• Journal of Preventive Medicine and Public Health
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• 제22권1호
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• pp.57-64
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• 1989

A decision support system (DSS) was developed to support doctor's decision-making in diagnosing hearing loss. The final diagnosis encompassed 41 diseases with the problem of hearing loss. The system was developed by integrating model-oriented DSS technique and artificial intelligence technology. The system can be used as both diagnosis tool and teaching tool for medical students. Furthermore, the AI technology obtained from this study may also be used in developing DSS for hospital management.

• 대한간호학회지
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• 제44권3호
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• pp.294-304
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• 2014

Purpose: The influence of dietary composition on blood pressure is an important subject in healthcare. Interactions between antihypertensive drugs and diet (IBADD) is the most important factor in the management of hypertension. It is therefore essential to support healthcare providers' decision making role in active and continuous interaction control in hypertension management. The aim of this study was to implement an ontology-based clinical decision support system (CDSS) for IBADD management (IBADDM). We considered the concepts of antihypertensive drugs and foods, and focused on the interchangeability between the database and the CDSS when providing tailored information. Methods: An ontology-based CDSS for IBADDM was implemented in eight phases: (1) determining the domain and scope of ontology, (2) reviewing existing ontology, (3) extracting and defining the concepts, (4) assigning relationships between concepts, (5) creating a conceptual map with CmapTools, (6) selecting upper ontology, (7) formally representing the ontology with Protege (ver.4.3), (8) implementing an ontology-based CDSS as a JAVA prototype application. Results: We extracted 5,926 concepts, 15 properties, and formally represented them using Protege. An ontology-based CDSS for IBADDM was implemented and the evaluation score was 4.60 out of 5. Conclusion: We endeavored to map functions of a CDSS and implement an ontology-based CDSS for IBADDM.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.135-142
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• 2018

Purpose: When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision. Methods: This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017. Results: Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226). Conclusions: Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

• 한국임상약학회지
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• 제16권2호
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• pp.96-100
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• 2006

Korea Food and Drug Administration (KFDA) has been expediting the Biological Equivalence Examination (BEE) project to encourage generic substitution without expense of inappropriate therapeutic outcome. However, little is known about which considerations are most important in making the decision to prescribe a drug among many generic drugs. The purpose of this survey was to identify how strongly the KFDA certification of BEE influenced doctors when they make a choice between brand and generics of glimepiride preparations. Telephone survey was performed towards doctors working at local clinics by using a questionnaire. Most influential factor to doctors' decision was drug cost followed by pharmaceutical representatives, therapeutic efficacy, and review guideline for reimbursement. Advertisement of the drug was the least influential followed by KFDA certification of BEE. The meaning of BEE was best understood by relatively young doctors with specialty in surgical parts. This survey result further indicated that the doctors considered the therapeutic equivalence examination a preferred measure to expedite generic substitution.

• 동의생리병리학회지
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• 제28권1호
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• pp.113-121
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• 2014

With the development of information technology, knowledge information-oriented and information systems are being rapidly paced. In addition, doctor's needs of the system that assist decision making is gradually increasing. Because the complex process of decision-making should be a lot. We propose a web based system for supporting medical treatment based on Korean medicine ontology. There are three kinds of processes. First, a pattern is decided for patient' symptoms, a formula for the pattern is selected and medicinal materials constituting the formula is added or removed. Second, a formula is decided for patient' symptoms, medicinal materials constituting the formula is added or removed. Third, a Treat method is decided for patient' symptoms, medicinal materials constituting the formula is added or removed. We have designed and implemented the clinical decision support system that supports flexible processes and necessary information and functions. The system shows the appropriate form of ontology knowledge as interrelated and provide analysis and processing, does not show simply search. The system is one of the systems utilizing ontology and a web based system that can be used in anywhere. Therefore, This system Will be useful as for doctors to make decision.

• 한국임상약학회지
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• 제3권2호
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• pp.175-185
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• 1993

The goal of this clerkship is to expose the student to basic skills needed fir a patient oriented pharmacist to assume an existing clinical role and participate in therapeutic decision making processes. As the pharmacy profession has moved from the traditional product orientation to a patient orientation, curricula within the college of pharmacy have evolved to include more experiential coursework to lister this patient orientation. This change has been supported by the philosophy of pharmaceutical care which encourages pharmacists to assume a patient advocacy role in optimizing a patient's drug therapy while minimizing the adverse effects of the medication. The role of experiential education, and especially the clerkship experience will be to hasten and enhance the development of this concept and philosophy for pharmacy students.

• 대한핵의학회지
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• 제35권4호
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• pp.224-230
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• 2001

EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1749-1763
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• 2021

Coronary computed tomography angiography (CCTA) is routinely used for anatomical assessment of coronary artery disease (CAD). However, invasive measurement of fractional flow reserve (FFR) is the current gold standard for the diagnosis of hemodynamically significant CAD. CT-derived FFRCT and CT perfusion are two emerging techniques that can provide a functional assessment of CAD for risk stratification and clinical decision making. Several clinical studies have shown that the diagnostic performance of concomitant CCTA and functional CT assessment for detecting hemodynamically significant CAD is at least non-inferior to that of other routinely used imaging modalities. This article aims to review the current clinical evidence and recent developments in functional CT techniques.

• 기본간호학회지
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• 제16권4호
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• pp.459-471
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• 2009

Introduction: Critical thinking involves identifying problem(s), assessing resources, and generating possible solutions and allows clinical nurses to decide which solution is the most reasonable under the given circumstances, taking into consideration the "hat ifs" and how they will affect the end result. This research was conducted to further understanding and identification of subjective factors in critical thinking in clinical nurses. Methods: The research design was a Q-Methodological Approach. Q-population was formulated from a non-structured questionnaire and interviews from 17 experienced clinical nurses. Thirty selected Q-statements were sorted by 30 experienced clinical nurses. Results: Four factors for critical thinking were identified: (1) Deductive reasoning based on causal relation, (2) Construction of an effective model based on patients' responses, (3) Formulating categories based on priorities for effective interventions, and (4) Judging validity of the situational significance on clinical performances. Conclusion: Critical thinking is an attitude and reasoning process. From this study, the frame of reference for clinical nurses in formulating critical thinking within the context of clinical settings is identified and indicates the way nurses utilize thinking skills when they care for patients and areas that need further exploration as nurses and faculty develop education systems to advance clinical performance competency.

• 대한간호
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• 제32권5호
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• pp.93-105
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• 1994

Nursing is indeed a practice discipline with experiential learning in clinical practice areas comprising an overwhelming portion of a Nursing Student's education. The statement is used to provide a basis for discussion of some issues involved in relation to clinical nursing education. However the lack of substantial research in the area of clinical nursing education would suggest that this 'heart' of the nursing student's professional education has olng been ignored. The purpose of this study is to critically review and analysis then suggest effective approaches of clinical nursing education. First. the curriculum can be developed by faculty consistently. Curriculum design begins with the writing of philosophy and the selection of objectives for the program. The philosophy must include a statement of beliefs and intrinc values about human being. nursing and teaching learning process. Second. faculty practice can be narrowed practice-theory gaps. Third. clinical teaching strategies can be used many different methods in order to facilitate development of clinical judgement and decision making. Fourth, clinical teacher's rols can influence student's learning attitude and intrinsic value; relating to students as mature individuals; creating an atomosphere where in the student felt comfortable approaching the instructor; providing support crisis situations. Fifth. clinical nursing evaluation can be developed the integrated models.