1.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
2.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
3.Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer
Sung Eun OH ; Yun-Suhk SUH ; Ji Yeong AN ; Keun Won RYU ; In CHO ; Sung Geun KIM ; Ji-Ho PARK ; Hoon HUR ; Hyung-Ho KIM ; Sang-Hoon AHN ; Sun-Hwi HWANG ; Hong Man YOON ; Ki Bum PARK ; Hyoung-Il KIM ; In Gyu KWON ; Han-Kwang YANG ; Byoung-Jo SUH ; Sang-Ho JEONG ; Tae-Han KIM ; Oh Kyoung KWON ; Hye Seong AHN ; Ji Yeon PARK ; Ki Young YOON ; Myoung Won SON ; Seong-Ho KONG ; Young-Gil SON ; Geum Jong SONG ; Jong Hyuk YUN ; Jung-Min BAE ; Do Joong PARK ; Sol LEE ; Jun-Young YANG ; Kyung Won SEO ; You-Jin JANG ; So Hyun KANG ; Bang Wool EOM ; Joongyub LEE ; Hyuk-Joon LEE ;
Journal of Gastric Cancer 2025;25(2):382-399
Purpose:
This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.
Materials and Methods:
A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
Results:
Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).
Conclusions
Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.
4.Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer
Sung Eun OH ; Yun-Suhk SUH ; Ji Yeong AN ; Keun Won RYU ; In CHO ; Sung Geun KIM ; Ji-Ho PARK ; Hoon HUR ; Hyung-Ho KIM ; Sang-Hoon AHN ; Sun-Hwi HWANG ; Hong Man YOON ; Ki Bum PARK ; Hyoung-Il KIM ; In Gyu KWON ; Han-Kwang YANG ; Byoung-Jo SUH ; Sang-Ho JEONG ; Tae-Han KIM ; Oh Kyoung KWON ; Hye Seong AHN ; Ji Yeon PARK ; Ki Young YOON ; Myoung Won SON ; Seong-Ho KONG ; Young-Gil SON ; Geum Jong SONG ; Jong Hyuk YUN ; Jung-Min BAE ; Do Joong PARK ; Sol LEE ; Jun-Young YANG ; Kyung Won SEO ; You-Jin JANG ; So Hyun KANG ; Bang Wool EOM ; Joongyub LEE ; Hyuk-Joon LEE ;
Journal of Gastric Cancer 2025;25(2):382-399
Purpose:
This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.
Materials and Methods:
A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
Results:
Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).
Conclusions
Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.
5.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
6.Prospective Multicenter Observational Study on Postoperative Quality of Life According to Type of Gastrectomy for Gastric Cancer
Sung Eun OH ; Yun-Suhk SUH ; Ji Yeong AN ; Keun Won RYU ; In CHO ; Sung Geun KIM ; Ji-Ho PARK ; Hoon HUR ; Hyung-Ho KIM ; Sang-Hoon AHN ; Sun-Hwi HWANG ; Hong Man YOON ; Ki Bum PARK ; Hyoung-Il KIM ; In Gyu KWON ; Han-Kwang YANG ; Byoung-Jo SUH ; Sang-Ho JEONG ; Tae-Han KIM ; Oh Kyoung KWON ; Hye Seong AHN ; Ji Yeon PARK ; Ki Young YOON ; Myoung Won SON ; Seong-Ho KONG ; Young-Gil SON ; Geum Jong SONG ; Jong Hyuk YUN ; Jung-Min BAE ; Do Joong PARK ; Sol LEE ; Jun-Young YANG ; Kyung Won SEO ; You-Jin JANG ; So Hyun KANG ; Bang Wool EOM ; Joongyub LEE ; Hyuk-Joon LEE ;
Journal of Gastric Cancer 2025;25(2):382-399
Purpose:
This study evaluated the postoperative quality of life (QoL) after various types of gastrectomy for gastric cancer.
Materials and Methods:
A multicenter prospective observational study was conducted in Korea using the Korean Quality of Life in Stomach Cancer Patients Study (KOQUSS)-40, a new QoL assessment tool focusing on postgastrectomy syndrome. Overall, 496 patients with gastric cancer were enrolled, and QoL was assessed at 5 time points: preoperatively and at 1, 3, 6, and 12 months after surgery.
Results:
Distal gastrectomy (DG) and pylorus-preserving gastrectomy (PPG) showed significantly better outcomes than total gastrectomy (TG) and proximal gastrectomy (PG) with regard to total score, indigestion, and dysphagia. DG, PPG, and TG also showed significantly better outcomes than PG in terms of dumping syndrome and worry about cancer. Postoperative QoL did not differ significantly according to anastomosis type in DG, except for Billroth I anastomosis, which achieved better bowel habit change scores than the others. No domains differed significantly when comparing double tract reconstruction and esophagogastrostomy after PG. The total QoL score correlated significantly with postoperative body weight loss (more than 10%) and extent of resection (P<0.05 for both).Reflux as assessed by KOQUSS-40 did not correlate significantly with reflux observed on gastroscopy 1 year postoperatively (P=0.064).
Conclusions
Our prospective observation using KOQUSS-40 revealed that DG and PPG lead to better QoL than TG and PG. Further study is needed to compare postoperative QoL according to anastomosis type in DG and PG.
7.Dementia Overdiagnosis in Younger, Higher Educated Individuals Based on MMSE Alone: Analysis Using Deep Learning Technology
Hye-Geum KIM ; Dai-Seg BAI ; Bon-Hoon KOO ; Eun-Jin CHEON ; Seokho YUN ; So Hye JO ; Byoungyoung GU
Journal of Korean Medical Science 2025;40(9):e20-
Background:
Dementia is a multifaceted disorder that affects cognitive function, necessitating accurate diagnosis for effective management and treatment. Although the Mini-Mental State Examination (MMSE) is widely used to assess cognitive impairment, its standalone efficacy is debated. This study examined the effectiveness of the MMSE alone versus in combination with other cognitive assessments in predicting dementia diagnosis, with the aim of refining the diagnostic accuracy for dementia.
Methods:
A total of 2,863 participants with subjective cognitive complaints who underwent comprehensive neuropsychological assessments were included. We developed two random forest models: one using only the MMSE and another incorporating additional cognitive tests.These models were evaluated based on their accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC) on a 70:30 training-to-testing split.
Results:
The MMSE-alone model predicted dementia with an accuracy of 86% and AUC of 0.872. The expanded model demonstrated increased accuracy (88%) and an AUC of 0.934.Notably, 17.46% of the cases were reclassified from dementia to non-dementia category upon including additional tests. Higher educational level and younger age were associated with these shifts.
Conclusion
The findings suggest that although the MMSE is a valuable screening tool, it should not be used in isolation to determine dementia severity. The addition of diverse cognitive assessments can significantly enhance diagnostic precision, particularly in younger and more educated populations. Future diagnostic protocols should integrate multifaceted cognitive evaluations to reflect the complexity of dementia accurately.
8.Pregnant women’s experiences of online prenatal education in Korea during COVID-19: a phenomenological study
Hyun Kyoung KIM ; Geum Hee JEONG ; Hye Young MIN
Women’s Health Nursing 2024;30(3):192-202
Purpose:
This study aimed to explore the significance and insights derived from the experiences of pregnant women in Korea who participated in online prenatal education during the COVID-19 pandemic.
Methods:
This study employed the hermeneutic phenomenology framework developed by Colaizzi. It involved 12 pregnant women who participated in online prenatal education provided by public health centers in Chuncheon, Korea. Data collection was achieved through in-depth interviews conducted in Korea from October 2021 to April 2022.
Results:
In total, 51 significant statements were extracted from the interview data and then categorized into 10 themes. Finally, three categories were formed by merging similar themes. The three basic categories of participants’ experiences of online prenatal education were “feeling of safety and comfort in body and mind,” “frustrated by a lack of interaction,” and “digital education being a double-edged sword.” Pregnant women expressed ambivalence regarding the benefits and drawbacks of the online educational experience. They desired more interactive and practical learning opportunities, even as they appreciated the comfort of learning remotely.
Conclusion
This study revealed the phenomenon of online prenatal education as an advanced form of distance-based prenatal education instead of the traditional in-person classroom. To maximize the educational effectiveness of this new format, public health center policies must address the digital literacy gap and enhance accessibility by leveraging the immersive multimedia experiences that online education offers to pregnant women. We recommend that maternal healthcare providers adopt this innovative approach to prenatal education, utilizing distance education technology to improve participation and promote immersion.
9.Pregnant women’s experiences of online prenatal education in Korea during COVID-19: a phenomenological study
Hyun Kyoung KIM ; Geum Hee JEONG ; Hye Young MIN
Women’s Health Nursing 2024;30(3):192-202
Purpose:
This study aimed to explore the significance and insights derived from the experiences of pregnant women in Korea who participated in online prenatal education during the COVID-19 pandemic.
Methods:
This study employed the hermeneutic phenomenology framework developed by Colaizzi. It involved 12 pregnant women who participated in online prenatal education provided by public health centers in Chuncheon, Korea. Data collection was achieved through in-depth interviews conducted in Korea from October 2021 to April 2022.
Results:
In total, 51 significant statements were extracted from the interview data and then categorized into 10 themes. Finally, three categories were formed by merging similar themes. The three basic categories of participants’ experiences of online prenatal education were “feeling of safety and comfort in body and mind,” “frustrated by a lack of interaction,” and “digital education being a double-edged sword.” Pregnant women expressed ambivalence regarding the benefits and drawbacks of the online educational experience. They desired more interactive and practical learning opportunities, even as they appreciated the comfort of learning remotely.
Conclusion
This study revealed the phenomenon of online prenatal education as an advanced form of distance-based prenatal education instead of the traditional in-person classroom. To maximize the educational effectiveness of this new format, public health center policies must address the digital literacy gap and enhance accessibility by leveraging the immersive multimedia experiences that online education offers to pregnant women. We recommend that maternal healthcare providers adopt this innovative approach to prenatal education, utilizing distance education technology to improve participation and promote immersion.
10.Pregnant women’s experiences of online prenatal education in Korea during COVID-19: a phenomenological study
Hyun Kyoung KIM ; Geum Hee JEONG ; Hye Young MIN
Women’s Health Nursing 2024;30(3):192-202
Purpose:
This study aimed to explore the significance and insights derived from the experiences of pregnant women in Korea who participated in online prenatal education during the COVID-19 pandemic.
Methods:
This study employed the hermeneutic phenomenology framework developed by Colaizzi. It involved 12 pregnant women who participated in online prenatal education provided by public health centers in Chuncheon, Korea. Data collection was achieved through in-depth interviews conducted in Korea from October 2021 to April 2022.
Results:
In total, 51 significant statements were extracted from the interview data and then categorized into 10 themes. Finally, three categories were formed by merging similar themes. The three basic categories of participants’ experiences of online prenatal education were “feeling of safety and comfort in body and mind,” “frustrated by a lack of interaction,” and “digital education being a double-edged sword.” Pregnant women expressed ambivalence regarding the benefits and drawbacks of the online educational experience. They desired more interactive and practical learning opportunities, even as they appreciated the comfort of learning remotely.
Conclusion
This study revealed the phenomenon of online prenatal education as an advanced form of distance-based prenatal education instead of the traditional in-person classroom. To maximize the educational effectiveness of this new format, public health center policies must address the digital literacy gap and enhance accessibility by leveraging the immersive multimedia experiences that online education offers to pregnant women. We recommend that maternal healthcare providers adopt this innovative approach to prenatal education, utilizing distance education technology to improve participation and promote immersion.

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