[논문]사상체질 진단 연구의 전문가 일치도와 진단 정확률

한은경; 권영규

doi:10.15188/kjopp.2018.08.32.4.185

사상체질 진단 연구의 전문가 일치도와 진단 정확률
Inter-expert Agreement and Diagnostic Accuracy of Sasang Constitution Medicine 원문보기

동의생리병리학회지 = Journal of physiology & pathology in Korean Medicine, v.32 no.4, 2018년, pp.185 - 196

한은경 (채영한의원) , 권영규 (부산대학교 한의학전문대학원 양생기능의학부)

Abstract ▼ AI-Helper

The purpose of this study is to evaluate the current inter-expert agreement of Sasang Constitution Medicine (SCM), to expand the current knowledge on the causes of imperfect inter-expert agreement, and to explore possible solutions for improving inter-expert agreement. A literature search was conducted to gather data on the studies on diagnosis of SCM. The 127 articles included in this analysis had a mean 4.1 publications per year, 56.0% published in the Journal of Sasang Constitutional Medicine between the year of 1987 and 2017. SCM specialist participated in 96.3% of all the expert judgment cases. Inter-expert agreement was reported in 14.8% of the cases that had two or more experts. We recommend that expert panels integrate the results of current status of diagnostic consensus into guideline development and strengthen expert education and training with the aim of improving SCM diagnostic accuracy.

주제어

AI 본문요약
AI-Helper

* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.

문제 정의

본 연구는 사상체질 진단의 객관성을 확보하기 위해 전문가 간 진단 일치도를 파악하고 이를 향상시킬 수 있는 전문가 집단 차원에서의 방안을 논의하기 위한 기초 연구이다.
이를 통해 사상체질 진단에서 전문가 간 일치도 향상 방안을 논의하고자 한다.
진단 일치도를 향상시키기 위해 집단 차원에서의 노력이 필요하다. 전문가간 진단 일치도 현황 파악을 통해 얻어진 사실들을 진단 가이드라인 정립 및 개정에 활용하는 것과 진단 정확도 향상을 목표로 전문가 집단의 교육 및 훈련과정을 강화하는 것을 고려할 수 있다.

제안 방법

2007년 이후 출판된 사상체질 진단 연구를 재분류해 살펴보았다. 전문가를 통해 체질을 진단한 연구는 총 26편이었으며, 이 중 25편(96.
검색식은 “제목 : 사상 체질 진단 초록 : 사상 체질 진단”으로 하였다. 검색된 논문의 참고문헌 수기검색을 통해 누락된 문헌을 추가 확인하였다. 중복 검색을 제외하고 총 187건의 논문이 검색되었다.
체형 분석법에 관한 연구에서는 체간과 사지의 계측값을 진단에 사용⁹³⁾하였다. 음성 분석에 관한 연구는 서로 다른 음성의 주파수 등을 이용하여 체질을 구분할 수 있는 근거를 찾기 위한 성음분석⁷⁸⁾, 음향분석^79,80), 성문분석⁸¹⁾을 실시하였다. 기타의 비설문 진단도구는 한약 복용 후의 환자 반응¹⁰⁵⁾, O-Ring 경근계측¹¹²⁾, 양도락¹¹⁵⁾, 홍채¹¹⁶⁾의 활용을 포함하였다.
사상체질 진단 연구는 1995년 QSCCII의 개발 이후와 2007년 과학기술부-한국학의학연구원의 이제마 프로젝트 출범 이후에 각각 논문의 출판빈도와 출판주제의 종류가 증가하는 경향을 보였다. 진단연구 내용 분석을 통하여 관련 동향을 표로 정리하였다(Table 2).

대상 데이터

이 외, 논문 제목과 초록 검토를 통하여 연구주제와 직접 관련이 없는 것을 제외하였다. 127편의 논문을 최종 분석대상으로 하였다.
학술데이터베이스 KISS(Korean studies Information Service System), RISS(Research Information Sharing Service), DBPia, NDSL(National Discovery for Science Leaders)를 사용하여 분석대상 논문을 검색하였다. 2017년 12월까지 출판된 모든 국내 학술지 논문을 대상으로 하였다. 제목 또는 초록에 ‘사상’, ‘체질’, ‘진단’을 포함한 연구로 한정하였다.
분석대상 논문은 사상체질의학회지(舊 사상의학회지, 71편), 한국자료분석학회지(16편), 동의생리병리학회지(10편), 한국한의학연구원논문집(6편), 전자공학회 소속 학술지(5편), 정보처리학회지(2편), 대한침구의학회지(2편), 대한한의학회지(2편)외 대한예방한의학회지, 한국콘텐츠학회지, 한국정보통신학회지, 동서간호학연구지, 한국정신과학학회지, 한국전자통신학회지, 지역사회간호학회지, 성인간호학회지, 전통의학지, 한국통신학회지, 한국통계학회지, 경희대학교대학원 고황론집, 대한전기학회학술대회논문집에서 각 1편이 출판되었다. 분석대상 기간내 사상체질 진단 연구를 2편 이상 출판한 학회는 8개였다(Fig.
제목 또는 초록에 ‘사상’, ‘체질’, ‘진단’을 포함한 연구로 한정하였다.
검색된 논문의 참고문헌 수기검색을 통해 누락된 문헌을 추가 확인하였다. 중복 검색을 제외하고 총 187건의 논문이 검색되었다. 이 중에서 제목이 같으면서 1, 2부로 나누어 게재된 경우이거나 제목이 같으면서 세부 내용의 차례를 달리하여 2편 이상의 논문으로 출판된 경우는 1편으로 간주하였다.
학술데이터베이스 KISS(Korean studies Information Service System), RISS(Research Information Sharing Service), DBPia, NDSL(National Discovery for Science Leaders)를 사용하여 분석대상 논문을 검색하였다. 2017년 12월까지 출판된 모든 국내 학술지 논문을 대상으로 하였다.

이론/모형

또 이 연구에서는 권고등급을 결정할 때 각 연구에서 사용한 검토방법으로 얻어진 불일치율의 측정값이 ‘매우 불확실’ 한 것으로부터 ‘추후의 연구에 의해 바뀌기 어려울 정도로 확실함’에 이르는 4단계의 권고등급(grade)으로 구성된 GRADE Framework138)를 사용했다.

성능/효과

본 연구의 분석대상 논문에서 보고된 전문가간 진단 일치도는 다양하였다. 이것은 사상체질 진단요소 중에서 전문가간 일치도가 특히 낮은 항목을 탐색하고 그 원인을 파악하는 연구들이 추가될 필요를 시사한다.

후속연구

Trese(2015)는 진단에서 주관적 요소를 제거할 수는 없다고 하더라도 전문가의 판단과 객관적인 정보가 결합되었을 때 진단 불일치 정도를 줄이고 환자에 대한 보다 나은 의료가 가능하다고 하였다⁴⁾. 따라서 전문가 간 진단 일치도를 파악하여 향후 전문가 합의의 정도 및 진단 정확도를 향상시키고 의료의 질과 효율을 제고할 필요가 있다.
본 연구 결과는 전문가간 진단 일치도를 체계적인 방법을 통해 파악하고 그 원인을 탐색하는 연구뿐 아니라 진단 일치도를 향상시키기 위해 집단 차원에서의 노력이 필요함을 시사한다. 최근의 선행연구를 참조하면 전문가간 진단 일치도 현황 파악을 통해 얻어진 사실들을 진단 가이드라인 정립 및 개정에 활용하는 것과 진단 정확도 향상을 목표로 전문가 집단의 교육 및 훈련과정을 강화하는 것¹³⁶⁾ 등이 공통적으로 제안되고 있다.
5%’에 서 ‘90% 이상’에 이르기까지 다양하였다. 사상체질 진단요소 중에서 전문가간 일치도가 특히 낮은 항목을 탐색하고 그 원인을 파악하는 연구들이 추가될 필요가 있다.
본 연구의 분석대상 논문에서 보고된 전문가간 진단 일치도는 다양하였다. 이것은 사상체질 진단요소 중에서 전문가간 일치도가 특히 낮은 항목을 탐색하고 그 원인을 파악하는 연구들이 추가될 필요를 시사한다. 최근 연구에서 임상연구의 편향성(bias)을 판별하는 데 이른바 전문성을 표방한 대상자들이 실제 편향성 판별에서는 다양한 불일치를 보였다는 결과¹³⁵⁾를 참조하면, 이러한 노력이 한층 강화될 필요가 있다.
Trese(2015)는 진단에서 주관적 요소를 제거할 수는 없다고 하더라도 전문가의 판단과 객관적인 정보가 결합되었을 때 진단 불일치 정도를 줄이고 환자에 대한 보다 나은 의료가 가능하다고 하였다⁴⁾. 따라서 전문가 간 진단 일치도를 파악하여 향후 전문가 합의의 정도 및 진단 정확도를 향상시키고 의료의 질과 효율을 제고할 필요가 있다.
8%였다. 향후 사상체질 진단연구 설계 시 복수의 전문가를 참여시키고 전문가 간 진단 일치도를 Kappa 값등을 사용하여 체계적인 연구방법에 따라 보고한 연구의 숫자가 늘어날 필요가 있다.

질의응답

핵심어	질문	논문에서 추출한 답변
	진단이란 무엇인가?	진단은 질병을 범주화하고 치료계획을 수립하며 환자의 예후를 추적하기 위한 도구이다. 진단에서 전문가의 지식과 경험은 필수적인 요소1)이지만, 공통된 진단이 필요한 상황에서 복수의 전문가 간 진단 불일치(inter-expert diagnosis discrepancy)는 의료의 질과 효율을 저하시킬 수 있다는 문제가 지속적으로 제기되어 왔다2).
	미국 IOM(Institute of Medicine) 위원회에 따르면 진단은 어떤 과정인가?	이에 대하여 2015년 미국 IOM(Institute of Medicine) 위원회와 NAS(The National Academies of Science·Engineering·Medicine) 에서는 진단을 ‘협동적인 노력(collaborative effort)’으로 정의하였다3). IOM에 따르면 진단은 그 불일치 현황과 요인에 대해 파악하 고 이를 해결하기 위해 전문가 집단 안에 폭넓은 합의를 구축하는 종합적인 과정이다3). Trese(2015)는 진단에서 주관적 요소를 제거 할 수는 없다고 하더라도 전문가의 판단과 객관적인 정보가 결합되었을 때 진단 불일치 정도를 줄이고 환자에 대한 보다 나은 의료가 가능하다고 하였다4).
	진단에서 제기되는 문제는 무엇인가?	진단은 질병을 범주화하고 치료계획을 수립하며 환자의 예후를 추적하기 위한 도구이다. 진단에서 전문가의 지식과 경험은 필수적인 요소1)이지만, 공통된 진단이 필요한 상황에서 복수의 전문가 간 진단 불일치(inter-expert diagnosis discrepancy)는 의료의 질과 효율을 저하시킬 수 있다는 문제가 지속적으로 제기되어 왔다2). 이에 대하여 2015년 미국 IOM(Institute of Medicine) 위원회와 NAS(The National Academies of Science·Engineering·Medicine) 에서는 진단을 ‘협동적인 노력(collaborative effort)’으로 정의하였다3).

참고문헌 (141)

Brush JE Jr, Sherbino J, Norman GR. How Expert Clinicians Intuitively Recognize a Medical Diagnosis. Am J Med. 2017;130(6):629-34.

상세보기
Gschliesser A, et al. Inter-expert and intra-expert agreement on the diagnosis and treatment of retinopathy of prematurity. Am J Ophthalmol. 2015 Sep;160(3):553-60.e3.

상세보기
National Academies of Sciences, Engineering, and Medicine. 2015. Improving Diagnosis in Health Care. Washington, DC: The National Academies Press. https://doi.org/10.17226/21794.
Trese MT. Subjectivity in Retinopathy of Prematurity Screening. Am J Ophthalmol. 2015;160(3):406-7.

상세보기
Song I. Sasang Constitutional Medicine. Jibmoondang; 2008.
Yoo J, Jang E, Lee H, Kim Y, Kim H, Lee S. Knowledge and Attitude of Sasang Constitution Investigatorson the Sasang Constitution Clinical Study in Korea. J Sasang Constitut Med. 2008;20(3):118-32.
Park D, Park K, Jin H. The Web Application to Improve Utilization of Sasang Constitutional Diagnosis Questionnaire - KS-15(Korea Sasang Constitutional Diagnostic Questionnaire). J Sasang Constitut Med. 2017;29(3):224-31.
Kim S, Jang E, Koh B. The Methodological Review on the Accuracy Study of Questionnaire for Sasang Constitution Diagnosis. J Sasang Constitut Med. 2012;24(3):1-16.
Hahm T, Hwang M, Lee T, Kim S, Lee S, Koh B. A Study on the Concordance Rate of the Diagnostic Results Among Sasang Constitutional Medicine(SCM) Specialists. J Sasang Constitut Med. 2006;18(3):124-30.
Kim Y, Jang E. Test-Retest Reliability of Brief KS-15 - Korean Sasang Constitutional Diagnostic Questionnaire. J Sasang Constitut Med. 2016;30(3):177-83.
Pak Y, Kim J, Park B, Yoo J, Lee J, Koh B, et al. The Reliability and Validity Test of Sasangin Diagnostic Questionnaire for Specialist(SDQ_S). J Sasang Constitut Med. 2016;18(2):110-22.
Baek Y, Jang E, Park K, Yoo J, Jin H, Lee S. Development and Validation of Brief KS-15 (Korea Sasang Constitutional Diagnostic Questionnaire) Based on Body Shape, Temperament and Symptoms. J Sasang Constitut Med. 2015;27(2):211-21.

원문보기 상세보기
Shin D, Song J. A Study on the Standardization of TS-QSCD. J Sasang Constitut Med. 2009;21(1):99-126.
Kim KK, Kang CW, Kim JW. Stabilization of Sasang Constitution Discrimination Function using Check List Data with Mixed Measurement Scale. Journal of the Korean Data Analysis society. 2008;10(5):2471-85.
Jeon S, Jeong S, Kwon S, Park S, Kim K, Kim J. A Study on the Diagnostic Accuracy Rate of the Sasang Constitution Questionnaire for Doctors Used in the On-line System. J Sasang Constitut Med. 2008;20(3):82-93.
Lee S, Joo J, Lee S, Lee H, Jang E. A Study on the Response Differences to the Sasang Constitution Questionnaire by Sasang Constitutions. J Sasang Constitut Med. 2007;19(3):89-98.
Kim J, Choi M, Jung W, Shin W, Kim S, Yoo J. A Study on the Sasang Constitutional Checkup List and Inspection Diagnosis of Face and Tongue. J Sasang Constitut Med. 2007;19(3):156-75.
Lee J, Kim Y, Hwang M, Kim J, Lee E, Song I, et al. Survey Study about Sasangin's Characteristics of Face, Voice, Skin and Pulse Diagnosis. J Sasang Constitut Med. 2007;19(3):126-43.
Shin D, Kim J, Choi D, Lim M, Lee K, Song J, et al. A Development of the Two Step Questionnaire for the Sasang Constitution Diagnosis (TS-QSCD). J Sasang Constitut Med. 2006;18(1):75-90.
Kim J, Lee E, Kim K. Comparisons of Diagnosis Accuracy of Sasang Constitution Discrimination Function for Doctors based on Sex, Age and BMI, Journal of the Korean Data Analysis society. 2007;9(3):1077-88.
Sul Y, Jeon S, Kwon S, Kim H, Lee E, Kim K, et al. Importance Analysis of Questionnaire for Doctors and Questionnaire for Patients. J Sasang Constitut Med. 2006;18(3):94-123.
Kim J, Jeong S, Kim K, Lee E, Kim J, Lee Y. Validity Study of the Questionnaire for Doctors for Sasang Constituion Diagnosis. J Physiol & Pathol Korean Med. 2006;20(1):209-14.
Kim K, Kim J, Lee E. Comparative Study on Categorical Error Rate of Check List used in Sasang Constitution Discrimination. Journal of the Korean Data Analysis Society. 2005;7(5):1571-81.
Kim J, Jung S, Choi M, Kim K, Lee E, Kim J, Lee Y. Study on Golden Standard for Sasang Constitution Diagnosis. J Physiol & Pathol Korean Med. 2005;19(6):1504-12.
Lee E, Kim J, Kim K, Kim JY, Kwak C, Yoo J, et al. The test for the item-branch of Sasangin Diagnosis Questionnaire-on the differences of 2 item-branch and 3 item-branch questionnaire. Journal of the Korean Data Analysis society. 2005;7(1):101-11.
Kim J, Lee E, Kim K, Kim JY, Lee Y. Study on Methods for Sasang Constituion Diagnosis. J Physiol & Pathol Korean Med. 2005;19(6):1471-4.
Park J, Wang M, Kim J. A Study on the Simplification of Questionnaire for Sasang Constitution Classification(QSCC 2). Journal of Korean Academy of Community Health Nursing. 2003;14(2):334-50.
Lee E, Choi S, Kim J, Jung S, Lee H, Kim J, et al. The Study About The QSCC II For The Diagnosis Of Sasang Constitution (Around The Analysis of subjects). J Sasang Constitut Med. 2003;15(3):11-21.
Yoo J, Lee E, Koh B, Song I, Kim T. The Study on the Upgrade of QSCC II (I). 2003;15(1):27-38.
Choi J, Park S. The Characteristics of Questionnaire Response Using decision tree method. J Sasang Constitut Med. 2003;15(3):177-86.
Kim S, Lee S, Lee E, Choi S, Koh B, Song I, et al. Revision of the Questionnaire for the Sasang Constitution Classification. J Sasang Constitut Med. 2003;15(3):100-17.
Kim Y, Lee E, Choi S, Jung S, Lee Y, Jo H, et al. The Study About The QSCC II For The Diagnosis Of Sasang Constitution (Around The Analysis of subjects). J Sasang Constitut Med. 2003;15(3):1-10.
Choi S, Yoon Y, Nam B, Moon J, Kang B, Yoo Y. I. Study on development of Sasang Constitution Diagnosis Questionnaire. KIOM Report. 2003;12:2-147.
Park J. Comparison of the Results of Clinical Diagnostic Assay according to Sasang Constitution Classification. The Journal of Korean Academic society. of Adult Nursing. 2003;15(2):215-25.
Jang H, Lee E, Goh B, Song I. Validation Study on Diagnosis of Taeeum-In in Sasang Constitutional Medicine. J Sasang Constitut Med. 2001;13(1):45-50.
Park E, Park S. A Study on Comparison of responses to the questionnaire based on Sasang institution's differences-Questionnaire of Sasang Constitution Classification II (QSCCII). J Sasang Constitut Med. 2000;12(2):78-93.
Kim T, Kim J. The Study for clinical application of the New Sasang Constitution Questionnaire. J Sasang Constitut Med. 2000;12(1):173-85.
Lee S, Lee E, Goh B, Song I, Kim S. Validation Study on Diagnosis of Soeum-In in Sasang Constitutional Medicine. J Sasang Constitut Med. 2000;12(1):94-103.
Kim Y, Kim j. A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION II. J Sasang Constitut Med. 1999;11(1):119-35.
Park S, Park E, Choi J. Analysis of Inter-Questionnaire Agreement in Determining Sasang Constitution. J Sasang Constitut Med. 1999;11(1):103-17.
Kim Y, Kim J,. The Study in Objectification of the diagnosis of Sasang Constitution(According to Analysis of the Past Questionnaires). J Sasang Constitut Med. 1999;11(2):151-83.
Kim S, Go B, Song I. A Study on the Standardization of QSCCII (Questionnaire for the Sasang Constitution Classification II). J Sasang Constitut Med. 1996;8(1):187-246.
Kim S, Go B, Song I. A Study on the Standardization of QSCCII (Questionnaire for the Sasang Constitution Classification II). J Sasang Constitut Med. 1996;8(1):187-246.
Kim Y, Kim j. A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION II. J Sasang Constitut Med. 1999;11(1):119-35.
Lee EJ, Ko BH, Song IB. The Study on The Validity of "Questionnaire of Sasang Constitution Classification(I). J Sasang Constitut Med. 1995;7(2):89-100.
Kim S, Go B, Song I. A Validation Study of Questionnaire of Sasang Constitutional Classification (QSCC). J Sasang Constitut Med. 1993;5(1):67-85.
Goh B. Study on Sasang Constitution medicine. Method. Journal of Korean medicine. 1987;8(1):139-60.
Kim D, Lee J, Kim K. A Comparison of Statistical Methods for Sasang Constitution Classification. Journal of the Korean Data Analysis society. 2014;16(3):1249-58.
Jin H, Lee H, Kim M, Kim H, Kim J. Two-Stage Decision Tree Analysis for Diagnosis of Personal Sasang Constitution medicine. Type. J Sasang Constitut Med. 2010;22(3):87-97.
Shin SS, Beum S, Kim KK, Cho JC, Woo YW. Sasang Constitution Classification Using Fuzzy Method. The Journal of the Korea Institute of Electronic Communication Sciences. 2010;4:224-7.
Chae H, Hwang S, Eom I, Kim B, Kim Y, Kim B, Kwon Y. Development of Sasang Type Diagnostic Test with Neural Network. J Physiol & Pathol Korean Med. 2009;23(4):765-71.
Hwang SM, Park SP, Gang K, Kwon Y, Chae H. Generalized Analysis on Validity of Sasang Type Diagnosis. J Physiol & Pathol Korean Med. 2009;23(5):950-7.
Hong JW, Kim YI, Park SJ, Kim BC, Eom IK, Hwang MW, et al. Data mining Algorithms for the Development of Sasang Type Diagnosis. J Physiol & Pathol Korean Med. 2009;23(6):1234-40.
Lee SJ, Kim M, Chae H. Multi-facet Analysis on Validity of Sasang Type Diagnostic Test. Journal of Korean Medicine. 2008;29(1):7-14.
Beom S, Kim K, Kim JW. Study on Implementation of Diagnosis System of Sasang Constitution Using Discriminant Analysis Model. Journal of the Korean Data Analysis Society. 2007;9(2):585-95.
Jin H, Moon J, Go S, Ku I, Lee S, Lee D, et al. Preliminary Study to Establish a Decision Support System in Sasang Constitutional medicine with Clinical Data. Korean Journal of Oriental Medicine. 2007;13(2):75-81.
Jang ES, Baek YH, Kim HS, Lee SW. The Study on Sensitivity and Specificity of Sasang Constitution Diagnosis Methods). Korean Journal of Oriental Medicine. 2007;13(3):125-31.
Kim K, Kang C, Kim J. Comparisons of Discriminant Analysis Model and Generalized Logit Model in Sasang Constitution Classification. Journal of the Korean Data Analysis Society. 2007;9(1):2173-81.
Kim K. Study on Methods of Improving Correct Rate in Sasang Constitution Discriminant Function. Journal of the Korean Data Analysis Society. 2007;9(6):2689-702.
Kim J, Lee E, Kim K. Establishment of Indeterminate Range in Sasang Constitution Discrimination. Journal of the Korean Data Analysis Society. 2007;9(4):1639-52.
Lee Y, Kim H. The Development of Constitution Classification Model at Oriental medicine. Using the Data Mining Techniques -Focus on Ordinary Symptoms. Journal of the Korean Data Analysis Society. 2007;9(2):597-609.
Jang E, Kim H, Lee S, Kim J. The research on agreement statistics analysis between factors of diagnosis. Korean Journal of Oriental Medicine. 2006;12(2):103-13.
Kim K, Kim J, Lee E. Comparative Study on Discriminant and Cluster Analysis used in Development of Sasang Constitution Classification Function. Journal of the Korean Data Analysis Society. 2006;8(1):93-104.
Choi S, Lee S, Yoon Y, Kim J. The Study of Data Factors for SCIB(Sasang Constitution Information Bank. 2005;17(1):45-55.
Kim K, Kim J, Lee E. Transformation Methods of Anthropometric Data used in Sasang Constitution Classification. Journal of the Korean Data Analysis Society. 2005;7(4):1175-85.
Kim K, Kim J, Lee E. Development Methods of Sasang Constitution Discrimination Function When Sample Size are Very Different. Journal of the Korean Data Analysis society. 2005;7(6):1957-69.
Kim KK, Kim JW, Lee EJ, Kim JY, Choi S. Study on Classification Function into Sasang Constitution Using Data Mining Techniques. Korean Journal of Oriental Physiology & Pathology. 2004;18(6):1938-44.
Kim K, Cho M. Study on Development of Classification Function into Sasang Constitution. Journal of the Korean Data Analysis Society. 2004;6(1):303-15.
Kim K, Kim J, Lee E, Choi S, Cho M, Kim D, et al. Study on Development of Classification Function into Sasang Constitution using Discriminant Analysis Model (I) - Variable Selection based on Cronbach's Alpha Coefficients. Journal of the Korean Data Analysis society. 2004;6(2):493-504.
Kim K. Study on Development of Classification Function into Sasang Constitution using Decision Trees Model (I) - Variable Selection based on Cronbach's Alpha Coefficients. Journal of the Korean Data Analysis Society. 2004;6(3):751-66.
Lee Y, Park S, Park E. A study of constitution diagnosis using decision tree method. J Sasang Constitut Med. 2001;13(2):144-55.
Kim DY, Lee JW. A Statistical Study on Generalization of Sasang Constitution Medicine. Journal of Korean Statistics Society. 1999:228-33.
Park HJ, Kim J, Jang J. A Study about Reliability of Sasang Constitutional Voice Diagnosis according to Operator Presence. J Sasang Constitut Med. 2016;28(4):309-19.

원문보기 상세보기
Kim Y, Nam J, Kim JY, Jang J. Robustness Evaluation of Sasang Constitutional Voice Diagnosis System in Different Recording Environments. Journal of Institute of Electronics and Information Engineers. 2013;7:1817-9.
Kang JK, Lee H,. Voice Classification Algorithm for Sasang Constitution. Journal of Korean Institute of Electrical Engineers. 2009;7:1982-3.
Kim BH, Lee SH, Cho DU. Classification of Sasang Constitutution Taeumin by Comparative of Speech Signals Analysis. The KIPS Transactions : Part B. 2008;15(1):17-24.
Kim BH, Lee SH, Cho DU, Park SA, Ka MK. Generation Sasang Constitution Diagnosis and Classification Using Acoustics Analysis Element. The Journal o fKorea Information and Communications Society. 2006;11(614):617.
Yoo J, Kim D. A Study on the Sasang Constitutional Diagnosis by Perceptual Voice Analysis. J Sasang Constitut Med. 2004;16(3):46-58.
Kim S, Shin M, Kim D, Kwon K. A study on the correlation between Sound Characteristic and Sasang Constitution by Laryngograph, EGG. J Sasang Constitut Med. 2000;12(1):144-56.
Shin M, Kim D. An Study on the Correlation between Sound Characteristics and Sasang Constitution by CSL. J Sasang Constitut Med. 1999;11(1):137-57.
Kim D, Park S, Gun G. An objective study of sasang constitution diagnosis by sound analysis. J Sasang Constitut Med. 1998;10(1):65-80.
Jun J, Jin Y. Relations Between Sasang Constitution and Human Vocal Signals. Korean Journal of the society. of Body.Mind.Spirit Science. 1998;8:37-46.
Roh M, Kim J, Do J. A Preliminary Study on the Repeatability of Facial Feature Variables Used in the Sasang Constitutional Diagnosis. J Sasang Constitut Med. 2017;29(1):29-39.

원문보기 상세보기
Lee S, Koh B, Lee E, Lee J, Hwang M. Systematic Review on Researches of Sasang Constitution Diagnosis Using Facial Feature. J Sasang Constitut Med. 2012;24(4):17-27.
Do J, Kim JY. Technologies in Sasang Constitution Diagnosis through Recognizing Human Facial Information. Magazine of the IEEK. 2010;37(7):53-61.
Jang K. Facial Impression Classification for Sasang Constitution Diagnosis. Journal of the Korea Institute of Maritime Information and Communication Engineering. 2008;12(1):196-204.
Cho DU, Kim BH, Lee SH. Image Processing : Sasang Constitution Classification System Using Face Morphologic Relation Analysis. The KIPS Transactions : Part B. 2007;14(3):153-62.
Seok J, Yoon J, Lee J, Hwang M, Cho Y, Kho B, et al. The Upgrade of Sasangin Classification System by the Morphologic Study of Head and Face : Facial Differences on Sex and Age. J Sasang Constitut Med. 2007;18(3):30-50.
Kwak C, Seok J, Song J, Kim H, Hwang M, Yoo J, et al. An Error Analysis of the 3D Automatic Face Recognition Apparatus (3D-AFRA) Hardware. J Sasang Constitut Med. 2007;19(2):22-9.
Park H, n Kim H, Kim K, Lee S. The Suggestion of the clinical application of Sasang Constitutional Diagnosis. J Sasang Constitut Med. 2001;13(2):138-43.
Hong S, Lee E, Lee S, Han G, Kho B, Song I. A Morphological Study On The Upper Face Of Moire According To The Sasang Constitution. J Sasang Constitut Med. 1998;10(2):271-81.
Ko B, Song I, Cho Y, Choi C, Kim J, Hong S, et al. A Morphologic Study of head and face for Sasang Constitution. J Sasang Constitut Med. 1996;8(1):101-86.
Kim JW, Sul YK, Choi JJ, Kwon SD, Kim KK, Lee YT. Comparative Study of Diagnostic Accuracy Rate by Sasang Constitutions on Measurement Method of Body Shape. Korean Journal of Oriental Physiology & Pathology. 2007;21(1):338-46.
Sul Y, Lee E, Kim K, Kim J. Comparative Study of Sasang Constitutions Diagnostic Accuracy Rate on Measurement Method of Body Shape by IBS-2000 Compensator. J Sasang Constitut Med. 2007;19(1):71-85.
Kwon S, Sul Y, Lee E, Kim K, Kim J. Diagnosis Accuracy Rate Comparative Study of Each Sasang Constitutions and Sex Distinction by Body Measurement Method between 3D Body Measuring Instrument and Hand-operating. J Sasang Constitut Med. 2007;19(1):60-77.
Jeon S, Sul Y, Kim K, Lee E, Kim J. A Study on the Body Shape Classified by Sasang Constitutions and Gender Using Physical Measurements. J Sasang Constitut Med. 2006;18(1):54-61.
Park E, Park S. A Morphological Study of Hand and Foot according to the Sasang Constitution. J Sasang Constitut Med. 1999;11(2):195-208.
Hong S, Lee S, Lee E, Han G, Chou Y, Choi C, et al. A Study on the morphologic characteristics of each constitution's trunk. J Sasang Constitut Med. 1998;10(1):101-42.
Choi S, Hong J, Chi S, Jung B, Ahn K. A Study on the Association between Sasang Constitutions(QSCCII)and Huh's Morphological Diagramming). Korean Journal of Oriental medicine. 2002;8(1):75-92.
Choi S, Chi S, Jung B, Sung H, Ahn K, Koh B. A Study on the Association between Sasang Constitutions and Body Composition. J Sasang Constitut Med. 2001;13(1):24-34.
Lee S, Lee U, Hong S, Ko B. An analysis on the characteristics of Sa-sang constitution - centering on the body measures and diagnosis results. J Sasang Constitut Med. 1996;8(1):349-76.
Huh MH, Song J, Kim D, Go B. A Study on the Morphological Diagrgmmings of Four Constituents. J Sasang Constitut Med. 1992;4(1):107-48.
Hong S, Lee U, Lee S, Han G, Go B, Song I1. A Morphological Study for Generalization of Sasang Constitution Diagnosis: So-Eum-In Type. J Sasang Constitut Med. 1998;10(1):171-80.
Huh MH, Go B, Song I. A Study on the Morphological Diagrgmmings of Sasang Constitution. J Sasang Constitut Med. 1989;1(1):29-39.
Lee H, Ryu D, Jeon S, Kim K, Kim J. A Comparative Study of Sasang Constitution Diagnostic Accuracy Rate between Herb medicine. Taking and Non Taking Patients. J Sasang Constitut Med. 2011;23(2):208-17.
Shin S, Kim JK. Comparisons of the Accuracy of Classification Methods in Sasang Constitution Diagnosis with Pulse Waves. Journal of the Korea Contents Society. 2009;9(10):249-57.
Song J, Song B, Kwon K. Clinical Study of Discrimination of Sasang Constitution with 7-Zone-Diagnostic System(VEGA-DFM722). J Sasang Constitut Med. 2007;19(2):82-3.
Park SJ, Kwon YK. Analysis of Reproducibility of Constitutions by IGM(InyoungGigu Macjin:人迎氣口脈法) and Agreement Rate between Sasang Constitutions by QSCCII and Constitutions by IGM. Korean Journal of Oriental Physiology & Pathology. 2006;20(1):262-7.
Park S, Kim DK. Implementation of the automatic pulse-power diagnostic system and the discrimination algorithm of four constitutions. Journal of the institute of electronics engineers of Korea 2004;41(2):53-60.
Hwang W. Study to compare interrelation between Sasang and Iris Constitution. The Journal of Traditional Korean Medicine. 2000;10(2):221-9.
Park S, Choi J, Chung M, Kim Y, Lee J, Lee K, et al. A Morphological Study of Fingerprints and Palm Prints in Sasang Constitution. J Sasang Constitut Med. 1998;10(1):81-99.
Yang KM, Kim YY, Kim JM, Lee EW, Jeong DM. Development of O-Ring Measurement Systems of Muscular Meridians for objectification of the constitutional diagnosis. Journal of the institute of electronics engineers of Korea. 1995;6:388-92.
Kim Y, Kim J, Lee E, Jung D. A Study on Objective Diagnosis of Constitutions by Laser Stimulation and O-Ring Measurement Systems of Muscular Meridians. Journal of the institute of electronics engineers of Korea. 1995;5:173-8.
Kang M. Review on the Diagnosis of Sasang Constitution and Won-Hyul-Diagnosis using O-Ring Test. Journal of Korean acupuncture & moxibustion medicine society. 1994;11(1):549-58.
Oh MJ, Shim YS, Song HS. Original Article : Sasang Constitutional Diagnosis by Portable Ryodoraku Device: Comparative Study with QSCC II Questionnaire. Journal of Korean acupuncture & moxibustion medicine society. 2013;30(4):161-7.
Park H, Chung C. Sasang Constitutional Diagnosis by Iridology: Comparative Study with QSCCII Questionnaire. Korean Journal of Oriental Preventive Medical Sociaty. 2008;12(2):131-43.
Jang E, Kim H, Jung J, Yoo J, Lim J, Lee S. The Pilot Study on the Association of Diagnosis Results between Sasang Constitutional medicine. and Eight Constitutional Medicine. Korean Journal of Oriental medicine. 2008;14(2):93-9.
Park C, Park C. Comparion on different methods in Sasang Constitution Diagnosis. GoHwang Non Jib. 1998;23:181-7.
Do J, Nam J, Jang E, Jang J, Kim J, Kim Y, et al. Comparison between Diagnostic Results of the Sasang Constitutional Analysis Tool (SCAT) and a Sasang Constitution Expert. J Sasang Constitut Med. 2013;25(3):158-66.

원문보기 상세보기
Jang E, Park K, Baek Y, Lee S, Kim S, Joo J. A Development of Sasang Constitution Diagnosis Program Based on Characteristics of Body Shape Face Physiological Symptom and Personality. J Sasang Constitut Med. 2012;24(1):21-31.

원문보기 상세보기
Jeon Y, Kim J, Kim J, Bae J, Kim J, Kim K. Development and Evaluation of Repeatability of the Integrated Constitutional Diagnosis System. J Sasang Constitut Med. 2012;24(3):34-41.

원문보기 상세보기
Jang E, Jin H, Do J, Lee S, Kim J. The Preliminary Study on the Coincidence between Sasang Constitutional Analysis Tool ${\beta}$ -version and Expert of Sasang Constitution. J Sasang Constitut Med. 2012;24(2):1-7.
Baek Y, Kim H, Lee S, Jang E. The Concordance and Validity Assessment of Diagnosis for the Expert in Sasang Constitution. J Sasang Constitut Med. 2014;26(3):295-303.

원문보기 상세보기
Lee J, Lee H, Lee Y, Kim K, Kim S, Lee S, et al. Relations between the Questionnaire and Health State in each Sasang Constitution based on the Oriental medical doctors diagnoses. J Sasang Constitut Med. 2011;23(1):108-14.
Jang E, Kim H, Yoo J, Kim S, Baek Y, Lee S. The Verification of Concordance Coefficient in Sasang Constitutional Factors by Expert. J Sasang Constitut Med. 2008;21(2):79-86.
Kim J, Jung W. The Study on the Clinical Application of the Methods of Sasang Constitution Diagnosis. J Sasang Constitut Med. 2000;12(2):34-42.
Kim YY, Kwon JH, Lee SW, Yoo JH. Trends in Nursing Research using Sasang Constitutional Theory. Journal of East-West nursing research. 2012;18(1):40-6.
Kim JY, Lee YJ, Kim KH. Development of Elder-friendly Diagnosis and Treatment System based on Sasang Constitution. Journal of the institute of electronics engineers of Korea. 2010;6:1933-5.
Ban D, Lee S, Park S. The study about Sasang Constitution diagnosis and research trendsin the case reports. J Sasang Constitut Med. 2009;21(2):107-14.
Lee S, Hwang J, Yoo J, Oh S, Joo J, Jang E. A Survey on the Sasang Constitution Clinical Study. J Sasang Constitut Med. 2008;20(2):21-9.
Song I. The Future Prospect of the Studies on the Objectification of Sasang Constitution. J Sasang Constitut Med. 1998;10(1):1-11.
Jung W, Kim J. The Bibliographical Investigation of Sasang Constitution Diagnosis. J Sasang Constitut Med. 1999;11(2):95-117.
Song I. A Study on the Symptomatic-pharmacology of Sasang Constiution. J Sasang Constitut Med. 1998;10(2):1-14.
Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977;33(1):159-74.

상세보기
Zwann L, Moneteiro S, Sherbino J, Ilgen J, Howey B, Norman G. Is bias in the eye of the beholder? A vignette study to assess recognition of cognitive biases in clinical case workups. BMJ Qual Saf. 2017;26:104-10.

상세보기
Croskerry P. From nindless to mindful practice-cognitive bias and clinical decision making. N Engl J Med. 2013;368:2445-8.

상세보기
Nakhleh RE, Nose V, Colasacco C, Fatheree LA, Lillemoe TJ, McCrory DC, et al. Interpretive Diagnostic Error Reduction in Surgical Pathology and Cytology: Guideline From the College of American Pathologists Pathology and Laboratory Quality Center and the Association of Directors of Anatomic and Surgical Pathology. Arch Pathol Lab Med. 2016 Jan;140(1):29-40.

상세보기
Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924-6.

상세보기
Clark LA, Cuthbert B, Lewis-Fernandez R, Narrow WE, Reed GM. Three Approaches to Understanding and Classifying Mental Disorder: ICD-11, DSM-5, and the National Institute of Mental Health's Research Domain Criteria (RDoC). Psychol Sci Public Interest. 2017 Sep;18(2):72-145.

상세보기
Appelbaum PS. Moving Toward the Future in the Diagnosis of Mental Disorders. Psychological Science in the Public Interest. 2017;18(2):67-71.

상세보기
Graber ML, Wachter RM, Cassel CK. Bringing diagnosis into the quality and safety equations. JAMA. 2012 Sep 26;308(12):1211-2.

상세보기

LOADING...

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증