Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (2) Invasive Diagnostic Testing for Fetal Chromosomal Abnormalities

Lee Ji Yeon,Kwon Ji Young,Na Sunghun,Choe Seung-Ah,Seol Hyun-Joo,Kim Minhyoung,김민아,Park Chan-Wook,Kim Kunwoo,Ryu Hyun Mee,Hwang Han-Sung,Shim Jae-Yoon 대한의학회 2021 Journal of Korean medical science Vol.36 No.4

The Korean Society of Maternal Fetal Medicine proposed the first Korean guideline on prenatal aneuploidy screening and diagnostic testing, in April 2019. The clinical practice guideline (CPG) was developed for Korean women using an adaptation process based on good-quality practice guidelines, previously developed in other countries, on prenatal screening and invasive diagnostic testing for fetal chromosome abnormalities. We reviewed current guidelines and developed a Korean CPG on invasive diagnostic testing for fetal chromosome abnormalities according to the adaptation process. Recommendations for selected 11 key questions are: 1) Considering the increased risk of fetal loss in invasive prenatal diagnostic testing for fetal genetic disorders, it is not recommended for all pregnant women aged over 35 years. 2) Because early amniocentesis performed before 14 weeks of pregnancy increases the risk of fetal loss and malformation, chorionic villus sampling (CVS) is recommended for pregnant women who will undergo invasive prenatal diagnostic testing for fetal genetic disorders in the first trimester of pregnancy. However, CVS before 9 weeks of pregnancy also increases the risk of fetal loss and deformity. Thus, CVS is recommended after 9 weeks of pregnancy. 3) Amniocentesis is recommended to distinguish true fetal mosaicism from confined placental mosaicism. 4) Anti-immunoglobulin should be administered within 72 hours after the invasive diagnostic testing. 5) Since there is a high risk of vertical transmission, an invasive prenatal diagnostic testing is recommended according to the clinician's discretion with consideration of the condition of the pregnant woman. 6) The use of antibiotics is not recommended before or after an invasive diagnostic testing. 7) The chromosomal microarray test as an alternative to the conventional cytogenetic test is not recommended for all pregnant women who will undergo an invasive diagnostic testing. 8) Amniocentesis before 14 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 9) CVS before 9 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 10) Although the risk of fetal loss associated with invasive prenatal diagnostic testing (amniocentesis and CVS) may vary based on the proficiency of the operator, the risk of fetal loss due to invasive prenatal diagnostic testing is higher in twin pregnancies than in singleton pregnancies. 11) When a monochorionic twin is identified in early pregnancy and the growth and structure of both fetuses are consistent, an invasive prenatal diagnostic testing can be performed on one fetus alone. However, an invasive prenatal diagnostic testing is recommended for each fetus in cases of pregnancy conceived via in vitro fertilization, or in cases in which the growth of both fetuses differs, or in those in which at least one fetus has a structural abnormality. The guidelines were established and approved by the Korean Academy of Medical Sciences. This guideline is revised and presented every 5 years.

외국인 학부생의 학업 수행 한국어 능력 진단 평가 기초 연구

이경애 한국사회언어학회 2022 사회언어학 Vol.30 No.3

The purpose of this study is to present a diagnostic evaluation tool that can more accurately determine the academic performance level in Korean language proficiency of foreign undergraduate students studying at domestic universities. The diagnostic evaluation diagnoses the academic Korean language proficiency of foreign undergraduates, and provides the diagnosis results to foreign undergraduates, professors, and university institutions so that teaching activities can be conducted efficiently. In this study, it was considered that the ‘Basic Academic Ability Diagnostic Test for the Korean Language Subject' was suitable as a test tool for diagnosing to diagnose the academic achievment of foreign undergraduates. This diagnostic test is a diagnostic tool designed for Korean students in Korea, and it not only continuously verifies its reliability and validity, but also includes background knowledge that Korean university students in Korea are basically acquiring. To prove that the 'Basic Academic Ability Diagnostic Test' is suitable as a diagnostic evaluation tool for foreign undergraduates, the correlation with the Korean language achievement evaluation was analyzed. The correlation between diagnostic evaluation and other items showed a significantly positive correlation. When the diagnostic evaluation score was good, the pre-test and post-test scores of Korean language proficiency, and the TOPIC level was also high. This result proves that the basic academic ability diagnostic test tool is very suitable as a diagnostic evaluation tool for foreign undergraduate students. Also, the analysis result of the pre- and post-tests and the TOPIK test showed a very significant and strong positive correlation with the post-test, and the higher the TOPIK grade, the higher the score of the pre‐test.

진단 목적의 컴퓨터 기반 영어 시험에 대한수험생 반응

김해동 인하대학교 교육연구소 2018 교육문화연구 Vol.24 No.2

This study intends to analyze test-takers’ responses to a computer-based English test designed with a diagnostic purpose. A total of 798 university freshmen took a computer-based test (CBT) developed by a university in South Korea and also participated in a questionnaire survey asking about their opinions about the test. The analysis of the survey results showed that the questions about the authenticity of listening, the appropriateness of reading, the screen organization of reading and the illustrations were positively responded. However, the level of difficulty in listening and reading, the length of time in listening and the sound quality were negatively answered. The results of ANOVAs revealed that those who achieved lower scores from the diagnostic test responded more negatively to the questions about the level of difficulty, the length of the time and the authenticity than those who received higher scores. These results suggest that it should be difficult to replace immediately a paper-and-pencil test with a CBT. The test-takers should be given more opportunities to be familiarized with the new diagnostic test. 본 연구는 영어 능력 진단 평가용으로 개발된 컴퓨터 기반 시험(computer-based test, CBT)에 대하여 수험생들의반응을 분석하는 것에 목적을 두고 있다. 연구 참가자는 총 798명의 대학 신입생들로서 이들은 국내에서 개발한컴퓨터 기반 시험에 응시하였다. 이들은 시험 후 대상 시험에 대한 의견을 묻는 설문에 참여하였다. 설문 응답을분석 한 결과 듣기 영역 문항의 진정성, 읽기 영역 문항의 적절성, 읽기 영역 화면 구성 그리고 삽화에 대하여 긍정적인응답을 한 것으로 드러났다. 그러나 듣기와 읽기 영역의 난이도, 듣기 영역 시간의 길이 및 듣기의 음질에 대한응답은 부정적인 것으로 나타났다. 일원분산분석(ANOVA)의 결과에 따르면 진단 평가에서 낮은 점수를 받은 수험생들은난이도 수준, 시간의 길이 및 진정성에 대한 설문 문항에 대하여 높은 점수를 받은 수험생들 보다 더 부정적으로반응하였다. 이러한 결과는 대학생 대상 영어 능력 진단 평가의 경우 현재의 CBT가 기존의 지필고사를 즉각 대신할 수는 없음을 시사한다. 향후 시험 실행자나 개발자들은 수험생들이 컴퓨터 기반 시험에 익숙해지도록 안내하고경험할 기회를 보다 많이 제공해야한다.

Diagnostic Accuracy of Clinical Test for Anterior Cruciate Ligament Injury: Systematic Review

데니즈 야스민,변상우,이형수,김성은,한선규,이동엽,홍지헌,유재호,김진섭,김성길 대한물리치료학회 2023 대한물리치료학회지 Vol.35 No.3

Purpose: The aim of this study was to conduct a systematic review of randomized controlled studies from 2012 to present that explore the diagnostic accuracy of clinical tests used for diagnosing anterior cruciate ligament (ACL) injury. Methods: Study design: Systematic review. Literature search of the PubMed and Scholar databases was conducted using keywords re- lated to diagnostic accuracy of clinical tests for ACL injury. The PRISMA Guidelines were followed to conduct this study. The Cochrane Risk of Bias Tool was utilized to assess the quality of each included study. Results: As a result, 8 studies were included, and 6 clinical tests used in ACL tears were evaluated for diagnostic accuracy. The pivot shift test was reported as having the highest +LR (29.5) value with a sensitivity of 59% and a specificity of 98%. However, the test with the lowest -LR value was the lever test, and the values were as follows: -LR (0.08), +LR (4.7), specificity (80%), sensitivity (94%). Conclusion: In this study, it was concluded that a single clinical test is not sufficient to determine the presence of ACL injury. Test com- binations have a higher diagnostic accuracy than a single test. In this study, the accuracy of the clinical tests was examined without considering the amount of ACL rupture and acute-chronic condition. Further research is required to examine the impact of these two factors on diagnostic accuracy of clinical test.

세종학당 온라인 진단평가에 대한 연구 - 인도네시아 A 세종학당을 대상으로

이선현 ( Lee Sun Hyun ) 고려대학교 한국어문교육연구소 2024 한국어문교육 Vol.47 No.-

누리-세종학당 한국어 온라인 진단평가는 배치평가이면서 범용 자가 진단 평가다. 한국어로 원활한 의사소통을 하며 이러한 능력 향상을 목표로 하는 세종학당에서 자신의 수준에 맞는 교육과정에 배치가 되어 원만하게 한국어를 학습하기 위해서는 배치평가가 매우 중요한 출발점이다. 그리고 많은 세종학당은 온라인 진단평가를 통해 학습자의 수준을 판정하여 반배치를 하고 있으나 반 내에서 학습자들의 불균등한 수준으로 인해 학습 운영에 고충이 많다. 이에 세종학당 온라인 진단평가를 한 후에 보완 평가로 쓰기와 말하기를 추가로 하는 인도네시아 A 세종학당에서 3년 동안 배치평가를 받은 317명 학습자들의 결과를 살펴보면서 세종학당 온라인 진단평가에 대해서 연구하였다. The Nuri-Sejong Institute Korean Online Diagnostic Evaluation is both a placement test and a self-diagnostic evaluation test for general purpose. The placement test is very important as it serves to help learners by placing them in a course with a curriculum appropriate for their level at a King Sejong Institute, whose aim is to help learners communicate smoothly in Korean and improve related skills. In addition, many King Sejong Institutes place students in classes after determining learners’ levels through the online diagnostic evaluation test. However, in some cases, students of different levels end up in the same class, which sometimes makes effective class management difficult. Accordingly, the study examined the King Sejong Institute online diagnostic evaluation test by looking at the three years' results of 317 learners who took the placement test at Indonesia A Sejong Institute, which gives writing and speaking tests as supplementary tests in addition to the King Sejong Institute online diagnostic evaluation test.

신포괄수가제 도입과 정책가산율의 증가가 진단검사의학 검체검사 활용도에 미치는 영향

이혜련,김솔잎,윤여민,허재혁,이건세,정호진,권계철,엄태현,김형수 대한의사협회 2020 대한의사협회지 Vol.63 No.8

A new diagnosis-related group (DRG) based payment system has been implemented in most public hospitals in Korea. We investigated the effects of the new DRG system and its incentive policy on the utilization rate of diagnostic laboratory tests. Three groups were categorized; 36 hospitals under the new DRG system (participant group), 72 hospitals (control-1) matching with 36 participants according to the number of beds, and 42 tertiary hospitals (control-2). The patients of acute myocardial infarction, cerebral infarction, type 2 diabetes mellitus, and gonarthrosis receiving total arthroplasty were included. We analyzed the mean length of stay and the number of diagnostic laboratory tests conducted during hospitalization of the three groups according to the new DRG system and the incentive policy rates under the new DRG system. Before participating in the new DRG system, the number of diagnostic laboratory tests in the participant group was less than that in the two control groups for all four diseases. However, although the participant group’s length of stay decreased under the new DRG system, the number of diagnostic laboratory tests increased as the maximum incentive policy rate increased. The increment of the number of diagnostic laboratory tests was prominent in the period of a maximum of 35% incentive policy rates. Finally, the number of diagnostic laboratory tests of the participant group was similar to or exceeded that of the control-2 group. The new DRG system’s incentive policy rates played a driving force on the increased utilization rate of the diagnostic laboratory test. For preparing in advance for the change in incentive policy rates, monitoring and guidelines for the utilization of diagnostic laboratory tests are necessary.

Diagnostic performance of enzyme-linked immnosorbent assays for diagnosing paratuberculosis in cattle: a meta-analysis

Pak, Son-Il The Korean Society of Veterinary Science 2004 大韓獸醫學會誌 Vol.44 No.4

To evaluate the diagnostic accuracy of two commercial ELISA tests (Allied- and CSL-ELISA) for the diagnosis of Mycobacterium paratuberculosis in cattle, Meta-analysis using English language papers published during 1990-2001 was performed. Diagnostic odds ratios (DOR) were analyzed using regression analysis together with summary receiver operating characteristic (ROC) curves. The difference in diagnostic performance between the two ELISA systems was evaluated by using linear regression. Publication bias was assessed by funnel plot and linear regression. The pooled sensitivity and specificity were 44% (95% CI, 38 to 51) and 98% (95% CI, 96 to 99) for the random-effect model. The DOR between studies was heterogeneous. The area under the fitted ROC curve (AUC) was 0.72 for the unweighted and 0.77 for the weighted model. Maximum joint sensitivity and specificity for the unweighted and weighted model from their summary ROC curve were 70% and 75%, respectively. Based on the fitted model, at a specificity of 95%, sensitivity was estimated to be 52% for the unweighted and 57% for the weighted model. From the final multivariable model study characteristic, the country was the only significant variable with an explained component variance of 13.3%. There were no significant differences in discriminatory power, sensitivity, and specificity between the two ELISA tests. The overall diagnostic accuracy of two commercial ELISA tests was moderate, as judged by the AUC, maximum joint sensitivity and specificity, and estimates from the fitted model and clinical usefulness of the tests for screening program is limited because of low sensitivity and heterogeneous of DOR. It is, therefore, recommended to use ELISA tests as a parallel testing with other diagnostic tests together to increase test sensitivity in the screening program.

Meta-Analysis of Diagnostic Test Accuracy

이영호 한양대학교 의과대학 2015 Hanyang Medical Reviews Vol.35 No.1

Diagnosis is a critical step in clinical treatment. Meta-analysis is a useful tool for evaluating the accuracy of diagnostic tests and can be used to obtain precise accuracy estimates when small studies for a given test and subject pool are available. Meta-analysis uses statistical techniques to combine and compare data from different studies, thus increasing the power of the estimates of diagnostic accuracy in primary research. Meta-analysis of diagnostic tests summarizes the accuracy of diagnosis. Therefore, it is necessary for clinicians to understand meta-analytical procedures for diagnostic tests. Herein, we describe the basic steps in a meta-analysis to evaluate test accuracy: 1) describing the results of individual studies, 2) searching for heterogeneity, 3) testing for the threshold effect, 4) deciding on the model for statistical pooling, 5) dealing with heterogeneity, and 6) interpreting meta-analysis results of diagnostic tests. Meta-analysis of diagnostic test accuracy provides useful information for clinical practice and for the formulation of questions to be tested in future studies.

영어 진단평가 영역 순서 변경의 효과

김정태 한국영어평가학회 2020 영어평가 Vol.15 No.1

The sequence of test domains might affect test-takers’ scores in an English diagnostic test, in particular, for the students whose English language proficiency is low. However, there is a little literature on the relationship. This study investigated the effect of the different domain sequence on test-takers’ scores at a college level. The previous test for a non-curricular English program for beginner level consisted of the domain order: reading, grammar, vocabulary, and conversation. In the study, a new diagnostic test was developed based on the results of examining test validity of the test items and instructor interview. The domain order of the new test was modified into the one: grammar, and conversation, and reading which included vocabulary part. 133 students at a Korean university were given both of the tests. The results firstly indicated that examining the test validity resulted in different difficulty of the domain order and unbalanced difficulty assignment. Secondly, a paired t-test showed that there was statistically significant difference between the two means of the test scores. Thirdly, the results of a post-survey revealed that they preferred the order of the new test to that of the previous test. Some suggestions are discussed in terms of the order of test domains and test scores.

국어과 교과학습 진단평가 도구 개발 연구

박정진 한국언어문화교육학회 2008 언어와 문화 Vol.4 No.3

The purpose of this study is to develop the standardized instrument for diagnostic assessment of coursework in Korean Language Education. For this purpose, we develop the elements which can show the Korean Language Ability. We presented the elements of the Korean Language Ability that is related the 7th curriculum. The developed instrument was applied as a diagnostic assessment at two elementary schools in seoul. The students who participated in this study were 793 that is consisted in 268 third graders, 264 forth graders, and 261 fifth graders. Difficulty, reliability, discrimination index were analyzed and revised tests items to qualify standardized test. Cut off score was decided for using these test as diagnostic assessment. And that was confirmed two methods cooperatively norm referenced test as well as criterion referenced test. (The National Institute of the Korean Language) The purpose of this study is to develop the standardized instrument for diagnostic assessment of coursework in Korean Language Education. For this purpose, we develop the elements which can show the Korean Language Ability. We presented the elements of the Korean Language Ability that is related the 7th curriculum. The developed instrument was applied as a diagnostic assessment at two elementary schools in seoul. The students who participated in this study were 793 that is consisted in 268 third graders, 264 forth graders, and 261 fifth graders. Difficulty, reliability, discrimination index were analyzed and revised tests items to qualify standardized test. Cut off score was decided for using these test as diagnostic assessment. And that was confirmed two methods cooperatively norm referenced test as well as criterion referenced test. (The National Institute of the Korean Language)