Total Number Of Examinees Research Articles

Item analysis: the impact of distractor efficiency on the difficulty index and discrimination power of multiple-choice items

BackgroundDistractor efficiency (DE) of multiple-choice questions (MCQs) responses is a component of the psychometric analysis used by the examiners to evaluate the distractors’ credibility and functionality. This study was conducted to evaluate the impact of the DE on the difficulty and discrimination indices.MethodsThis cross-sectional study was conducted from April to June 2023. It utilizes the final exam of the Principles of Diseases Course with 45 s-year students. The exam consisted of 60 type A MCQs. Item analysis (IA) was generated to evaluate KR20, difficulty index (DIF), discrimination index (DIS), and distractor efficiency (DE). DIF was calculated as the percentage of examinees who scored the item correctly. DIS is an item’s ability to discriminate between higher and lower 27% of examinees. For DE, any distractor selected by less than 5% is considered nonfunctional, and items were classified according to the non-functional distractors. The correlation and significance of variance between DIF, DI, and DE were evaluated.ResultsThe total number of examinees was 45. The KR-20 of the exam was 0.91. The mean (M), and standard deviation (SD) of the DIF of the exam was 37.5(19.1), and the majority (69.5%) were of acceptable difficulty. The M (SD) of the DIS was 0.46 (0.22), which is excellent. Most items were excellent in discrimination (69.5%), only two were not discriminating (13.6%), and the rest were of acceptable power (16.9%). Items with excellent and good efficiency represent 37.3% each, while only 3.4% were of poor efficiency. The correlation between DE and DIF (p = 0.000, r= -0.548) indicates that items with efficient distractors (low number of NFD) are associated with those having a low difficulty index (difficult items) and vice versa. The correlation between DE and DIS is significantly negative (P = 0.0476, r=-0.259). In such a correlation, items with efficient distractors are associated with low-discriminating items.ConclusionsThere is a significant moderate negative correlation between DE and DIF (P = 0.00, r = -0.548) and a significant weak negative correlation between DE and DIS (P = 0.0476, r = -0.259). DIF has a non-significant negative correlation with DIS (P = 0.7124, r = -0.0492). DE impacts both DIF and DIS. Items with efficient distractors (low number of NFD) are associated with those having a low difficulty index (difficult items) and discriminating items. Improving the quality of DE will decrease the number of NFDs and result in items with acceptable levels of difficulty index and discrimination power.

Evaluating the cutoff score of the advanced practice nurse certification examination in Korea

AimThis study aimed to evaluate the cutoff score of the Advanced Practice Nurse (APN) certification examination determined using two standard-setting methods and to compare it with the current score. BackgroundThe APN qualification is established by passing a certification examination. However, the method of determining the passing criterion is different among countries. In Korea, the passing criterion has been predetermined as 60% of the total score or above without any theoretical or empirical basis. DesignIn this study, two typical and popular standard-setting methods, the modified Angoff and Bookmark methods, were used to determine the passing criterion of the APN certification examination. MethodsThe performance data of a gerontological APN certification examination were used to conduct standard setting with both the modified Angoff and Bookmark methods. The total number of examinees in the dataset was 121. Item analysis with a 2-parameter logistic model was performed based on the item response theory using the Bilog-MG3.0 program. A total of 5 raters in APN education and clinical nursing practice were selected. ResultsThe modified Angoff and Bookmark methods gave cutoff scores of 113 and 110.5 with passing ratios of 52.9% and 57.0%, respectively. These results were different from the conventional cutoff score of 90 with a passing ratio of 93.4%. ConclusionThe present arbitrary fixed cutoff score should be reconsidered to improve the robustness of the APN qualification and standard-setting methods should be employed to determine an adequate cutoff score for the APN certification examination to ensure the competency of APNs in providing advanced care.

Cytological examination of the thyroid in children and adolescents after the Fukushima Nuclear Power Plant accident: the Fukushima Health Management Survey.

The Fukushima Daiichi Nuclear Power Plant accident occurred on March 11 2011, following the Great East Japan Earthquake and tsunami. Radioactive materials, including I-131, were released into the environment after the accident. Shortly after, the prefectural government initiated the Fukushima Health Management Survey for monitoring the long-term health conditions of the residents of Fukushima Prefecture. In the survey, thyroid ultrasonography was scheduled for all people aged 18 years or younger who were living in Fukushima Prefecture at the time of disaster. The total number of examinees was approximately 370,000 in the Preliminary Baseline Survey (PBLS), and 380,000 in the first Full-scale Survey (FSS). First, thyroid ultrasonography was performed as the Primary Examination. When a thyroid nodule that meets the fine needle aspiration cytology (FNAC) guideline is detected, thyroid FNAC is performed. By the end of June 2017, the cytological specimens of 187 examinees had been interpreted as Malignant or Suspicious for Malignancy (SFM). In this article, the cytological results of whole categories are presented using the criteria of The Bethesda System for Reporting Thyroid Cytopathology. The total numbers of examinees with SFM or Malignant in PBLS and at the first FSS were 106 (62.0%) and 71 (38.0%), respectively. The data of the cytological results of SFM and Malignant were already reported. However, this is the first report of cytological data from categories other than SFM and Malignant. The results of the current study will contribute to future research into the thyroid conditions of children and adolescents.

Risk Factors and Prevalence of Deep Vein Thrombosis After the 2016 Kumamoto Earthquakes.

After previous earthquakes, a high prevalence of deep vein thrombosis (DVT) has been reported. We examined DVT prevalence and risk factors in evacuees of the Kumamoto earthquakes by performing mobile DVT screening at various evacuation centers around the epicenter. Methods and Results: For 1 month after the Kumamoto earthquake on 14 April 2016, mobile DVT screening using portable ultrasonography (US) was performed at 80 evacuation centers. Questionnaires, physical examination, and US of the lower limb were carried out, and simple D-dimer measurements were undertaken for DVT-positive examinees. The total number of examinees was 1,673, of whom 178 (10.6%) had DVT. The prevalence of DVT seemed to be gradually decreasing in the screening period, but age, use of sleep medication, prevalence of hypertension, dyslipidemia, leg edema, and lower leg varix were significantly higher in the DVT positive group than in the negative group. On multivariable logistic regression analysis, high age (≥70 years old), use of sleep medication, lower leg edema, and lower leg varix were significant predictors of DVT. In examinees with these 4 predictors, the DVT positive rate was 71.4%. In the first month after the Kumamoto earthquakes, DVT prevalence and severity, evaluated on D-dimer level, decreased with the passage of time. Mobile DVT screening indicated significant factors stratifying DVT risk in the evacuees.

Monitoring Items in Real Time to Enhance CAT Security

An IRT‐based sequential procedure is developed to monitor items for enhancing test security. The procedure uses a series of statistical hypothesis tests to examine whether the statistical characteristics of each item under inspection have changed significantly during CAT administration. This procedure is compared with a previously developed CTT‐based procedure through simulation studies. The results show that when the total number of examinees is fixed both procedures can control the rate of type I errors at any reasonable significance level by choosing an appropriate cutoff point and meanwhile maintain a low rate of type II errors. Further, the IRT‐based method has a much lower type II error rate or more power than the CTT‐based method when the number of compromised items is small (e.g., 5), which can be achieved if the IRT‐based procedure can be applied in an active mode in the sense that flagged items can be replaced with new items.

ULTRASONOGRAPHIC AND SCINTIGRAPHIC PARAMETERS OF MALIGNANCY OF THE DOMINANT THYROID NODULE

An adequate approach to diagnosis and treatment of the dominant thyroid nodule is a matter of debate. The aim of the study is to determinate the most significant ultrasaund and scintigraphic parametars of malignancy in dominant thyroid nodules. The study involved 95 patients treated surgically for polynodous goiter with a dominant nodule for whom ultrasonographic and scintigraphic diagnosis was made prior to surgery. Echosonographic and scintigraphic findings were compared and analyzed against the operative and histopathologic findings of the dominant nodule. Our male examinees were 59.4 ± 11.66 years, and female examinees 53.02 ± 12.78 old on the average. Of the total number of examinees, there were 74 with benign and 21 with malignant changes. Considering the ultrasound and scintigraphy parameters of malignancies, the following could be singled out as statistically significant: non-sharply delineated nodule change (OR = 0.765; 95% CI = 0.555-0.985); hypoechogenicity (OR = 2.152; 95% CI = 1.111-2.456); avascular nodule (OR = 2.156; 95% CI = 1.111-4.589); and hypofunctional nodule (OR = 2.154; 95% CI = 1.111-3.589). The sensitivity and specificity of ultrasound in dominant nodule detection were 80% and 90%, respectively, while for scintigraphy the percentages were 55% and 60%. The most important diagnostic parameters of a malignancy of the dominant thyroid nodule are non-sharp delineation of the change, hypoechogenicity and nodule avascularization. Ultrasound has higher sensitivity and specificity than scintigraphy in the diagnosis of malignant dominant thyroid nodules.

1664 – Evaluation of the effectiveness of treatment response applying panss, GAF and MOCA in patients with schizophrenia

Introduction Schizophrenia (SCH) is considered the most serious psychiatric disorder with complex pathogenetic and pathophysiological mechanisms and inadequate treatments. Objectives Given the association of psychotropic medication and cognitive, functional, and neuropsychiatric symptoms (NPS), the use of certain measuring instruments among patients who suffer from schizophrenia is important because the quantification of treatment effects is crucial for optimizing the management of patients with schizophrenia. Aims To assess the efficacy of antipsychotic therapy in schizophrenic patients with predominantly negative and positive symptoms, cognitive impairment and social, occupational and psychological dysfunction. Methods Two main groups were selected for analysis: (N=34) included patients taking first-generation antipsychotics (FGAs) and (N=16) included patients taking second generation antipsychotics (SGAs). We used the Positive and Negative Syndrome Scale (PANNS), Global Assessment Functioning (GAF) and Montreal Cognitive Assessment Scale (MOCA). Results Out of the total number of examinees (n=50), 15/50 (30%) were males and 35/50 (70%) were females; the age of onset was 38.4±1.77; duration of illness (mean±SD) 32.5±5.00; SANS-Total (mean±SD) (23.82±9.962); SAPS-Total (mean ±SD) (28.6±9.74). Analysis of the PANSS scale bipolar index shows that patients on SGA, on average, had lower scores (2.37±12.5) compared to patients on FGA (5.91 ±9.61). Conclusions Preliminary evidence showed that there are no significant advantages in the use of atypical antipsychotics compared with typical ones in a group of patients suffering from schizophrenia. It is important to realize what role the advancement of antipsychotics has played and what still needs to be accomplished to further improve the outcome of sch patients.

Correlation of In-training Examination Score with the Residency Program or the Score of the Board Examination of Laboratory Medicine

An in-training examination is given annually to the all laboratory medicine residents of in Korea. The purpose of this study was to evaluate the results of the in-training examinations according to the examinees' postgraduate years, a number of teaching faculty members and hospital beds, and the score of the board examination. A total number of examinees during the 5-year period from 2001 to 2005 were 311. All residents took the same in-training examinations given each year irrespective of the postgraduate year (PGY). The scores of in-training examinations increased with advance in the examinees' PGY (P<0.01). The scores were not different according to the size of teaching faculty or hospital beds (P>0.05). The correlation coefficients of each PGY scores were from 0.474 to 0.755 (P<0.01). The scores of the 4th PGY were correlated with those of the board examinations (r=0.627, P<0.001). These results suggest that the scores of the in-training examinations may be a valid measure of knowledge acquired by residents during their training years and provide a useful information for improving the laboratory medicine residency training program.

Clinical study of the lower third molars eruption level influence on incidence of acute infection

The aim of this paper was estimate if there was correlation between clinically and radiographically evaluated eruption level of the lower third molar and incidence and severity of the acute infection, respectively. Methods and material: The study was conducted in 100 male examinees, age range from 18 to 25 years old, with clinical and radiographic diagnosis of partially erupted or non erupted third molars. Results: Total number of examinees with clinically registered partially erupted lower third molars was 75, of which 62 (82.6%) manifested infection. Non erupted third molars were in 25 examinees of which 11 (44%) had signs of infection. Partial eruption stage of the third molar was the most common cause of the light infection form (68.8%). Infective complications in over 60% of examinees were related to higher levels of teeth eruption. Higher eruption positions of lower third molars were causing light infections in 56.1%, and in 31.5% - severe forms of infection. Most frequently, lower third molar was related to occurrence and severity of the infection when positioned in occlusal plane level. Conclusion: Partially erupted lower third molar, when positioned in occlusal plane level, is the high risk tooth for an infection to occur.

Screening for gastric cancer.

Mass screening for gastric cancer in Japan has been conducted nationwide since 1960. The total number of examinees in 1985 amounted to 5,161,876 and 6,240 cases (0.12%) of gastric cancer were detected. Approximately half of these cases were early stage cancers. According to the studies of mass gastric screening in the Miyagi Prefecture, Japan, the sensitivity of the screening test by the indirect x-ray method was 82.4%, and the specificity was 77.2%. The positive predictive value was 1.78%. Recently, mortality from gastric cancer has been decreasing in Japan. Many studies have been carried out to investigate the relationship between the decreasing trend of mortality from cancer of the stomach and the effectiveness of mass gastric screening. From these studies and from time trend analyses of incidence and death rates, case-control studies, nonexperimental cohort studies, etc., it is believed that mass screening for gastric cancer is effective in reducing the death rate from cancer at this site.

The American Board of Internal Medicine recertification examination: process and results.

On 26 October 1974, 3356 diplomates of the American Board of Internal Medicine (ABIM) took a 1-day written examination for recertification consisting of multiple-choice, matching, and true-false questions derived from the American College of Physicians' Medical Knowledge Self-Assessment Program III and the ABIM Certifying Examination pool. The passing score was set by using a normative standard applied to a reference group of internists practicing general internal medicine who had had 2 or more years of residency training completed between the years 1949 and 1958. The passing score represented approximately 63% correct answers. The failure rate for the total number of examinees was 4.3%. Mean score of examinees showed an inverse relation with age but relatively slight differences when analyzed according to the degree of subspecialization, practice setting, hospital affiliation, or size of patient community.