Establishment of Reference Value Using Korean Adult Medical Checkup Data and Interpretation of Test Results / 임상검사와정도관리

BACKGROUND: There is room for doubt that the reference intervals currently used in many hospitals or health institutions in Korea are appropriate, because some scientists do not agree that the selections of reference individuals were valid universally. If we adopt the inappropriate reference intervals in the decision making of examinees' health status, we are liable to lead to false-negatives or false-positives. METHODS: We selected 555 healthy and 2,134 unhealthy adult samples who took medical check-up at an institution between 2000 and 2004 through semi-stratified random sampling method. Disease groups were divided into 7 subgroups: hepatic, gastrointestinal, obesity, circulatory, endocrine, urogenital and others. RESULTS: Through parametric and non-parametric methods, we produced new reference intervals and compared the newly developed intervals with current ones. Some reference values should be adjusted newly; ALT-male < or =33 IU/L, ALT-female < or =22 IU/L, AST < or =28 IU/L, cholesterol < or =198 mg/dL, triglyceride-male < or =172 mg/dL, triglyceride-female < or =133 mg/dL, fasting blood sugar 65-101 mg/dL. CONCLUSIONS: In order to reduce the rate of false-positives or false-negatives, we suggest that reference ranges of some items might be reestablished or adjusted according to gender through the further studies on current reference ranges.

A Comparative Study of Item Analysis by Item Response Theory Based for Initiating CAT(Computer Adaptive Test) System / 한국의학교육

Prior to CAT, the parameter estimation on executed items should be accomplished by IRT.and the item banking must be build up on the basis of the parameter of difficulty. A program developed by Korea ETS Inc, Bilog and Bigsteps were all found to be very powerful to understand the attributes of items. Though multiple true-false type K items have some merits, the items should be examined quantitatively if they are appropriate or not by IRT. Through the study we have finally confirmed that the new program developed by Korea ETS has its ability to check the validities of items from preparing or scoring to item analysis.