• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• Journal of Korean Dental Science
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• v.3 no.2
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• pp.34-39
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• 2010

In our daily practice, we think about the diagnosis of our patient and get into a situation wherein we have to make a clinical decision. Diagnosis and treatment come from the knowledge and experiences that each dentist should have, but sometimes, we can have doubts on our decisions. "On what evidence did I make such decision? Was that really right?" Drawing our attention these days as a possible answer to this question, evidence-based dentistry seeks to apply the best available evidence gained from the scientific method to medical decision making. To make a good decision, the strength of evidence is assessed. Specifically, randomized controlled trial, systematic review, and meta-analysis are considered the highest level of evidence; cohort study, case control study, case series, animal study, bench test, and biological plausibility follow. With the approach of evidence-based dentistry, we can make objective, scientifically sound clinical decisions. It is also patient-oriented, incorporating clinical experiences and stressing good judgments; thorough and comprehensive, it uses transparent methodology. That is the reason evidence-based dentistry can be better than other assessment methods when we make a clinical decision in modern dentistry.

• The Korean Journal of Emergency Medical Services
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• v.28 no.2
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• pp.63-75
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• 2024

Purpose: This study investigated career identity, decision-making, and preparation behaviors among emergency medical service (EMS) students after clinical practice, aiming to enhance their career guidance by identifying influential factors. Methods: This study targeted 178 students enrolled in the Department of Paramedicine in K-do, G-do, and D metropolitan cities. Data were collected between March 14th and April 30, 2024. The collected data were analyzed using SPSS 25.0, employing techniques such as frequency, correlation, and multiple regression analyses. Results: The findings indicated that components of career identity, encompassing affective and cognitive aspects, exerted significant effects on career decision levels (career assurance and career indecision) (p<.01, p<.001), whereas behavioral factors influenced aspects of career preparation, such as tool preparation, information collection, and practical effort(p<.001). Moreover, career decision levels (career assurance and career indecision) were found to affect information collection, a subcomponent of career preparation(p<.05, p<.01). Conclusion: Considering these factors and actively empathizing with and counseling students would lead to effective career guidance in the field of Emergency Medical Services.

• The KIPS Transactions:PartB
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• v.17B no.4
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• pp.317-326
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• 2010

To improve the diagnosis and prescription for military personnel, it is required to adopt Clinical Decision Support System (CDSS) in armed forces hospitals. The objective of this paper is to suggest a CDSS for armed forces hospitals using semantic web technologies. To this end, we designed military medical ontologies and military medical rules which consist of the various concepts and rules for supporting medical activities. We developed a semantic web-based CDSS to demonstrate the use of the ontologies and rules for treating military patients. We also showed the process of semantic search for the medical records which are created from the semantic web-based CDSS.

• Journal of Korean Neurosurgical Society
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• v.50 no.2
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• pp.81-88
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• 2011

Objective : The purpose of this study was to analyze the clinical and anatomic features involved in determining treatment modalities for anterior communicating artery (AcoA) aneurysms. Methods : The authors retrospectively evaluated 112 AcoA aneurysms with pretreatment clinical features including age, Hunt and Hess grade, medical or neurological comorbidity, and anatomical features including aneurysm size, neck size, dome-to-neck ratio, vessel incorporation, multiple lobulation, and morphologic scoring system. Post-treatment clinical results were classified according to the Glasgow Outcome Scale, and anatomic results in coiled patients were classified according to the modified Raymond scale. Using multivariate logistic regression, the probabilities for decision making between surgical clipping and coil embolization were calculated. Results : Sixty-seven patients (60%) were treated with surgical clipping and 45 patients (40%) with endovascular coil embolization. The clinical factor significantly associated with treatment decision was age (${\geq}$65 vs. <65 years) and anatomical factors including aneurysm size (small or large vs. medium), dome-to-neck ratio (<2 vs. ${\geq}$2), presence of vessel incorporation, multiple lobulation, and morphologic score (${\geq}$2 vs. <2). In multivariate analysis, older patients (age, 65 years) had significantly higher odds of being treated with coil embolization relative to clipping (adjusted OR=3.78; 95% CI, 1.39-10.3; p=0.0093) and higher morphological score patients (${\geq}$2) had a higher tendency toward surgical clipping than endovascular coil embolization (OR=0.23; 95% CI, 0.16-0.93; p=0.0039). Conclusion : The optimal decision for treating AcoA aneurysms cannot be determined by any single clinical or anatomic characteristics. All clinical and morphological features need to be considered, and a collaborative neurovascular team approach to AcoA aneurysms is essential.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.3
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• pp.391-402
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• 2009

Purpose: The purpose of this research was to describe the decision making experience of VIP ward nurses in the clinical practice adjustment process. The research question was about "how nurses adjust their clinical practice to nursing situations and develop decision making process in a VIP ward." Method: The methodology of collecting and analyzing the data was based on the grounded theory of Strauss and Corbin(1998). The data was collected through in-depth interviews with 10 nurses from July to November, 2007. Results: The core category of nursing care decision making process was named as "adjusting with flexibility and deepened insight." The clinical practice adjustment process in nursing care decision making has progressed through four preceding interlocking phases: 1) dependent phase, 2) defensive phase, 3) independent phase, 4) integrative phase. These phases were classified by the level of nurses' dependency, proactivity, presupposition and integration. Conclusion: The result of this study indicated that nurse's decision making depended on their experiences and the nature of social context in which nursing occurs. Therefore, it is important to elaborate an effective training program for nurses to develop the phases of nursing care decision making.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.18 no.2
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• pp.284-310
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• 2024

Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.

• Journal of Trauma and Injury
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• v.31 no.3
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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.

• Journal of Sasang Constitutional Medicine
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• v.27 no.2
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• pp.222-230
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• 2015

Objectives The purpose of this study is to design a research to find clinical factors involved in the decision-making process for determining the constitutional prescription based on prospective clinical data. Methods We have created a draft of the case report form. Therefore, seven constitutional experts was interviewed for additional items to be important used to determine the constitutional prescription in clinic. Interviews were done from December 2012 to March 2014, experts per person 2-3 times, took time of about 120 minutes per interview. Since then, we developed the final case report form through the expert meeting. At the same time, the developing the electronic case report form (eCRF) and the protocol to collect constitutional treatment cases was also discussed. Results & Conclusions The items of the case report form were subject general, lifestyle, health measurement, record of expert, prescription and evaluation after medication. The part of the clinical symptoms of the record of expert allowed to be recorded in the 5-point scale for the collection of quantitative data as much as possible. Assuming a re-visit of the patient, if necessary, twice the recording were to be possible. At the same time, the eCRF and the protocol to collect constitutional treatment cases were also developed. In this study, it will be able to more objectively standardize the medical decision making process that the experts of constitutional prescription decision. As a result, it will be possible to provide the standardized constitutional medical services.

• Proceedings of the Korea Inteligent Information System Society Conference
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• 2001.01a
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• pp.336-342
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• 2001

One of the most important problems on rule induction methods is that they cannot extract rules, which plausibly represent experts decision processes. On one hand, rule induction methods induce probabilistic rules, the description length of which is too short, compared with the experts rules. On the other hand, construction of Bayesian networks generates too lengthy rules. In this paper, the characteristics of experts rules are closely examined and a new approach to extract plausible rules is introduced, which consists of the following three procedures. First, the characterization of decision attributes (given classes) is extracted from databases and the classes are classified into several groups with respect to the characterization. Then, two kinds of sub-rules, characterization rules for each group and discrimination rules for each class in the group are induced. Finally, those two parts are integrated into one rule for each decision attribute. The proposed method was evaluated on a medical database, the experimental results of which show that induced rules correctly represent experts decision processes.