• Title/Summary/Keyword: 근거 기반 치료

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A Case Study of Software Architecture Design by Applying the Quality Attribute-Driven Design Method (품질속성 기반 설계방법을 적용한 소프트웨어 아키텍처 설계 사례연구)

  • Suh, Yong-Suk;Hong, Seok-Boong;Kim, Hyeon-Soo
    • The KIPS Transactions:PartD
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    • v.14D no.1 s.111
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    • pp.121-130
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    • 2007
  • in a software development, the design or architecture prior to implementing the software is essential for the success. This paper presents a case that we successfully designed a software architecture of radiation monitoring system (RMS) for HANARO research reactor currently operating in KAERI by applying the quality attribute-driven design method which is modified from the attribute-driven design (ADD) introduced by Bass[1]. The quality attribute-driven design method consists of following procedures: eliciting functionality and quality requirements of system as architecture drivers, selecting tactics to satisfy the drivers, determining architectures based on the tactics, and implementing and validating the architectures. The availability, maintainability, and interchangeability were elicited as duality requirements, hot-standby dual servers and weak-coupled modulization were selected as tactics, and client-server structure and object-oriented data processing structure were determined at architectures for the RMS. The architecture was implemented using Adroit which is a commercial off-the-shelf software tool and was validated based on performing the function-oriented testing. We found that the design method in this paper is an efficient method for a project which has constraints such as low budget and short period of development time. The architecture will be reused for the development of other RMS in KAERI. Further works are necessary to quantitatively evaluate the architecture.

A Web-based 'Patterns of Care Study' System for Clinical Radiation Oncology in Korea: Development, Launching, and Characteristics (우리나라 임상방사선종양을 위한 웹 기반 PCS 시스템의 개발과 특성)

  • Kim, Il Han;Chie, Eui Kyu;Oh, Do Hoon;Suh Chang-Ok;Kim, Jong Hoon;Ahn, Yong Chan;Hur, Won-Joo;Chung, Woong Ki;Choi, Doo Ho;Lee, Jae Won
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.291-298
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    • 2003
  • Purpose: We report upon a web-based system for Patterns of Care Study (PCS) devised for Korean radiation oncology. This PCS was designed to establish standard tools for clinical quality assurance, to determine basic parameters for radiation oncology processes, to offer a solid system for cooperative clinical studies and a useful standard database for comparisons with other national databases. Materials and Methods: The system consisted of a main server with two back-ups in other locations. The program uses a Linux operating system and a MySQL database. Cancers with high frequencies in radiotherapy departments in Korea from 1998 to 1999 were chosen to have a developmental priority. Results: The web-based clinical PCS .system for radiotherapy in www.pcs.re.kr was developed in early 2003 for cancers of the breast, rectum, esophagus, larynx and lung, and for brain metastasis. The total number of PCS study items exceeded one thousand. Our PCS system features user-friendliness, double entry checking, data security, encryption, hard disc mirroring, double back-up, and statistical analysis. Alphanumeric data can be input as well as image data. In addition, programs were constructed for IRB submission, random sampling of data, and departmental structure. Conclusion: For the first time in the field of PCS, we have developed a web-based system and associated working programs. With this system, we can gather sample data in a short period and thus save, cost, effort and time. Data audits should be peformed to validate input data. We propose that this system should be considered as a standard method for PCS or similar types of data collection systems.

Survey of COPD Management among the Primary Care Physicians in Korea (우리나라 일차 진료의사의 만성폐쇄성폐질환(COPD) 진료실태조사)

  • Park, Myung Jae;Choi, Cheon Woong;Kim, Seung Joon;Kim, Young Kyoon;Lee, Sung Yong;Kang, Kyung Ho;Shin, Kyeong-Cheol;Lee, Kwan Ho;Lee, Jin Hwa;Kim, Yu-Il;Lim, Sung-Chul;Park, Yong Bum;Jung, Ki-Suck;Kim, Tae-Hyung;Shin, Dong Ho;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.109-124
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    • 2008
  • Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process (수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발)

  • Choi, Jin Ju;Kim, Hyeon Jeong;Kang, Hye Min;Chu, Hee Young;Kim, Kyeong Sug
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.2
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    • pp.187-198
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    • 2021
  • Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

Systematic Review on Effect of Comprehensive Early Intervention for Pre-school Children With Autism Spectrum Disorder(ASD) (자폐스펙트럼장애 아동들의 효과적인 조기 중재에 대한 체계적 고찰)

  • Jeong, Byoung-Lock
    • Therapeutic Science for Rehabilitation
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    • v.7 no.3
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    • pp.9-21
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    • 2018
  • Objective : This systematic review aimed to evaluate the global literature on the effect of early intervention for preschool children with autism spectrum disorder (ASD). Methods : A literature search of the PubMed database identified 10 studies published up to December 2017, using the following search terms: autism, autism spectrum disorder, ASD, high-function autism, high-function ASD, Asperger syndrome, pervasive developmental disorder, PDDNOS, intervention, and early intervention. Results : Early intervention for children with ASD used Applied Behavior Analysis in 8 of the 10 selected studies. The other two studies used a Sensory Integration approach and Technology-based intervention. Most studies reported positive effects on communication skills, social interaction skills, intelligence, adaptive behavior, and improved attention through early intervention. Conclusions : These results suggested a basis for early intervention for children with ASD. Further research is needed to determine the effectiveness of early intervention.

An Analysis of Physicians' Online Information Search Process at the Point of Care (의사의 임상질문 해결을 위한 온라인 정보검색과정 연구)

  • Kim, Soon;Chung, EunKyung
    • Journal of the Korean Society for information Management
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    • v.33 no.3
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    • pp.177-193
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    • 2016
  • This study aims to analyze physicians' online information search process to solve the clinical questions at the point of care. To achieve this purpose, ten university hospital-based physicians participated in-depth interviews and observation studies. Based on Wilson's problem solving process, this study analyzed the characteristics of each information search stage and efficiency of online searching. The results showed that participants tend to relatively immediately formulate their clinical questions. However, basic searching strategies were only used and a few preferred information sources were chosen. However, average satisfaction degree of online searching appeared high with 5.7 (7 Likert-scale) and problem-solving index increased after searching. As physicians are likely to use well organized and evidenced-based credible information easily, it implies the needs for an integrated search system within the electronic medical record (EMR). In addition, as other online resources' awareness is lower comparing Google and PubMed, active promotions and training of other resources are needed.

The Effect of Group Occupational Activity Program on Visual Perception and Motor Function of Children in Community Children Center (집단 작업 활동 프로그램이 지역아동센터 아동의 시지각 및 운동기능에 미치는 효과)

  • Kim, Hye-Jin;Kim, Eun-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.14 no.1
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    • pp.9-18
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    • 2016
  • Objective : The current study investigated the effectiveness of group occupational activity program in increasing visual-perception and motor function of children in Community Children Center. Methods : Five children aged between 6-9 years in a community children center participated in the group occupational activity program. The program was designed to facilitate children's visual-perception and motor function based on play occupations. We examined performances of MVPT-3 and BOT-2 before and after the program. Results : Children who participated in the group program showed significant increases in visual perception and motor function. Conclusion : The study revealed the effectiveness of group occupational activity program in promoting visual perception and motor function of children in a community children center, which suggests the possibility of application of occupational activity toward low-income children in the community.

The evaluation of methodological quality of meta-analysis studies in speech language pathology using AMSTAR (AMSTAR에 기반한 국내 언어치료 분야 메타분석 논문의 방법론적 질평가)

  • Han, Minju;Byeon, Haewon
    • Journal of the Korea Convergence Society
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    • v.11 no.2
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    • pp.161-165
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    • 2020
  • Although research using meta-analysis is increasing in the field of rehabilitation science, not all meta-analytical papers are of the same quality. In particular, although meta-analysis is a research method with the highest level of evidence, it may be possible to derive distorted conclusions or alternatives by simply integrating representative values without considering heterogeneity among individual studies. This study analyzed the current status of meta-analysis papers on the subject of language arbitration published in Korea from January 2010 to June 2019, and used A Measurement Tool to Assess the Methodological Quality of Systematic Review (AMSTAR). As a result of evaluating the methodological quality of the final five papers, the average of 7.4 points out of 11 points was found above average. In order to raise the qualitative level of Meta-analysis in speech-language pathology in the future, it is necessary to include verification of publication bias and specification of conflicts of interest.

Korean Clinical Imaging Guidelines for Justification of Diagnostic Imaging Study for COVID-19 (한국형 COVID-19 흉부영상 진단 시행 가이드라인)

  • Kwang Nam Jin;Kyung-Hyun Do;Bo Da Nam;Sung Ho Hwang;Miyoung Choi;Hwan Seok Yong
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.265-283
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    • 2022
  • To develop Korean coronavirus disease (COVID-19) chest imaging justification guidelines, eight key questions were selected and the following recommendations were made with the evidence-based clinical imaging guideline adaptation methodology. It is appropriate not to use chest imaging tests (chest radiograph or CT) for the diagnosis of COVID-19 in asymptomatic patients. If reverse transcription-polymerase chain reaction testing is not available or if results are delayed or are initially negative in the presence of symptoms suggestive of COVID-19, chest imaging tests may be considered. In addition to clinical evaluations and laboratory tests, chest imaging may be contemplated to determine hospital admission for asymptomatic or mildly symptomatic un-hospitalized patients with confirmed COVID-19. In hospitalized patients with confirmed COVID-19, chest imaging may be advised to determine or modify treatment alternatives. CT angiography may be considered if hemoptysis or pulmonary embolism is clinically suspected in a patient with confirmed COVID-19. For COVID-19 patients with improved symptoms, chest imaging is not recommended to make decisions regarding hospital discharge. For patients with functional impairment after recovery from COVID-19, chest imaging may be considered to distinguish a potentially treatable disease.

A Systematic Review of Assessment Tools of Activities of Daily Living for Stroke Patients (뇌졸중 환자를 위한 일상생활활동 평가도구에 관한 체계적 고찰)

  • Kang, Jae-Won;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.6 no.2
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    • pp.11-28
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    • 2017
  • Objective: The purpose of this study was conducted to systematic review about assessment tools for Activities of Daily Living (ADL) for stroke patients. Methods: Studies tools was administered by using four electronic databases (Pubmed, Embase, Cochrane and NDSL). For the main key words,"stroke AND activities of daily living AND occupational therapy AND assessment OR evaluation OR measurement"was used. We analyzed the types and frequency of evaluation tools. In addition, the evaluation tools for activities and participation were classified based on the classification criteria of International Classification of Functioning, Disability and Health (ICF). Results: In this study, 111 studies were analyzed and 30 assessment tools were identified. As the number of studies on stroke patients has been increased recently, the types and frequency of evaluation tools have been also increased. The most commonly used evaluation tools were Functional Independence Measure (FIM), Barthel Index (BI) and Canadian Occupational Performance Measure (COPM). In addition, according to classification based on ICF, we found that the types of assessment tools which assess participation were few. Conclusion: Although there were many kinds of assessment tools, the types of evaluation tools which were used in the research or field were very limited. Using various assessment tools, more research should be conducted to support evidence-based occupational therapy. Evaluation tools for participation also should be developed.