. The criticality analysis is used to chart the probability of failure modes against the severity of their consequences. The result highlights failure modes with relatively high probability and severity of consequences, allowing remedial effort to be directed where it will produce the greatest value. However, there are several limitations. Measuring severity of failure consequences is subjective and linguistic. Since The result of FMECA only gives qualitative and quantitative informations, it should be re-analysed to prioritize critical units. Fuzzy set theory has been introduced by Lotfi A. Zadeh (1965). It has extended the classical set theory dramatically. Based on fuzzy set theory, fuzzy logic has been developed employing human reasoning process. IF-THEN fuzzy rule based assessment approach can model the expert's decision logic appropriately. Fault tree analysis (FTA) is one of most common fault modeling techniques. It is widely used in many fields practically. In this paper, a simple fault tree analysis is proposed to measure the severity of components. Fuzzy rule based assessment method interprets linguistic variables for determination of critical unit priorities. An rail-way transforming system is analysed to describe the proposed method.

• Journal of the Korean Society of Safety
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• v.31 no.1
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• pp.1-6
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• 2016

Severity and frequency of industrial accidents are typically used to assess the "absolute" risk associated with the industrial machines and devices ("items") which are subject to safety certification or self-declaration of conformity. However, the "relative" risk associated with a particular item can further be assessed based on unit severity and unit frequency where the total number of item in use is taken into account. This study first attempts to estimate the total number of each item in use which was recently selected for safety certification or self-declaration of conformity. The appropriateness of such selection is recapitulated based on the relative risk involved. Analysis results indicate that depending on items, the relative risk is differentiated from the absolute risk. Recent selection of items for safety certification or self-declaration of conformity is then revisited for its validity. The relative risk based on unit severity and unit frequency of industrial accidents, together with the absolute risk, may be used to further categorize items for safety certification or self-declaration of conformity in the future.

• Proceedings of the KSRS Conference
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• 2003.11a
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• pp.328-330
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• 2003

The land cover of burned area has changed dramatically since Daxinganling forest fire in Northeastern China during May 6 ? June 4, 1987. This research focused on determining the burn severity and assessment of forest recovery. Burned severity was classified into three levels from June 1987 Landsat TM data acquired just after the fire. A regression model was established between the forest canopy closure from 1999 forest stand map and the NDVI values from June 2000 Landsat ETM+ data. The map of canopy closure was got according to the regression model. And vegetation cover was classified into four types according to forest closure density. The change matrix was built using the classified map of burn severity and vegetation recovery. Then the change conversions of every forest type were analyzed. Results from this research indicate: forest recovery status is well in most of burned scars; and vegetation change detection can be accomplished using postclassification comparison method.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.244-252
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• 2001

Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.