The Journal of Pediatrics of Korean Medicine (대한한방소아과학회지)

The Association of Korean Oriental Pediatrics (대한한방소아과학회)
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A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines

소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구

  • Bang Miran (Department of Pediatrics of Korean Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong) ;
  • Lee Sun Haeng (Department of Pediatrics of Korean Medicine, Kyung Hee University Korean Medicine Hospital) ;
  • Chang Gyu Tae (Department of Pediatrics of Korean Medicine, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong)
  • 방미란 (강동경희대학교병원 한방소아과) ;
  • 이선행 (경희대학교한방병원 한방소아과) ;
  • 장규태 (강동경희대학교병원 한방소아과)
  • Received : 2024.04.19
  • Accepted : 2024.05.18
  • Published : 2024.05.31
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Abstract

Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Keywords

Acknowledgement

본 연구는 보건복지부의 재원으로 한국보건산업진흥원의 보건의료기술연구개발사업 지원에 의하여 이루어진 것임 (과제고유번호: HF21C0096).

References

  1. Korean standard classification of disease and cause of death [Internet]. KOICD; 2020 [Updated 2020 July; cited 2024 January 17]. Available from: http://www.koicd.kr/.
  2. Department of Pediatrics, Nationwide Korean Medicine College. Pediatrics of Korean medicine. 3rd ed. Seoul: Ui Sung Dang Publishing Co. 2020:397-401.
  3. Seo HS, Kim HY, Park SG, Lee SH, Lee JY, Chang GT. A review of etiology, pattern identification, treatment of traditional Chinese medicine for childhood anorexia. J Pediatr Korean Med. 2022;36(1):1-37.
  4. Lee J, Lee SH, Kim JH, Park YS, Park S, Chang GT. Survey of clinical practice patterns of Korean medicine doctors for anorexia in children: a preliminary study for clinical practice guidelines. Children (Basel). 2022;9(9).
  5. Lee B, Kwon CY, Lee SH, Chang GT. Herbal medicine for the treatment of anorexia in children: a systematic review and meta-Analysis. Front Pharmacol. 2022;13:839668.
  6. Lee B, Ko MM, Lee SH, Chang GT. Acupuncture for the treatment of childhood anorexia: A systematic review and meta-analysis. Complement Ther Med. 2022;71:102893.
  7. Liang SB, Lai BY, Cao HJ, Cai QH, Bai X, Li J, Zhang YP, Chi Y, Robinson N, Liu JP. Pediatric tuina for the treatment of anorexia in children under 14 years: a systematic review and meta-analysis of randomized controlled trials. Complement Ther Med. 2020;51:102411.
  8. Hasson F, Keeney S, McKenna H. Research guidelines for the Delphi survey technique. J Adv Nurs. 2000;32(4):1008-15.
  9. Handbook for grading the quality of evidence and the strength of recommendations using the GRADE [Internet]. GRADE Handbook; 2013 [Updated 2013 October; cited 2024 January 17]. Available from: https://gdt.gradepro.org/app/handbook/handbook.html.
  10. Silverman AH. Interdisciplinary care for feeding problems in children. Nutr Clin Pract. 2010;25(2):160-5.
  11. Bryant-Waugh R, Markham L, Kreipe RE, Walsh BT. Feeding and eating disorders in childhood. Int J Eat Disord. 2010;43(2):98-111.
  12. Milano K, Chatoor I, Kerzner B. A functional approach to feeding difficulties in children. Curr Gastroenterol Rep. 2019;21(10):51.
  13. Cardona Cano S, Tiemeier H, Van Hoeken D, Tharner A, Jaddoe VW, Hofman A, Verhulst FC, Hoek HW. Trajectories of picky eating during childhood: a general population study. Int J Eat Disord. 2015;48(6):570-9.
  14. Rudolf MC, Logan S. What is the long term outcome for children who fail to thrive? a systematic review. Arch Dis Child. 2005;90(9):925-31.
  15. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to their eating behavior, food preferences, and growth? Pediatrics. 2007;120(4):e1069-75.
  16. Lee EJ, Lee B, Lee J, Chang GT. A Study on the recent trend of chief complaint of Korean pediatric and adolescent outpatients. J Pediatr Korean Med. 2016;30(1):45-58.
  17. Shin HJ, Park YS, Lee J, Chang GT. Recent trends in clinical research of herbal medicine treatment for anorexia in children. J Pediatr Korean Med. 2019;33(4):1-25.
  18. Jeong K, Joo J. The Korean version Children's eating behaviour questionnaire(K-CEBQ). Kor J Psychol Health. 2012;17(4):943-61.