• 대한한방내과학회지
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• 제44권3호
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• pp.466-484
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• 2023

Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

• 한방재활의학과학회지
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• 제33권4호
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• pp.203-213
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• 2023

Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

• 대한한방소아과학회지
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• 제38권2호
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• pp.21-31
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• 2024

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.

• 대한한방부인과학회지
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• 제37권2호
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• pp.109-119
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• 2024

Objectives: This study is aimed to survey public's experience of medical use for developing Korean medicine clinical practice guideline of female infertility. Methods: The study engaged women who had experienced infertility despite regular conjugal relations, selected from an online survey company's national panel. Participants were surveyed from November 3 to 8, 2021. The questionnaire, developed from prior studies on Korean medicine, was emailed to 29,465 adults; 550 responses were analyzed after exclusions. The study received an IRB exemption from Pusan National University Korean Medicine Hospital and utilized Microsoft Excel for statistical analysis. Results: Among 550 respondents, 32.2% had experienced infertility, predominantly due to unexplained causes (52%). About half had received medical treatment (49.3%), primarily at hospitals and general hospitals (54.2%) and obstetrics and gynecology clinics (49.4%), with Korean medicine facilities also utilized (24.7% for clinics, 14.4% for hospitals). The most common treatments included herbal medicine in Korean medicine and ovulation induction in Western medicine, with most treatments lasting less than six months (71.4%) and costing between 1 to 5 million won (50.5%). Efforts to conceive included lifestyle adjustments such as maintaining a warm lower abdomen, supplement intake, and avoiding alcohol and tobacco. Conclusions: It is necessary that the guidelines be revised to address female infertility and to integrate recommendations for combining Korean medical treatments and Western medical treatments, which will enhance patient care in managing female infertility.

• 동의신경정신과학회지
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• 제34권4호
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• pp.335-347
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• 2023

Objectives: The study aimed to understand the current treatment patterns in Korean medicine to develop clinical practice guidelines for autonomic dysfunction in Korean medicine. Methods: This study sent an online survey vai text message to 25,900 Korean medicine doctors whose contact information was registered with the Association of Korean Medicine. A total of 1,410 Korean medical doctors completed the online survey. Results: When autonomic treating dysfunction clinically, 77% of the cases included only a description without entering a diagnosis code. The most commonly used information to diagnose o autonomic dysfunction was history-taking and symptoms (79%), and the main symptoms of autonomic dysfunction were palpitations, dizziness, sleeping difficulties, anxiety/nervousness, and depression/lethargy. The most frequently mentioned cause of autonomic dysfunction was mental problems (54%). The most commonly used Korean medicine treatment method for autonomic dysfunction was herbal medicine (70%), and Soyo-san/Gamisoyo-san is the most frequently used herbal medicine preparation. Liver qi depression used to indicate the most often mentioned Korean medicine pattern identification used to indicate autonomic dysfunction (31%). When asked whether cardiac neurosis in Chinese medicine can be considered autonomic dysfunction, opinions for and against it are determined almost equally. Conclusions: Our results serve are a foundation for developing clinical practice guidelines for autonomic dysfunction in Korean medicine and are expected to catalyst promoting future clinical research on autonomic dysfunction.

• 대한예방한의학회지
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• 제21권3호
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• pp.1-10
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• 2017

Objectives : The purpose of this study is to investigate the practice patterns of traditional Korean medicine (TKM) doctors and the acceptance of payment model in order to develop a new TKM health insurance payment model linked with TKM clinical practice guidelines (CPGs). Methods : Lumbar herniated intervertebral disc (HIVD) and idiopathic facial palsy (IFP) were selected as a test diseases to develop a new TKM payment model. The level of benefit coverage in the National Health Insurance (NHI) was designed. The survey asked 228 TKM doctors about their practice patterns in HIVD and IFP patients and acceptance of new payment model. Results : Mean of medical cost for treatment of HIVD was 441,000 KW, mean of treatment period ranged from 4.9 to 17.5 weeks, and mean of number of treatment ranged from 14.6 to 50.4 HIVD patients. In the case of IFP, mean of medical cost for treatment of IFP was 468,000 KW, mean of treatment period was at least 4.2 and up to 15.9 weeks and mean of number of treatment ranged from 14.2 to 52 IFP patients. Conclusions : Current study suggests that mixed payment model of per-visit and episode-based model seem to be proper. The model 1 bundles both items which were covered and not covered by NHI in a rational way. The model 2 is based on the development and application of critical pathway. Lastly, model 3 suggests bundling of items covered by current NHI. Acceptance of TKM doctors is expected to be highest in the model 3.

• 대한소아치과학회지
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• 제42권2호
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• pp.158-163
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• 2015

치과치료를 위해 진정법 또는 전신마취를 시행하는 목적은 일반적인 방법으로 치과 의료를 제공받기 어려운 환자에게 양질의 치과치료를 제공하기 위해서이다. 본 연구는 전북대학교 치과병원에서 외래전신마취 하에 치료받은 소아 및 장애인 환자들의 임상진료 실태를 분석하고 향후 일반적인 치과진료가 어려운 환자들의 외래전신마취 치료에 대한 지침을 마련하고자 하였다. 2005년 1월부터 2014년 3월까지 전북대학교 치과병원에 내원한 소아 및 장애인 환자들을 대상으로 조사한 결과, 총 325명의 환자들이 외래전신마취 하에서 치과치료를 받았다. 남자 환자의 비율이 62.2%로, 여자 환자의 비율(37.8%)보다 높았으며, 10세 이하의 환자가 151명(46.5%)로, 소아 및 청소년 환자가 높은 비율을 차지하고 있었다. 치료내용을 보면 수복치료와 발치가 주를 이루고 있었으며 2회 이상 전신마취를 시행한 환자가 43명(13.2%)이었다. 본 연구는 일반적인 치과치료가 어려운 소아 및 장애인 환자들을 위해 효율적이며 안전한 전신마취 시스템을 확충해서 환자들에게 보다 편안한 치료 환경을 제공해야 할 필요성을 제시하고 있다.

• 대한소아치과학회지
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• 제43권1호
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• pp.109-116
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• 2016

오늘날 소아치과 진료에 있어서 진정법은 필수 불가결한 요소로 받아들여지고 있다. 이에 대한소아치과학회는 학회원들의 보다 안전하고 효율적인 진정법 시행을 돕기 위해 진정법 위원회를 결성하고 2014년 소아치과 개원의들의 진정법 사용에 대한 실태조사를 실시 한 바 있다. 이 설문조사 결과, 진정법을 시행하는 교육 코스가 만들어 진다면 참여할 의사가 있는지에 대한 질문에 응답자의 86%가 참여의사를 밝혔으며 진정법 교육과정에서 배우고 싶은 내용으로 안전한 약물용량과 가이드라인이 2위를 차지하여 1위인 응급상황 시 대처법 다음으로 교육받고 싶은 내용으로 나타났다. 그러나 약물을 선택하고 용량을 결정하기 위해서는 여러 가지 요소를 고려해야 하므로 용량을 일률적으로 정하여 지침을 제정하는 것은 현실적으로 어려운 일이고 실제적으로도 그 어떤 진정법 지침에도 약물의 용량을 제시해 놓지는 않았다. 성공적인 진정법을 위해 소아치과의사는 각 과정마다 개별적인 치료 계획을 수립해야 하며, 각 진정제의 고유의 약효뿐 만 아니라 다른 약제들 간의 상호 작용에 대하여 충분히 숙지하는 것이 중요하다. 이 종설에서는 문헌 고찰을 통해 소아치과 임상에서 자주 사용되는 진정제들에 대한 정보를 되새기고 의사용 처방편람(Physicians' Desk Reference: PDR) 및 소아치과 분야의 다양한 교과서의 추천용량을 정리하여 소개하고자 한다.

• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• 대한예방한의학회지
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• 제20권1호
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• pp.55-64
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• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.