• Journal of Oral Medicine and Pain
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• v.41 no.3
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• pp.91-98
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• 2016

Purpose: Oral lichen planus (OLP) has generated many discussions and been associated with much controversy for a long time. A reliable diagnosis of OLP has proven challenging and significant disagreements concerning its diagnosis has continued. Therefore, the aim of this study was to apprehend newly proposed diagnostic criteria of OLP and oral lichenoid lesion (OLL) and to evaluate difference of final diagnosis of OLP and OLL in accordance with type of diagnostic criteria. Also, direct immunofluorescence (DIF) was compared to evaluate the value of DIF between two groups. Methods: Fifty-two patients with DIF result were retrospectively reviewed. The selected patients were classified by the modified World Health Organization (WHO) diagnostic criteria of OLP and OLL and by criteria proposed by American Academy of Oral and Maxillofacial Pathology (AAOMP). Results of DIF in OLP and OLL were classified by deposition intensity or pattern of fibrinogen. The classification of fluorescence pattern in each specimen was graded as positive, possibly positive or negative. Results: Patients diagnosed as OLP were a few more when the modified WHO diagnostic criteria were used than when criteria proposed by AAOMP were used. There was no statistical difference of DIF between OLP and OLL by applying the WHO modification criteria or criteria proposed by AAOMP. Conclusions: The final diagnosis of OLP could be changed in accordance with type of diagnostic criteria and difference of DIF between OLP and OLL was not found.

• The Journal of Internal Korean Medicine
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• v.33 no.1
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• pp.1-13
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• 2012

Background : In oriental medicine, the status of the tongue is an important indicator to diagnose the condition of one's health, such as physiological and the clinicopathological changes of internal organs. A tongue diagnosis is not only convenient but also non-invasive, and therefore widely used in Oriental medicine. However, the tongue diagnosis is greatly affected by examination circumstances, patient's posture, and doctor's diagnosis criteria. Objectives : This study was designed to assure the necessity for standardization of tongue diagnosis based on diagnostic criteria of tongue coating thickness (TCT). Methods : Thirty tongue photographs were acquired and analyzed by digital tongue diagnosis system (DTDS) which measured the percentage of TCT on the tongue surface. Fifteen oriental medical doctors evaluated TCT in 30 photographs. Afterward, the 15 assessors were trained for diagnostic criteria of TCT and evaluated the photographs again. The intraclass correlation coefficient (ICC) was used to obtain the agreement rate among the 15 assessors and the agreement rate between assessors' TCT scores and DTDS values. Results : The agreement rate among the 15 assessors after training was higher than before training. The agreement rate between assessors' TCT scores and DTDS values after training was also higher than before training. Furthermore, the difference of the agreement rate between before and after training was significant (p<0.05). Conclusions : The standardization of diagnostic criteria of TCT increased the agreement rate among the assessors and the agreement rate between assessors' TCT scores and DTDS values. Therefore, the standardization of diagnostic criteria is expected to contribute to the objectification and quantification of the tongue diagnosis system.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.2
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• pp.118-126
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• 2018

Purpose: Classical criteria for diagnosis of autoimmune hepatitis (AIH) are intended as research tool and are difficult to apply at patient's bedside. We aimed to study the accuracy of simplified criteria and the concordance with the expert diagnosis based on the original criteria. Methods: A cohort of children under study for liver disorder was selected through consecutive sampling to obtain the prevalence of AIH within the group of differential diagnoses. AIH was defined, based on classical criteria, through committee review of medical reports. Validity indicators of the simplified criteria were obtained in an intention to diagnose approach. Optimal cut-off and the area under the receiver operating characteristic (ROC) curve were calculated. Results: Out of 212 cases reviewed, 47.2% were AIH. For the optimal cut-off (6 points), the simplified criteria showed a sensitivity of 72.0% and a specificity of 96.4%, with a 94.7% positive and a 79.4% negative predictive value. The area under the ROC curve was 94.3%. There was a good agreement in the pre-treatment concordance between the classical and the simplified criteria (kappa index, 0.775). Conclusion: Simplified criteria provide a moderate sensitivity for the diagnosis of AIH, but may help in indicating treatment in cases under suspicion with 6 or more points.

• Journal of the Korean neurological association
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• v.36 no.4
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• pp.273-279
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• 2018

Multiple sclerosis (MS) is a diagnosis of exclusion and the lesions or objective findings should disseminate in space and time to diagnose MS. The diagnostic criteria of MS have continuously evolved overtime. The McDonald criteria were originally proposed in 2001, and the revised 2010 McDonald criteria have been used widely. Scientific advances in the past 7 years since 2010 induced the revised 2017 McDonald criteria. All revisions relied entirely on the available evidences, and not expert opinion. In this review, we will provide an overview of the way to diagnose MS and the 2017 McDonald criteria.

• Journal of Physiology & Pathology in Korean Medicine
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• v.17 no.4
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• pp.845-851
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• 2003

The objective is to establish the standard of criteria for differential diagnosis of signs and symptoms. This study selected signs and symptoms related to heart which stands for Fire(火) as a kind of five phase(五行). Eleven experts was asked to evaluate the adequateness of criteria which was developed by Korea Institute of Oriental Medicine(KIOM) and to suggest the amendment of them. To implement the study, we used the questionnaire which asks about the diagnosis criteria for an insufficiency of the heart-qi(心氣虛證), deficiency of the heart blood(心血氣證), deficiency of the heart-yin(心陰虛證), insufficiency of the heart-yang(心陽虛證), exuberant fire due to hyperactivity of the heart(心火亢盛證), stagnation of the heart blood(心血瘀阻證), heart disturbed by phlegm-fire(痰火擾心證), attack of the heart by retainedfluid(水氣凌心證). Every criteria consists of primary symptoms, secondary symptoms, tongue findings. and pulse findings. In perspectives of the classification of patterns for signs and symptoms and criteria for diagnosis, the result shows that the previous standard doesn't have so many problem. So many of experts were agree with the criteria which was suggested but the trend is that they use, in their actual practice, less than the criteria. Additionally, they pointed that every element in a criterion should have the different weight value, criteria for the overlapped pattern should be added, and, in future, criteria which are based on clinical investigation should be established.

• The Korean Journal of Pain
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• v.25 no.3
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• pp.173-182
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• 2012

Background: Fibromyalgia (FM) is characterized by chronic widespread pain with a low pain threshold. The aim of this study was to compare two criteria for the diagnosis and assessment of FM and to analyze the correlation and agreement between the 1990 and 2010 American College of Rheumatology (ACR) preliminary diagnostic criteria for FM. Methods: We studied 98 patients who had already been diagnosed as having FM using the 1990 criteria or 2010 preliminary criteria. Tender point examination, FM impact questionnaire (FIQ) and pain visual analog scale (VAS) were obtained. According to the preliminary criteria, FM was quantified as WPI (widespread pain index) and the SS scale (symptom severity) and the two criteria were compared. Results: Among 98 patients, 78.6% of the patients were diagnosed with the 1990 ACR criteria and 93.9% of the patients were diagnosed with the ACR preliminary diagnostic criteria, and there was also significant agreement between the two criteria (P < 0.01). There was a correlation with the WPI and the tender point, with the SS and the FIQ, and with the sum of the WPI and SS and the FIQ. Conclusions: The ACR preliminary diagnostic criteria for FM were in agreement with the 1990 ACR criteria during the disease course. The preliminary criteria were the more sensitive method than the 1990 criteria. In addition, the 2010 criteria might have advantages since it is easy to assess the physical and psychological symptoms and can be quantified. Therefore, the ACR preliminary diagnostic criteria for FM could be used more conveniently for clinical diagnosis and follow up evaluation after starting management of FM.

• Journal of the Korea institute for structural maintenance and inspection
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• v.22 no.4
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• pp.37-41
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• 2018

Recently, interest in the safety and maintenance of the structures is growing. However, due to the low-cost order placed by the ordering organization, the safety diagnosis specialized institution becomes insolvent and many problems have arisen due to insufficient inspection and diagnosis. Therefore, in this study, the current status of bid cost was examined through the survey of the practitioners and case analysis. As a result, Precision safety inspection is deemed that it is necessary to increase the efficiency of the criteria cost and to strengthen the rigidity of the criteria cost rather than adjusting the criteria cost. Precision safety diagnosis, the criteria cost for structures with a floor area of less than $10,000m^2$ is lowered to 80 % from the current standard. For structures larger than that, the current criteria cost are applied, but it is deemed necessary to strengthen the rigidity of the criteria cost.

• Proceedings of the KOSOMBE Conference
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• v.1990 no.05
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• pp.13-16
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• 1990

This paper describes a software algorithm for automatic diagnosis of arrhythmia using the criteria of Minnesota code manual. This algorithm represents more accurate and more objective information to medical doctor by standardizing the criteria of diagnosis of arrhythmia. Because this algorithm doesn't need complicated mathematic processing, it carries out the real-time automatic diagnosis that is very important in clinic. The Decision-Table technology suggests the proper results for the given conditions. So it expresses the complicated medical problems simply and clearly, those are not solved by the mathematical methods. The Decision-Tables have very simple structure and so it is very easy to correct or expand the system by adding or correcting some rules.

• Journal of Biomedical Engineering Research
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• v.11 no.1
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• pp.171-178
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• 1990

This paper describes a software algorithm for automatic diagnosis of arrhythmia using the criteria of Minnesota code manual. This algorithm provides more accurate and more objective information to medical doctor by standardizing the criteria of diagnosis of arrhythmia. Because this algorithm doesn't need complicated mathematic processing, it carries out the real-time automatic diagnosis that is very important in clinic. The Decision-Table technology suggests the proper results for the given conditions. So it can express clearly the complicated medical problems those are not solved by the mathematical methods. The Decision-Tables have very simple structure. Therefore, it is very easy to correct or expand the system by adding or correcting some rules.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.4
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• pp.178-184
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• 2018

Objectives: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). Methods: We retrospectively reviewed the medical records of 170 subjects (age range: 3-23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. Results: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. Conclusion: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.