Diagnostic Hierarchy of Tic Disorders in Real-World Clinical Practice

성예지,홍순범 대한소아청소년 정신의학회 2023 소아청소년정신의학 Vol.34 No.4

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.

Automatic Adverb Error Correction in Korean Learners’ EFL Writing

김지은 한국콘텐츠학회 2009 International Journal of Contents Vol.5 No.3

This paper describes ongoing work on the correction of adverb errors committed by Korean learners studying English as a foreign language (EFL), using an automated English writing assessment system. Adverb errors are commonly found in learners’ writings, but handling those errors rarely draws an attention in natural language processing due to complicated characteristics of adverb. To correctly detect the errors, adverbs are classified according to their grammatical functions, meanings and positions within a sentence. Adverb errors are collected from learners’ sentences, and classified into five categories adopting a traditional error analysis. The error classification in conjunction with the adverb categorization is implemented into a set of mal-rules which automatically identifies the errors. When an error is detected, the system corrects the error and suggests error specific feedback. The feedback includes the types of errors, a corrected string of the error and a brief description of the error. This attempt suggests how to improve adverb error correction method as well as to provide richer diagnostic feedback to the learners.

Automatic Adverb Error Correction in Korean Learners' EFL Writing

Kim, Jee-Eun The Korea Contents Association 2009 International Journal of Contents Vol.5 No.3

This paper describes ongoing work on the correction of adverb errors committed by Korean learners studying English as a foreign language (EFL), using an automated English writing assessment system. Adverb errors are commonly found in learners 'writings, but handling those errors rarely draws an attention in natural language processing due to complicated characteristics of adverb. To correctly detect the errors, adverbs are classified according to their grammatical functions, meanings and positions within a sentence. Adverb errors are collected from learners' sentences, and classified into five categories adopting a traditional error analysis. The error classification in conjunction with the adverb categorization is implemented into a set of mal-rules which automatically identifies the errors. When an error is detected, the system corrects the error and suggests error specific feedback. The feedback includes the types of errors, a corrected string of the error and a brief description of the error. This attempt suggests how to improve adverb error correction method as well as to provide richer diagnostic feedback to the learners.

Automatic Adverb Error Correction in Korean Learners’ EFL Writing

Jee-Eun Kim 한국콘텐츠학회(IJOC) 2009 International Journal of Contents Vol.5 No.3

This paper describes ongoing work on the correction of adverb errors committed by Korean learners studying English as a foreign language (EFL), using an automated English writing assessment system. Adverb errors are commonly found in learners’ writings, but handling those errors rarely draws an attention in natural language processing due to complicated characteristics of adverb. To correctly detect the errors, adverbs are classified according to their grammatical functions, meanings and positions within a sentence. Adverb errors are collected from learners’ sentences, and classified into five categories adopting a traditional error analysis. The error classification in conjunction with the adverb categorization is implemented into a set of mal-rules which automatically identifies the errors. When an error is detected, the system corrects the error and suggests error specific feedback. The feedback includes the types of errors, a corrected string of the error and a brief description of the error. This attempt suggests how to improve adverb error correction method as well as to provide richer diagnostic feedback to the learners.

영상의학의 오류와 불일치는 불가피한 것인가 혹은 피할 수 있는 것인가? 중추신경계 증상으로 촬영한 뇌 자기공명영상에서 간과된 청신경 종양 4예

이승민(Seoung-Min Lee),전정배(Jeong-Bae Jeon),이동희(Dong-Hee Lee) 대한두개저학회 2020 대한두개저학회지 Vol.15 No.1

Diagnostic error can be defined as “diagnosis that was unintentionally delayed (sufficient information was available earlier), wrong (wrong diagnosis made before the correct one), or missed (no diagnosis ever made), as judged from the eventual appreciation of more definitive information”. According to previous studies, estimated rate of errors and discrepancies in radiology are 3%-5% of studies reported. In 2014, Kim and Mansfield published classification system for radiological error. Errors and discrepancies in radiologic finding are somewhat inevitable and evitable. However, its impact to patients may be significant on some disease entities. Diagnostic error can give health system mistrust and dissatisfaction from both patients and doctors. We report four cases of acoustic neuroma that was not diagnosed on brain magnetic resonance images by diagnostic radiologists but detected by otolaryngologist later. Authors suggest that it is better to improve patient safety and reduce diagnostic error for clinicians to review carefully the images that was taken for other reasons but included area of interest. Clinicians should review the images by themselves as well as read radiologist’s interpretation.

육안검사기술의 실무적 이해

Woo-Hyun JI 대한임상검사과학회 2024 대한임상검사과학회지(KJCLS) Vol.56 No.1

육안검사는 정확한 병리조직학적 진단을 위해 수술, 내시경검사에서 채취된 검체를 육안검사를 통해 암의 육안정보를 기록하고 병변은 현미경 표본을 만들기 위해 절편을 채취하는 행위이다. 육안검사의 기술은 간결하고 정확한 표현, 적절한 구조화, 충분한 절제, 중요정보에 대한 오류가 없는 표준화, 복잡한 검체의 사진 도표화가 이루어져야 한다. 병리학적 판독의 만족도를 높이기 위해서는 육안검사에 대한 이해가 충분한 이론적 실무적 바탕에서 신뢰를 얻기 위한 정확하고 신중히 수행해야 하는 업무이다. 육안검사 분야에서 임상병리사들의 경험을 바탕으로, 추가 표본 유형이 실행 가능한 후보로 식별되고 치료 측면에서요구와 우려 사항을 신중하게 고려해야 한다. 또한, 각 기관의 부서에서는 임상과의 파트너쉽, 지속적인 전문인력 양성, 진단오류 및 가치 기반의 의료제공에 대한 국가적 초점 측면에서 검토해야 할 것이다. Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.

Causes and Predictive Factors Associated with “Diagnosis Changed” Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

강병주,조경욱,박태선,유정완,이세원,최창민,오연목,이상도,김우성,김동순,심태선 대한결핵및호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the “diagnosis changed” rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: “diagnosis maintained”, “diagnosis changed” (initially notified as TB, but ultimately diagnosed as non-TB), and “administrative error” (notified as TB due to administrative errors). Results: Excluding 17 patients in the “administrative error” group, the “diagnosis maintained” and “diagnosis changed” groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of “diagnosis changed” were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn’s disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a “diagnosis changed” result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high “diagnosis changed” rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the “diagnosis changed” rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of “diagnosis changed” cases is desirable.

Causes and Predictive Factors Associated with "Diagnosis Changed" Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

Kang, Byung Ju,Jo, Kyung-Wook,Park, Tai Sun,Yoo, Jung-Wan,Lee, Sei Won,Choi, Chang-Min,Oh, Yeon-Mok,Lee, Sang-Do,Kim, Woo Sung,Kim, Dong Soon,Shim, Tae Sun The Korean Academy of Tuberculosis and Respiratory 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the "diagnosis changed" rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: "diagnosis maintained", "diagnosis changed" (initially notified as TB, but ultimately diagnosed as non-TB), and "administrative error" (notified as TB due to administrative errors). Results: Excluding 17 patients in the "administrative error" group, the "diagnosis maintained" and "diagnosis changed" groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of "diagnosis changed" were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn's disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a "diagnosis changed" result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high "diagnosis changed" rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the "diagnosis changed" rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of "diagnosis changed" cases is desirable.

Causes and Predictive Factors Associated with “Diagnosis Changed” Outcomes in Patients Notified as Tuberculosis Cases in a Private Tertiary Hospital

( Byung Ju Kang ),( Kyung Wook Jo ),( Tai Sun Park ),( Jung Wan Yoo ),( Sei Won Lee ),( Chang Min Choi ),( Yeon Mok Oh ),( Sang Do Lee ),( Woo Sung Kim ),( Dong Soon Kim ),( Tae Sun Shim ) 대한결핵 및 호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Background: The aim of our study was to evaluate the “diagnosis changed” rate in patients notified as tuberculosis (TB) on the Korean TB surveillance system (KTBS). Methods: A total of 1,273 patients notified as TB cases on the KTBS in one private tertiary hospital in 2011 were enrolled in the present study. Patients were classified into three groups: “diagnosis maintained”, “diagnosis changed” (initially notified as TB, but ultimately diagnosed as non-TB), and “administrative error” (notified as TB due to administrative errors). Results: Excluding 17 patients in the “administrative error” group, the “diagnosis maintained” and “diagnosis changed” groups included 1,097 (87.3%) and 159 patients (12.7%), respectively. Common causes of “diagnosis changed” were nontuberculous mycobacterial (NTM) disease (51.7%, 61/118), and pneumonia (17.8%) in cases notified as pulmonary TB, and meningitis (19.5%, 8/41) and Crohn`s disease (12.2%) in cases notified as extrapulmonary TB. Being older than 35 years of age (odds ratio [OR], 2.18) and a positive acid-fast bacilli stain (OR, 1.58) were positive predictors and a TB-related radiological finding (OR, 0.42) was a negative predictor for a “diagnosis changed” result via multivariate logistic regression analysis in pulmonary TB cases. Conclusion: Because of a high “diagnosis changed” rate in TB notifications to the KTBS, the TB incidence rate measured by the KTBS may be overestimated. Considering the worldwide trend toward increased NTM disease, the “diagnosis changed” rate may increase over time. Thus, when reporting the annual TB notification rate in Korea, the exclusion of “diagnosis changed” cases is desirable.

선천성장애아의 출생과 법정책의 과제 : 프랑스 특별법의 제정 동기 및 그 내용을 중심으로

문성제 한국장애인재활협회 2008 재활복지 Vol.12 No.1

In case a disabled baby is born due to a doctor’s insufficient explanation and his or her diagnostic errors in spite of a possibility that the pregnant woman may be infected with rubella and so on and she may give birth to a disabled baby, a problem of whether the doctor is liable for damage arises. The point is that damages can be claimed against the doctor if the pregnant woman’s right for self-determination is infringed by his or her medical error and a disabled baby who might have been aborted if she had known her embryo’s disability. Furthermore, the parents may have to bear educational and other medical expenses if the baby is brought up. In this case, damages can be claimed against the doctor who is responsible. Yet the legal circles in Korea have negative views on the civil liability of the doctor in case a disabled baby is born due to his or her medical error. In Korean, one cannot claim damages against a doctor because parents cannot legally abort their baby if the baby has Down’s syndrome, a disease that isn’t included among the reasons for artificial abortion that the Mother and Child Health Law provides even if the doctor doesn’t know the baby’s disability or deformity with a deformity test. In America, wrongful life action has long been argued: it relates to action when damages are claimed against doctors by the disabled baby on condition that he or she was born with disability by undesired birth or by the parents themselves in case they are devoid of sufficient information on the possibility of birth of disabled child in spite of prior notice or in case abortion fails. But it is doubtful whether Korea can stick to this attitude if a similar suit is instituted. For example, the French Cour de Cassation passed a legal judgement in November 17, 2000 on the basis of wrongful life in England, which was socially criticized. This judicial precedent is of great significant. Therefore this paper is aimed at finding a new way by comparing the problems of birth of disabled babies in Korea with the judgement of the French Cour de Cassation. 태아의 장애사실을 미리 알았더라면 임신중절을 하였을 장애아를 의사의 진료상의 과실로 이를 알지 못하여 임산부의 자기결정권이 침해된 경우 이에 대한 손해배상을 청구할 수 있는가. 더 나아가 이 같은 이유로 출생한 장애아를 부양함에 있어 그의 부모는 그에 상당하는 교육비용과 기타 의료비 등을 부담하게 되는데, 이 같은 원인을 제공한 의사에게 손해 비용을 청구할 수 있는가. 이와 같은 논의가 미국, 영국을 비롯하여 우리나라에서도 이미 이루어져 왔는데 대부분의 국가에서는 이를 부정하는 입장이다. 우리나라에서 부정하는 이유로 드는 것은, 태아의 기형여부 검사에 있어서 의료상의 과실로 장애나 기형사실을 미리 알아내지 못하였다 하더라도 신생아에게 나타난 증세가 다운 증후군일 경우 모자보건법에서 규정하고 있는 인공임신중절 사유에 해당하지 않아 부모가 적법하게 낙태할 수 없다는 이유로 의사의 손해배상을 인정할 수 없다는 것이 우리 법원의 입장이다. 그러나 이 같은 소송이 다시 제기될 경우 같은 입장을 계속 유지할 수 있을 지는 의문이다. 왜냐하면 2000년 11월 17일 프랑스 파기원 판결에서는 이 같은 주장에 반하는 판결이 있어 주목되기 때문이다. 따라서 이 글은 우리나라에서 장애아의 출산과 관련하여 나타나는 제 문제를 프랑스 파기원의 판결등과 비교하면서 향후 제기될 수 있는 문제에 대한 새로운 방향모색을 위하여 연구되었다.