Reliability and Validity of Korean Brief Comprehensive Geriatric Assessment Questionnaire

Background: The purpose of this study was to evaluate the applicability of the Korean Brief Comprehensive Geriatric Assessment Questionnaire through testing the reliability and validity of it. Methods: Questionnaire consisted of items on medical, functional, mental, socioeconomic status and lifestyle was administered as test-retest on 78 elderly outpatients at 6 university hospitals in Seoul, Korea. Weighted kappa value, kappa value, Pearson correlation coefficients and overall percent agreement were calculated to measure reliability. Validity coefficient was estimated by using reliability coefficient. Results: Reliability coefficients and validity coefficients were higher than 0.50 (fair or good) for 28 items (87.5%) among 32. For test- retest reliability, median was 1.00 (range, 0.87-1.00) for overall percent agreement, 0.66 (range, 0.27~1.00) for kappa value, and 0.83 (range, 0.65~1.00) for Pearson's correlation coefficients. Differences of reliability and validity were identified by gender for 19 items (59.4%), and by age group for 12 items (37.5%). Conclusion: The Korean Brief Comprehensive Geriatric Assessment Questionnaire appears to be a reliable and valid screening tool. After additional study is performed, this instrument can be used as a useful tool for comprehensive outpatient geriatric assessment.

A Selection and Translation of Evidence Based Clinical Practice Guidelines for Primary Care Physician in Respiratory Disease Field

BACKGROUND: One method for achieving medical practice to be more evident, especially in the field of primary care, is to encourage the use of clinical guidelines. If development of guidelines is difficult because of time and cost, an evidence based foreign guidelines can be selected and translated into Korean for application. METHODS: A team was formed, consisting of 11 family physician experts on evidence based medicine and clinical practice guidelines. We selected six respiratory diseases requiring clinical guidelines because of variability in practice. We searched several clinical practice guideline databases and selected one guideline according to currency, scope of guideline, whether it was evidence based, and its feasibility in the field of primay care. We translated selected guideline's full-texts or summaries which were done by authorized organization into Korean. RESULTS: The selected respiratory diseases were chronic obstructive pulmonary disease, asthma, pneumonia, sinusitis, rhinitis, and influenza. According to criterion, we selected GOLD (Global Initiative for Chronic Obstructive Lung Disease) for chronic obstructive lung disease, GINA (Global initiative for asthma) for asthma, CDC (Center for disease control) guideline for influenza, IDSA (Infectious Diseases Society of America) guideline for pneumonia, AAP (American Academy of Pediatrics) guideline for sinusitis, and JCAAI (Joint Council of Allergy, Asthma and Immunology) for rhinitis. CONCLUSION: We selected six common respiratory diseases and the most appropriate evidence based guidelines for those particular diseases.

The Validity and Reliability of Korean Version of Bathel ADL Index

BACKGROUND: The functional status of elderly has been measured by many different methods including Karz ADL index, Bathel ADL index and physical self- maintenance scale. Among them, Bathel ADL index has been widely used in many countries because of easiness to scoring and administration. Therefore, we translated the Bathel ADL index and tested the translation validity and psychometric properties (validity and reliability) of Korean version of Bathel ADL index. METHODS: The Bathel ADL index was translated by multidisciplinary committee members. The quality of translation was rated by committee members using three criteria (clarity, use of common language, conceptual equivalence). Reliability was tested by internal consistency (Cronbach's alpha), two weeks test-retest reliability, and intraobserver agreement. Clinical validity and construct validity comparison with brain disability grade were tested for validity testing. RESULTS: Cronbach's alpha was 0.97. Two weeks test-retest correlations coefficient was 0.95 (P=0.00). Interrator agreements were high in all 10 items (kappa=0.82~1.0). Normal control group had lower scores than the patient group (P=0.000). Correlation coefficients between the Korean version of Bathel ADL index score and brain- disability grade was -0.58 (P=0.000). CONCLUSION: The Korean version of Bathel ADL index is a valid and reliable instrument for measuring functional status of the elderly.

The Validity and Reliability of Korean Version of Karz ADL Index

BACKGROUND: The functional status of elerly has been measured by mamy measures including Karz ADL index, Karz ADL index and physical self-maintenace scale. Amon them, Karz ADL index has been widely used in many countries because of easiness to scoring and adminstration. So we translated Karz ADL index and tested the translation validity, psychometric properties(validity and reliability) of Korean version of Karz ADL index. METHODS: The Karz ADL index was translated by multidisciplinary committee members. The quality of translation was rated by committee members using three criteria(clarity, use of common language, conceptual equivalence). Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest reliability, intraobserver agreement. Clinical validity and construct validity comparison with brain disability grade were tested for validity testing. RESULTS: Cronbach's alpha was 0.90. 2 weeks test-retest correlations coefficient was 0.94(p=0.00). Interrator agreements were high in all 10 items( =0.79 0.96). Normal control group had lower scores than patients group(p=0.000). Correlation coefficients between Korean version of Karz ADL index score and brain-disability grade was -0.68(p=0.000). CONCLUSION: Korean version of Karz ADL index is a valid and reliable instrument for measuring functional status of elderly.

The Validity and Reliability of Korean Activities of Daily Living(K-ADL) Scale

BACKGROUNDS: Korean Activities of Daily Living(K-ADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of Korean Activities of Daily Living(K-ADL) scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach's alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach's alpha was 0.937. 2 weeks test-retest correlations in all 7 items were higher than 7.0. Interrator agreements were high in all 7 items(h=0.86~1.0). Nonnal control group had lower scores than patients group in all 7 items(p=0.000). Correlation coefficients between K-ADL score and braindisability grade was between -0.465(eating) and -0.696(bathing)(p=0.000). CONCLUSIONS: Korean Activities of Daily Living(K-ADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-ADL and mortality, prognosis are needed.

The Development of Korean Activities of Daily Living(K-ADL) and Korean Instrumental Activities of Daily Living(K-IADL) Scale

BACKGROUNDS: Katz index of ADL and Barthel index of ADL have been used to evaluate the function of disabled elderly in Korea. But no ADL scale reflecting Korean's own language expression and culture has been developed and verified yet. METHODS: Descriptions of basic activities which needed others' help were collected from 190 Korean disabled elderly. The collected results were categorized into basic activities of daily living and instrumental activities of daily living, and then in each domain such as bathing, shopping, etc. Preliminary instrument items were selected by the judgement of the expert committee, considering the frequency of the responses and the importance of each item. A preliminary questionnaire was developed based on the selected items. The preliminary questionnaire was pretested twice, and corrected by the results. Finally a scholar on Korean literature verified the questionnaire on the grammar and context. RESULTS: A total of 408 basic activities of daily living and 242 instrumental activities of daily living were collected. The activities were categorized into 7 domains of ADL(dressing, washing face and hand, bathing, eating, transfer, toileting, continence) and 10 domains of IADL(decorating, housework, preparing meals, laundry, outgoing for a short distance, using transportation, shopping, handling money, using telephone, taking medicine) CONCLUSIONS: We developed a Korean Activities of Daily Living(K-ADL) scale and Korean Instrumental Activities of Daily Living(K-IADL) scale reflecting Korean elderly's own language expression and culture.

The Validity and Reliability of Korean Instrumental Activities of Daily Living(K-IADL) Scale

BACKGROUND: Korean Instrumental Activities of Daily Living(K-IADL) scale was developed to measure the elderly function. The aim of the present study was to establish the validity and reliability of K-IADL scale. METHODS: Clinical validity and convergent validity was tested. Reliability was tested by internal consistency(Cronbach`s alpha), two weeks test-retest method, and interrator correlation. RESULTS: Cronbach`s alpha was 0.938. 2 weeks test-retest correlations in all 10 items were higher than 0.674. Interrator agreements were high in all 10 items(H=0.808~0.947). Normal control group had lower scores than patients group in all 10 items(p=0.000). Correlation coefficient between K-IADL score and brain-disability grade was between -0.336(laundry) and -0.663(using transportation)(p=0.000). CONCLUSIONS: Korean Instrumental Activities of Daily Living(K-IADL) scale is a valid and reliable instrument. In the future, the studies showing an association between K-IADL and mortality, prognosis are needed.

Tuberculosis update

No abstract available.

Effects of TGF-beta, GM-CSF, and PDGF on Proliferation and Expression of Cytokine and Metalloproteinase Genes in Rheumatoid Synovial Cells / 대한면역학회지

To investigate effects of cytokines on rheumatoid synovial cells, proliferation and expression of cytokine and metalloproteinase genes were studied with the primary culture of rheumatoid synovial cells which was treated with TNF-alpha, GM-CSF, TGF-alpha, PDGF and IL-B. By [3H] thymidine incorporation assay, TGF-beta and PDGF increased proliferation of synovial cells by 1.5 and 2.5 folds respectively. Cytokine gene expression was assessed by RT-PCR. Rheumatoid synovial cells expressed constitutively TGF-beta and IL-B at a high level and IL-1B, GM-CSF, and MIP-1a at a relatively low level. TGF-beta, GM-CSF and PDGF increased IL-B expression. Expression of pro-inflammatory cytokines and chemokines was increased by GM-CSF and PDGF. Both GM-CSF and PDGF increased the expression of IL-1B, GM-CSF MIP-la and IL-8. In addition, GM-CSF enhanced expression of TNF-alpha. Stromelysin and collagenase are the major proteinases responsible for destruction ot joints in rheumatoid arthritis (RA). These genes were expressed constitutivefy in rheumatoid synovial cells. In summary, PDGF and GM-CSF may piay an important role by inducing or increasing expression of IL-1B, TGF-beta and PDGF by increasing proliferation of rheumatoid synovial cells.