내측 측두엽 위축의 T1-축영상 시각 척도제안: Schelten의 관영상 시각척도와 비교연구

김건하,권현지,고승아,김정은,박기덕,최경규,임기호,이종민,나덕렬,정지향 대한치매학회 2009 Dementia and Neurocognitive Disorders Vol.8 No.1

Background: Medial temporal atrophy (MTA) is the earliest pathological characteristic and a sensitive biologic marker for Alzheimer’s disease. The Schelten’s coronal visual rating scale has been commonly used for assessing MTA. But sometimes it has been difficult to apply Schelten’s coronal visual rating scale in large epidemiologic studies because it needs more sophisticated knowledge of hippocampal anatomy of each raters. The purposes of this study is to 1) suggest a new and easier visual rating scale using T1 axial images, 2) compare visual assessment of MTA using modified T1-coronal Schelten’s visual rating scale with T1-axial visual rating scale, and 3) test whether the degree of MTA in T1-axial visual rating scale correlates with the severity of cognitive impairment. Methods: Participants were 27 Alzheimer’s patients (23 women, 4 men) and 26 non-demented normal control (18 women, 8 men). Two neurologists blinded to diagnosis and age of the subjects assessed MTA by axial visual rating scale which assessed for the maximal hippocampal width and parahippocampal cerebrospinal fluid space. Intra-rater and inter-rater reliability were obtained. Hippocampal volume was assessed by manual tracing in 5 participants representing each visual axial grade. Results: The visual rating scale using T1-axial image was comparable to T1-coronal visual rating scale, showing significant agreement (kappa=0.745, p< 0.001). Inter-and intra-rater reliability in T1-axial visual rating scale of MTA was higher than those in Schelten’s T1-coronal visual rating scale. The degree of MTA in T1 axial visual rating scale showed negative correlation with MMSE (r=-0.460, p<0.001) and clinical dementia rating scale (sum of box) (r=0.563, p<0.001). Hippocampal volume tended to decrease according to visual axial grade. Conclusions: The T1-axial visual rating scale of MTA showed good agreement with Schelten’s T1-coronal visual rating scale and cognitive functions. Inter-and intra-rater reliability for T1-axial visual rating scale of MTA was higher than those of Schelten’s T1-coronal visual rating scale, which suggests of possibilities of application for axial visual rating scale in clinical practice. The correlation of degree of MTA in T1- axial visual rating scale with hippocampal volume should be studied in large number of subjects. Background: Medial temporal atrophy (MTA) is the earliest pathological characteristic and a sensitive biologic marker for Alzheimer’s disease. The Schelten’s coronal visual rating scale has been commonly used for assessing MTA. But sometimes it has been difficult to apply Schelten’s coronal visual rating scale in large epidemiologic studies because it needs more sophisticated knowledge of hippocampal anatomy of each raters. The purposes of this study is to 1) suggest a new and easier visual rating scale using T1 axial images, 2) compare visual assessment of MTA using modified T1-coronal Schelten’s visual rating scale with T1-axial visual rating scale, and 3) test whether the degree of MTA in T1-axial visual rating scale correlates with the severity of cognitive impairment. Methods: Participants were 27 Alzheimer’s patients (23 women, 4 men) and 26 non-demented normal control (18 women, 8 men). Two neurologists blinded to diagnosis and age of the subjects assessed MTA by axial visual rating scale which assessed for the maximal hippocampal width and parahippocampal cerebrospinal fluid space. Intra-rater and inter-rater reliability were obtained. Hippocampal volume was assessed by manual tracing in 5 participants representing each visual axial grade. Results: The visual rating scale using T1-axial image was comparable to T1-coronal visual rating scale, showing significant agreement (kappa=0.745, p< 0.001). Inter-and intra-rater reliability in T1-axial visual rating scale of MTA was higher than those in Schelten’s T1-coronal visual rating scale. The degree of MTA in T1 axial visual rating scale showed negative correlation with MMSE (r=-0.460, p<0.001) and clinical dementia rating scale (sum of box) (r=0.563, p<0.001). Hippocampal volume tended to decrease according to visual axial grade. Conclusions: The T1-axial visual rating scale of MTA showed good agreement with Schelten’s T1-coronal visual rating scale and cognitive functions. Inter-and intra-rater reliability for T1-axial visual rating scale of MTA was higher than those of Schelten’s T1-coronal visual rating scale, which suggests of possibilities of application for axial visual rating scale in clinical practice. The correlation of degree of MTA in T1- axial visual rating scale with hippocampal volume should be studied in large number of subjects.

주요우울증, 정신분열증 및 조증환자들이 호소하는 신체증상에 따른 자기보고척도 간의 비교

이규환,김대진,전태연 大韓神經精神醫學會 1994 신경정신의학 Vol.33 No.6

This study was designed to examine and compare the various self-rating scale scores of major depressives, schizophrenics and manics according to the somatic symptoms. The subjects consisted of 78 psychiatric inpatients(major depressives, 35 ; schizophrenics, 30 ; manics, 13) who were admitted to the Department of Psychiatry in the Kang Nam St. Mary's Hospital, TaeJon St. Mary's Hospital, St. Vincent's Hospital, and St. Andrew's Neuropsychiatric Hospital from September 1990 to June 1991. For the purpose of the assessment of somatic symptoms, the patients completed the questionaire that comprised 31 questions about somatic symptoms derived from somatization disorder by DSM-III-R diagnostic criteria. The patients were classified into two groups with higher scores or lower scores of somatic symptoms according to the cut-off point of the median number. And the patients also completed the self-rating scales such as Self-Rating Anxiety Scale, Self-Rating Depression Scale, Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. The self-rating scale scores were compared between the two groups by somatic symptoms. The results were as follows : 1) When the scores of Self-Rating Anxiety Scale and Self-Rating Depression Scale were compared among the groups of major depressives, Schizophrenics and manics, the group of major depressives significantly rated themselves as most depressed, and the groups of anxious and manics significantly rated themselves as least depressed and anxious. And in Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale, manics rated the factor of "day dreaming" as significantly lower and the factor "ability to describe feelings" as significantly higher than major depressives. And, the factor "ability to identify and distinguish between feelings and bodily sensation" was rated less both in major depressives and schizophrenics than in manics. 2) Generally, the more somatic group rated themselves as higher in Self-Rating Anxiety Scale scores and Self-Rating Depression Scale scores than the less somatic group, but the two groups did not show significant difference in Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. This might suggest that somatic symptoms of the patients were attributable to their depressive and anxiety equivalents rather than alexithymic trait. 3) For the major depressives and schizophrenics, the more somatic group rated themselves as higher than the less somatic group in Self-Rating Anxiety and Self-Rating Depression Scale, but the two groups did not show significant difference in Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale. 4) For the manics, two groups didn't show significant difference in any of the scales. The above results suggest that Self-Rating Anxiety Scale and Self-Rating Depression Scale would be more useful for evaluation of somatic of psychiatric inpatients than Schalling-Sifneos Personality Scale and Toronto Alexithymia Scale.

Current Use of Depression Rating Scales in Mental Health Setting

EunJeong Lee,JungBum Kim,ImHee Shin,KyungHee Lim,SangHee Lee,GyungAh Cho,HyungMo Sung,SungWon Jung,Mark Zmimmerman,Yanghyun Lee 대한신경정신의학회 2010 PSYCHIATRY INVESTIGATION Vol.7 No.3

Objective-This study was to investigate the current use of depression rating scales by psychiatrists and clinical psychologists in Korea. Methods-The questionnaires from many psychiatrists and clinical psychologists were included in the analysis. The questionnaire was composed of items about examining the percentage of patients clinically using depression rating scales, reasons for not use of them, the degree of satisfaction, the perceived agreement rate between the result of depression rating scales and doctor’s clinical interview in the evaluation of patients with depressive symptoms. Data were analyzed by χ2 and independent t-test. Results-The clinical use of depression rating scales was more frequent in the psychologists than in the psychiatrists. The purposes for using depression rating scales were assessed into six areas, there was no significant difference in between two groups, and both groups po-inted out their purpose as rating of severity and screening. The reasons for not using scales were that their interview may be sufficient for diagnosis and assessment of depressive patients and they are not familiar with the use of depression rating scales. The psychiatrists usually prefer the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale and Symptom Checklist 90-Revision (SCL-90-R) in order of frequency, and the clinical psychologists are more likely to use the BDI, Minnesota Multiphasic Personality Inventory and SCL-90-R. Overall rate of satisfaction in the use of the scales was 67.29±14.45% and overall perceived agreement rate was 70.89±16.45%. Conclusion-Currently used depression rating scales at the clinical practice were not various. Therefore, to heighten clinicians’ utility of these depression rating scales measures, either educational efforts or advertisements, or both, will be necessary to spread them wildly.

아동 및 청소년을 위한 참여와 환경 평가(Participation and Environment Measure-Children and Youth)의 평정척도 분석 연구

정윤화,홍덕기 대한작업치료학회 2019 대한작업치료학회지 Vol.27 No.4

목적 : 본 연구는 라쉬모델을 적용하여 아동 및 청소년을 위한 참여와 환경평가(Participation andEnvironment Measure-Children and Youth; PEM-CY)의 평정척도를 개발하고자 하였다. 연구방법 : 5~13세 비장애 및 장애 아동을 양육하는 부모 184명을 대상으로 PEM-CY의 자료를 수집하였다. 원 자료는 라쉬모델을 적용하여 PEM-CY의 가정, 학교 및 지역사회 영역 척도(참여빈도, 몰입도,환경적 촉진/방해요인)에 대한 평정척도 분석을 실시하였다. 결과 : 참여빈도 7점 척도는 가정 영역에서 3점 척도, 학교 및 지역사회 영역에서 4점 척도가 적합하였다. 몰입도 5점 척도는 가정, 학교 및 지역사회 영역 모두 3점 척도가 적합하였다. 환경적 촉진/방해요인 3점 척도는 모든 영역에서 적합한 것으로 분석되었으나, 4점 척도는 학교 영역에서만 적합하였으며, 가정및 지역사회 영역에서는 3점 척도가 적합한 것으로 분석되었다. 결론 : 라쉬모델을 적용하여 PEM-CY의 영역별 측정 변수에 따른 평정척도를 개발하였다. 새롭게 개발한PEM-CY의 평정척도가 평가 과정에서 유용하게 적용되길 기대하며, 향후에는 다양한 대상자 및 인구학적 특성을 고려하여 활동참여 양상 및 환경적 촉진/방해 요인에 대한 연구가 필요하다. Objective: The aim of this study was to develop a rating scale of the Korean Participation and Environment Measurefor Children and Youth (KPEM-CY) by applying the Rasch model. Methods: The KPEM-CY data were collected from 184 parents of children 5 to 13 years in age. The KPEM-CYrating scales (participation frequency, involvement, and environmental support/barriers at home, school, and in thecommunity) were analyzed using the Rasch model. Results: The results of the Rasch model showed that it is appropriate to change the 7-point rating scale of homeparticipation frequency to a 3-point rating scale and the 7-point school and community frequency rating scales to4-point rating scales. In terms of the involvement rating scale under three settings, it was considered suitable tochange from a 5-point to a 3-point rating scale. In addition, the 3-point rating scales of environmentalsupport/barriers under three settings were deemed reasonable. However, the 4-point rating scales of theenvironmental support/barriers at home and under a community setting need to be changed into 3-point ratingscales. Conclusion: The KPEM-CY rating scale was developed based on measurement variables using the Rasch model, andcan be applied for an occupational therapy evaluation. It is necessary to analyze the participation patterns ofchildren and the environmental support/barriers according to demographic characteristics and environmentalfactors.

한의학적 슬통 평가 척도 개발 및 타당성 평가

이은솔,오지윤,유아미,이은용,김은정,이승덕,김갑성 대한침구의학회 2013 대한침구의학회지 Vol.30 No.5

Objjectives : This study is performed to develop the oriental medical rating scale of knee painand to assess its validity. Methods : 250 knee pain patients completed the previously accepted rating scale of kneepain(VAS, WOMAC(pain, function, stiffness), 6 minute walk test(number of steps, distance)) andoriental medical rating scale of knee pain which was developed by Hwang et al at 2012,before and after the 6 weeks acupuncture treatment. Comparing these results, we assessedthe validity of oriental medical rating scale. Results : Comparing oriental medical rating scale of knee pain before acupuncture treatmentwith VAS, WOMAC(pain, function, stiffness) and 6 minute walk test(number of steps, distance),oriental medical rating scale showed correlation with VAS, WOMAC(pain, function, stiffness)and showed the highest correlation with WOMAC(function). Comparing the change of orientalmedical rating scale of knee pain after 6 weeks of acupuncture treatment with the change ofVAS, WOMAC(pain, function, stiffness) and 6 minute walk test(number of steps, distance) after6 weeks, change of oriental medical rating scale showed correlation with the change of VAS,WOMAC(pain, function, stiffness) and showed the highest correlation with the change ofWOMAC(function). Through factor analysis of oriental medical rating scale items, 4 factors(pain,swelling, deformation of the knee, thermal sense of the knee), 17 items were extracted. Conclusions : Oriental medical rating scale of knee pain reflected the patient’s pain, functionallimitation and stiffness well. And oriental medical rating scale reflected the patient’s functionalimprovement after the treatment well.

대학 영작문 수업에서 EBB 평가척도의 환류효과

이영주 한국중등영어교육학회 2018 중등영어교육 Vol.11 No.2

This study investigated the washback effect of the EBB rating scale in writing classes. Specifically, this study explored college students’ perceptions of the EBB rating scale, in comparison with the holistic rating scale. The participants were college students taking the academic writing course and they completed the survey right after evaluating their essays using the holistics rating scale as well as the EBB rating scale. The survey results showed that a majority of students perceived the EBB rating scale useful in checking out the mastery of overall lesson objectives. It was also found that students had different perceptions of usefulness of the EBB rating scale according to different background information such as TOEIC scores and self-assessment of English proficiency. Students with TOEIC scores below 500 thought that using the EBB rating scale made them grasp the overall lesson objectives. Also, students who self-assessed their English proficiency low perceived that the EBB rating scale was useful in diagnosing their own writing weaknesses and comprehending criterial questions. The findings can provide practical implications of the EBB rating scale for writing courses, which also can serve as a valuable reference for course planners in similar contexts.

아동 및 청소년을 위한 참여와 환경 평가(Participation and Environment Measure-Children and Youth)의 평정척도 분석 연구

정윤화,홍덕기 대한작업치료학회 2019 대한작업치료학회지 Vol.27 No.5

목적 : 본 연구는 라쉬모델을 적용하여 아동 및 청소년을 위한 참여와 환경평가(Participation and Environment Measure-Children and Youth; PEM-CY)의 평정척도를 개발하고자 하였다. 연구방법 : 5~13세 비장애 및 장애 아동을 양육하는 부모 184명을 대상으로 PEM-CY의 자료를 수집하 였다. 원 자료는 라쉬모델을 적용하여 PEM-CY의 가정, 학교 및 지역사회 영역 척도(참여빈도, 몰입도, 환경적 촉진/방해요인)에 대한 평정척도 분석을 실시하였다. 결과 : 참여빈도 7점 척도는 가정 영역에서 3점 척도, 학교 및 지역사회 영역에서 4점 척도가 적합하였다. 몰입도 5점 척도는 가정, 학교 및 지역사회 영역 모두 3점 척도가 적합하였다. 환경적 촉진/방해요인 3 점 척도는 모든 영역에서 적합한 것으로 분석되었으나, 4점 척도는 학교 영역에서만 적합하였으며, 가정 및 지역사회 영역에서는 3점 척도가 적합한 것으로 분석되었다. 결론 : 라쉬모델을 적용하여 PEM-CY의 영역별 측정 변수에 따른 평정척도를 개발하였다. 새롭게 개발한 PEM-CY의 평정척도가 평가 과정에서 유용하게 적용되길 기대하며, 향후에는 다양한 대상자 및 인구학 적 특성을 고려하여 활동참여 양상 및 환경적 촉진/방해 요인에 대한 연구가 필요하다. Objective: The aim of this study was to develop a rating scale of the Korean Participation and Environment Measure for Children and Youth (KPEM-CY) by applying the Rasch model. Methods: The KPEM-CY data were collected from 184 parents of children 5 to 13 years in age. The KPEM-CY rating scales (participation frequency, involvement, and environmental support/barriers at home, school, and in the community) were analyzed using the Rasch model. Results: The results of the Rasch model showed that it is appropriate to change the 7-point rating scale of home participation frequency to a 3-point rating scale and the 7-point school and community frequency rating scales to 4-point rating scales. In terms of the involvement rating scale under three settings, it was considered suitable to change from a 5-point to a 3-point rating scale. In addition, the 3-point rating scales of environmental support/barriers under three settings were deemed reasonable. However, the 4-point rating scales of the environmental support/barriers at home and under a community setting need to be changed into 3-point rating scales. Conclusion: The KPEM-CY rating scale was developed based on measurement variables using the Rasch model, and can be applied for an occupational therapy evaluation. It is necessary to analyze the participation patterns of children and the environmental support/barriers according to demographic characteristics and environmental factors.

위험군 영아에 대한 발달 평가: 한국 Bayley 영 유아 발달검사의 행동평정 척도를 중심으로

오명호,이인규,이희정 한국심리학회 산하 한국발달심리학회 2005 한국심리학회지 발달 Vol.18 No.1

This study was designed to explore behavior and developmental evaluation in preterms at risk, full-terms at risk, and normal infants. Specifically the purposes of the study were to investigate behavior rating scale based on Korean Bayley Scales of Infant Development-Ⅱ(K-BSID-Ⅱ)(2004). The subjects were 116 infants, 39 preterms at risk infants, 38 full-terms at risk infants and 39 normal infants. The data were analyzed through Kruskal-Wallis, a correlation and multiple regrression test to examine the behavioral ratings. It was shown that there were significant differences among three groups in attention/arousal, orientation/engagement and motor quality and the sum of the behavior rating scale. In the terms of behavior rating scale, mental developmental index and psychomotor developmental index, preterms at risk-, full-terms at risk-, and normal infants showed substantial corrrelations to each other. There were some differences on the behavior rating scale depending on the age of the subjects. For the infants of 1 to 5 months of age, mental development index and pyschomotor develpoment index are correlated while behavior rating scale and psychomotor development index are correlated for the infants of 6 to 12 months of age. Authors discussed in terms of canalization theory and future infant developmental study. 본 연구는 평균 연령 5.6개월의 일반아 39명, 미숙 위험아 38명 및 만삭 위험아 39명의 행동과 발달을 소아과 의사와 심리학자간 다 학제적 접근을 통하여 비교하고자 한 탐색적 연구이다. 측정도구로는 한국 Bayley 영 유아 발달검사(2004)의 인지척도와 동작 척도 및 행동 평정 척도(Behavior Rating Scale: BRS)를 사용하였다. 1-5개월 및 6-12개월 영아에 대하여 각 집단별 인지 지수와 동작지수 및 행동평정 척도에서의 주의/각성 척도, 과제 지향성 척도, 정서 조절 척도와 동작 수준 척도를 비교하였으며, 행동 평정 척도와 인지 및 동작 지수 간 상관 관계와 행동평정 척도 총점을 설명하는 변인을 측정하였다. 그 결과, 1-5개월 영아의 경우, 인지 및 동작 지수, 주의/각성, 동작 수준 및 행동평정 총점에서 집단 간 차이가 나타났으며, 6-12개월 영아의 경우, 인지 및 동작 지수, 과제 지향성, 동작 수준과 행동평정 척도 총점에서 집단 간 차이가 나타났다. 행동평정척도는 1-5개월 및 6-12개월 각각에서 집단별 인지 지수와 동작 지수와의 관련성도 높게 나타났다. 1-5개월 행동평정 척도를 설명하는 변인은 인지 지수와 동작 지수였으며, 6-12개월 행동평정 척도를 설명하는 변인은 동작 지수였다. 이상의 결과로 토대로 이론적 및 방법론적 추후 연구에 관하여 논의하였다.

지체장애인에 대한 보조공학 기기만족 척도의 평정척도 최적화

양현규 한국직업재활학회 2016 職業再活硏究 Vol.26 No.2

The purpose of this study was to optimize the rating scale of the assistive technology device satisfaction scale for people with physical disabilities. The raw data to be analyzed was obtained from the 2013 survey for satisfaction of assistive technology service, which was conducted by Korea Employment Agency for the Disabled(KEAD). The assistive technology device satisfaction data for 171 people with physical disabilities were extracted from the raw data and used to verify how well 5-point rating scale fits the Rasch rating scale model. Based on the results, the new structures of categories were searched by collapsing rating scale categories, which are likely to provide the most meaningful information and improve the quality of measurement taking place with the data. And then Rasch measurement analyses were performed to find the new structure of categories which best optimizes the use of the rating scale. The results of these analyses were as follows. First, it was found that the original 5-point scale was not acceptable with some fit problems. Second, the 4-point scale with categories 1 and 2 collapsed was considered optimal for people with physical disabilities. Based on the results, the future directions of the researches on the rating scale optimization were suggested. 본 연구는 지체장애인에 대한 보조공학 기기 만족 척도의 평정척도를 최적화하는 것에 목적을 두고있다. 이를 위해 한국장애인고용공단 고용개발원의 2013년 보조공학 기기 서비스 만족도 조사에서 제공하는 원본자료에서 보조공학 기기를 사용하는 지체장애인 171명에 대한 보조공학 기기 만족 조사 자료를 활용하였다. 5점 척도로 조사된 데이터에 대해 Rasch 평정척도 모형으로 분석하여 사용된 5점 척도가 지체장애인에게 적절한지를 검토하였고, 범주 병합으로 더 나은 적합도를 보일 새로운 평정척도구조를 탐색하고 이들 구조에 대해 자료를 재분석하며 최적의 평정척도 구조를 검토하였다. 분석을 통한 주요결과는 다음과 같다. 첫째, 보조공학 기기 만족 척도에 5점 평정척도를 사용하는 것은 지체장애인에게 적합하지 않았다. 둘째, 범주 1과 2를 병합한 구조의 불균형 척도가 지체장애인에게 가장 최적이었다. 이런 분석 결과를 바탕으로 향후 평정척도 최적화 연구가 나아갈 방향을 제언하였다.

Investigating the Validity of Rating Scales Using Many-Faceted Rasch Model

( So Young Jang ) 글로벌영어교육학회(구 호남영어교육학회) 2019 Studies in English education Vol.24 No.2

The characteristics of a test instrument, particularly the frame of a scoring system, would be a strong candidate to increase or decrease rater reliability due to individual raters’ different perceptions on each rating scale. This indicates that scoring reliability may be affected by two parts, both the rater and the scoring system. The purpose of this study is to quantitatively investigate the optimized scoring system in order to acquire the validity of a rating scale by reducing systematic errors from the test instrument. The validation process of an analytical rating scale was conducted and the utility of the newly proposed rating scales were evaluated using the Many-Faceted Rasch Measurement (MFRM). The rating data were derived from multiple ratings of ninety essays. Four scoring models were proposed and evaluated. The results showed that the rating scale seemed to show some problems at the initial analysis. As a remedy to consider this matter, the number of the rating categories was reduced and re-evaluated in terms of reliability. It was found that a scoring system would function more reliably and consistently when evaluating rater reliability. The findings are discussed in reference to their implications for the development of statistically solid rating scales. The validation process of the rating scale is essential in order to identify the source of errors, for instance, whether it comes from the test instrument or randomness in rater performance.