OBJECTIVES: Resistance to antibiotics is getting worse every day. Antibiotics are commonly prescribed medicines for the prevention and treatment of bacterial infections in dental clinics. Nationally, we are attempting to reduce the use of antibiotics, but this cannot be easily achieved. As a precedent study, we investigated factors affecting antibiotic prescription in dental clinics. METHODS: We analyzed electronic patient records of S dental hospital located in a big city. A total of 12,711 medical records were analyzed. The type of prescribed antibiotic, the prescription rate, and the number of prescription days were analyzed by chi-square test and t-test. Factors associated with the rate of antibiotic prescription were analyzed using logistic regression by dividing the independent variables into four groups: patient characteristics, dentist characteristics, treatment characteristics, and time characteristics. RESULTS: The rate of antibiotic prescription was 91.7% for the first implant surgery and 60.0% for minor operations including incision and drainage. The duration of antibiotic prescription differed according to the sex of the dentist and the type of treatment. The logistic regression analysis showed that the rate of antibiotic prescription was higher in male patients, in older patients, and in female dentists, and decreased with increasing age of the dentist. Compared with basic treatment, the odds ratio of first implant surgery was highest at 102.166 times, minor operation at 18.997, and extraction of impacted tooth at 14.429. CONCLUSIONS: This is the first study to analyze the factors affecting prescription rate of antibiotics in dental clinics. We found that the antibiotic prescription rate was significantly different for each dental treatment. It was necessary to analyze the prescription rate of antibiotics according to the type of treatment. The fact that prescribing antibiotics differed according to dentist characteristics indicated that consistent guidelines need to be established and promoted.
Anti-Bacterial Agents ; Bacterial Infections ; Dental Clinics ; Dentists ; Drainage ; Female ; Humans ; Logistic Models ; Male ; Medical Records ; Odds Ratio ; Prescriptions* ; Tooth, Impacted

OBJECTIVE: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. METHODS: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or −1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. RESULTS: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. CONCLUSIONS: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.
Chin ; Dental Occlusion ; Malocclusion ; Molar ; Orthodontics ; Overbite ; Treatment Outcome

BACKGROUND: Dentist's income is quite variable. We investigate the factors underlying the distribution of dental revenue and dentist income. METHODS: Financial and structural variables of private dental practices(N=13,967) were examined with 2010 Economic Census microdata which include non-insurance revenue. We conducted quantile regression method(QRM) and ordinary least square(OLS) in treating skewness and heteroskedasticity of distributions. The effective estimation for the upper and lower range of distribution becomes possible by QRM. RESULTS: Mid-career dentists are shown to have higher revenue and income. Male dentists achieve the higher revenue and income than female dentists in all quantiles. Group practices show lower income per owner than solo practices significantly. The revenue and income are increased with increasing size of clinics. The high cost in renting the clinic office is found to have a big positive effect on the revenue but a little positive effect on the income. Interestingly the density of dentists shows negative effect on the lowest quantile of the revenue but positive effect on the highest quantile. The lowest quantile of the revenue in the capital areas have the relatively high revenue. The lowest quantile of the income in metropolitan city show higher income than those in other areas significantly. CONCLUSION: The suggested QRM is shown to have more effective and efficient tool in finding out determinants of dentists' revenue and income of our concern. The results of this study are expected to be employed for dentists preparing for the opening practices in their organizational settings and locational selections. The distributional efficiency of dental human resources could be accomplished if policy makers guide dentists with this knowledge.
Administrative Personnel ; Censuses ; Dentists* ; Female ; Group Practice ; Humans ; Male ; Private Practice

OBJECTIVES: This study was performed to investigate the prevalence of impaired fasting glucose (IFG) and its related characteristics among healthy adults in some Korean rural areas. METHODS: We conducted a cross-sectional study using the data from 1352 adults who were over the age 40 and under the age 70 and who were free of diabetes mellitus (DM), cardiovascular diseases and other diseases and who participated in a survey conducted as part of the Korean Rural Genomic Cohort Study. IFG was defined as a serum fasting glucose level between 100 and 125 mg/dL. RESULTS: The prevalence of IFG was 20.4% in men, 15.5% in women and 12.7% overall. Multivariate logistic regression analysis demonstrated that the independent risk factors for IFG were male gender, having a family history of DM, the quartiles of gamma glutamyltransferase and high sensitive C-reactive protein and the waist circumference. The homeostatis model assessment for insulin resistance was very strongly associated with IFG. The prevalence of metabolic syndrome (MS) and MS components was higher in the subjects with IFG then in those with normal fasting glucose (NFG). CONCLUSIONS: The result of study could supply evidence to find the high risk population and to determine a strategy for treating IFG. Further research is needed to explain the causal relationship and mechanisms of IFG.
Adult ; Aged ; Body Weights and Measures ; Cross-Sectional Studies ; *Fasting ; Female ; Glucose Intolerance/*epidemiology ; Health Behavior ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Sex Factors ; Socioeconomic Factors

OBJECTIVES: The purpose of this study was to examine the relationship between serum ferritin and the metabolic syndrome (MS). METHODS: We conducted a cross-sectional study of 1,444 adults over age 40 and under age 70 that lived in a rural area and participated in a survey conducted as part of the Korean Rural Genomic Cohort Study (KRGCS). The MS was defined as the presence of at least three of the followings: elevated blood pressure, low high density lipoprotein cholesterol, elevated serum triglycerides, elevated plasma glucose, or abdominal obesity. After adjustment for age, alcohol intake, menopausal status, body mass index (BMI), high sensitivity C-reactive protein (hs-CRP), and alanine aminotransferase (ALT), odds ratios (ORs) for the prevalence of the MS by sex were calculated for quartiles of serum ferritin using logistic regression analysis. RESULTS: The MS was more common in those persons with the highest levels of serum ferritin, compared to persons with the lowest levels, in men (37.1% vs. 22.4%, p=0.006) and women (58.8% vs. 34.8, p<0.001). In both sexes, the greater the number of MS components presents, the greater the serum ferritin levels. After adjustment for age, alcohol intake, and menopausal status, the OR for metabolic syndrome, comparing the fourth quartile of ferritin with the first quartile, was 2.21 (95% confidence interval ; CI=1.26-3.87; p-trend=0.024) in men and 2.10 (95% CI=1.40-3.17; p-trend=0.001) in women. However, after further adjustment for BMI, hs-CRP, and ALT, the ORs were statistically attenuated in both sexes. CONCLUSIONS: Moderately elevated serum ferritin levels were not independently associated with the prevalence of the MS after adjusting for other risk factors. Further studies are needed to obtain evidence concerning the association between serum ferritin levels and the MS.
Adult ; Aged ; Blood Glucose ; Blood Pressure ; Body Weights and Measures ; Cohort Studies ; Cross-Sectional Studies ; Female ; Ferritins/*blood ; Health Behavior ; Humans ; Korea/epidemiology ; Lipids/blood ; Male ; Metabolic Syndrome X/*epidemiology ; Middle Aged ; Risk Factors ; *Rural Health

OBJECTIVES: This study was performed to investigate the associations between the metabolic syndrome (MetS) and inflammatory markers. METHODS: This cross-sectional analysis was performed using data from 1578 Koreans aged 40-69 years residing in a rural area. We investigated associations between MetS and circulating high sensitivity C-reactive protein (hs-CRP), white blood cells (WBC) and adiponectin. MetS was defined using the criteria proposed by the National Cholesterol Education Program Adult Treatment Panel III (ATP-III). RESULTS: Increased WBC counts and hs-CRP levels and decreased adiponectin levels were observed in subjects with MetS. WBC, hs-CRP and adiponectin levels linearly deteriorated with an increase in the number of MetS components (all ptrend <0.005). Finally, adjusted odds ratios (ORs) for the risk of MetS by increase/decrease in 3 inflammatory markers were calculated by multivariate logistic regression analyses. In terms of changes in inflammation markers, in men, the adjusted ORs (95% confidence interval) were 1.15 (1.01-1.31) for WBC, 1.64 (1.02-2.64) for hs-CRP, and 0.19 (0.08-0.45) for adiponectin, whereas corresponding adjusted ORs (95% CIs) in women were 1.27 (1.15-1.40), 0.98 (0.67-1.42), 0.09 (0.04-0.18), respectively. CONCLUSIONS: Serum adiponectin levels and WBC counts were found to be strongly associated with MetS in both sexes. However, hs-CRP lost its significance after adjusting for BMI and other inflammatory markers in women. This study shows that inflammatory response is associated with MetS in the Korean population. Further prospective studies are necessary to confirm the contribution made by inflammatory markers to the development of MetS.
Adiponectin/blood ; Adult ; Aged ; Biological Markers/blood ; Body Mass Index ; C-Reactive Protein/metabolism ; Female ; Humans ; Inflammation/*blood/complications ; Korea ; Male ; Metabolic Syndrome X/*immunology ; Middle Aged ; Multivariate Analysis ; Rural Population

OBJECTIVE: Ontology is becoming a core research field in the realm of medical informatics. The objective of our ongoing research is to explore the potential role of Formal Concept Analysis(FCA) in a context-based ontology building support in a medical domain. The concept hierarchy plays an important role as the backbone of ontology, but its construction is a complex and time-consuming process. We present a novel approach to the automatic acquisition of taxonomies or concept hierarchies from clinical documents. METHODS: Our approach is based on FCA, a mathematical tool used in data analysis and knowledge engineering. It provides methods to group objects and attributes into concepts, pairs of object-sets(clinical documents) and attribute-sets(fields contained in the clinical documents), such that the binary relation can be presented in a concept lattice. Based on the FCA, we have applied out approach for 8 clinical documents used in a university hospital. As a result of our experiments, we can extract 15 concepts with 7 common fields that can be shared with 8 clinical documents. RESULTS: We show how FCA can be used to classify clinical documents and acquire a concept hierarchy for the medical domain out of the clinical documents with maximal property factorization. CONCLUSION: The whole of our work is based on the concept lattice of which allows to construct a "well defined" ontological concept hierarchy. As an application of this approach, we presented some results of classification of clinical documents with maximally factorized common fields. We have shown that FCA can be useful method to classify and analyze various medical data by constructing concept hierarchy. From that concept hierarchy, we can acquire well-structured facts and knowledges in medical domain.
Classification* ; Medical Informatics ; Statistics as Topic

OBJECTIVE: The medical records of a patient with chronic obstructive pulmonary disease(COPD) were analyzed to extract medical concepts and their relationships in order to construct a basic medical ontology. METHODS: The medical records included the admission note, vital signs record, doctors' order sheets, progress notes, emergency notes, discharge summary, surgical record, and anesthesia record. RESULTS: A total of 396 concepts, 16 relationships, and 460 connections were created. Fourteen top-level concepts, such as body, sign, and procedure, were found. The most common relationship was 'isA' and the second was 'isPartOf'. All the relationships between the concepts were displayed using the graphic tool GraphViz. CONCLUSION: A pilot ontology on COPD was constructed through a medical record analysis. The asynchronous cooperation using a web interface for the ontology construction was helpful.
Anesthesia ; Emergencies ; Humans ; Medical Records* ; Pulmonary Disease, Chronic Obstructive* ; Vital Signs

OBJECTIVE: Medical narratives entry is a major issue to be solved in developing an electronic medical record system operating in practice, as they are, in large part, described in a free-text format. The issue can be dealt with in three aspects: to improve the reusability by structuring medical narratives, to support clinical pragmatics in medical fields, and to reduce the burden of data entry. With the aspects having in mind, this paper purports to present an ontological method for better way of medical narratives entry. METHODS: We developed an ontology for which medical knowledge is structurally represented. Then we can enter medical narrative texts with commands of the controlled natural language operable on the ontology model. RESULTS: Many theoretical studies on free-text entry were reviewed, based on which an authoring and editing tool for natural language description operable on the ontology model has been developed and tested. The performance of the tool is satisfactory within the limit of the domain models we developed here. CONCLUSION: The results of this paper are contributive for clinicians to make an easy entry of medical narratives as far as the ontology model covers their knowledge domain. It is also expected that the cost in recording medical narratives might be considerably reduced and data quality can be improved.
Electronic Health Records ; Models, Theoretical ; Data Accuracy

This study was performed to evaluate the relation of high-sensitivity C-reactive protein (hsCRP) with several cardiovascular risk factors such as age, blood pressure, smoking habit and serum lipids, body mass index, blood glucose, regular exercise, alcohol drinking, white blood cell counts in a cross-sectional survey. Plasma hsCRP was measured by immunoturbidimetry in 202 subjects, aged over 50 yr, who participated in health-check survey in a rural area of Jeollanamdo, Korea. Plasma hsCRP level was 1.9 +/- 3.0 mg/dL. There were significant associations between hsCRP levels and age, white blood cell counts, blood glucose, diastolic blood pressure, HDL-cholesterol, body mass index and smoking status. In stepwise multivariate regression analysis, white blood cell counts, age, blood glucose, smoking status and body mass index were independent correlates of hsCRP levels. In conclusion, plasma hsCRP levels were associated with several cardiovascular risk factors, and these data are compatible with the hypothesis that CRP levels may be a marker for preclinical cardiovascular disease. Further what we need now are prospective studies to evaluate the association of C-reactive protein concentrations with subsequent cardiac events.
Alcohol Drinking ; Blood Glucose/metabolism ; Blood Pressure ; Body Mass Index ; C-Reactive Protein/*metabolism ; Cardiovascular Diseases/*blood/physiopathology ; Cross-Sectional Studies ; Educational Status ; Female ; Humans ; Male ; Marital Status ; Multivariate Analysis ; Regression Analysis ; Research Support, Non-U.S. Gov't ; Risk Factors ; Smoking ; Socioeconomic Factors