• Title/Summary/Keyword: Clinical Practice Guidelines

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Clinical Practice Guidelines in Korean Medicine for Gastric Cancer (위암 치료에 대한 한의 임상 가이드라인)

  • Kim, Hyo-rin;Yoo, Hwa-seung;Baek, Dong-gi;Park, In-hae;Jang, Chul-yong;Kim, Hyo-young;Ha, Ye-jin;Moon, Goo
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.26-46
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    • 2016
  • Objectives: The purpose of this study was to present the clinical guidelines and traditional Korean medicines for gastric cancer.Results: Gastric cancer is the second most common cancer in Korea. Recent studies have reported that applying integrative Oriental and Western medicine can suppress the tumor, improve the survival, the immune system, and the quality of life in gastric cancer. However, there still is no unified protocol for gastric cancer treatment, which produces difficulty in clinical applications. In Korea, a “Synopsis on the Clinical Practice Guidelines of Gastric Cancer” was published by the Korean Journal of Gastroenterology in 2014. In China, Oriental medicine clinical practice guidelines were published for the first time in 2014. The present author proposed “Clinical Practice Guidelines of Korean Medicine for Gastric Cancer” in 2014, but there is a need for more advanced guidelines with reference to the aforementioned Oriental and Western guidelines. This study will be helpful for understanding and building systems for integrative gastric cancer treatment.Conclusions: Further studies on integrative gastric cancer treatment are needed to improve the survival of gastric cancer patients and build the clinical practice guidelines for gastric cancer.

Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • Quality Improvement in Health Care
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    • v.4 no.1
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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.

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Clinical Practice Guidelines of Korean Medicine for Hepatocellular Carcinoma (간세포암종 치료에 대한 한의 임상 가이드라인)

  • Hong, Sang-Hoon;Son, Ho-Young
    • Journal of Korean Traditional Oncology
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    • v.20 no.1
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    • pp.55-79
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    • 2015
  • Hepatocellular carcinoma(HCC) is the fifth most common cancer worldwide (fifth in male, seventh in female) and the third most common cause of cancer mortality. Since 2001, the various research group in the United States, Europe and Asia have published clinical practice guidelines for HCC. In Korea, a clinical practice guideline for HCC have been published by The Korean Liver Cancer Study Group in 2003, revised in 2009 and 2014. In China, oriental medicine clinical practice guideline have been published for the first time in 2014, and in the oriental medical profession of Korea, there is growing need for the guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for HCC in Korea, and existing korean medicine clinical practice guideline for Disease Analysis and Treatment(辨證論治) and herbal therapy of HCC. Further clinical research about various herbal medicines are needed to develop more advanced guideline of HCC.

Utilization of Evidence-Based Clinical Nursing Practice Guidelines in Tertiary Hospitals and General Hospitals (상급종합병원과 종합병원의 근거기반 임상간호실무지침의 활용도)

  • Eun, Young;Jeon, Mi Yang;Gu, Mee Ock;Cho, Young Ae;Kim, Jung Yeon;Kwon, Jeong Soon;Kim, Kyeong Sug
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.3
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    • pp.233-244
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    • 2021
  • Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelines developed by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means 'use sometimes'. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.

Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

  • Rim, Chai Hong;Seong, Jinsil
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.160-167
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    • 2016
  • In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

A Preliminary Study for Development of Clinical Practice Guidelines of Korean Medicine for Nasopharyngeal Cancer (비인두암의 한의학적 진료 지침 개발을 위한 기초 연구)

  • Lee, Jong-hoon;Kang, Sei-young;Yoo, Hwa-seung
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.516-528
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    • 2016
  • Objectives: The purpose of this study is to present clinical practice guidelines for nasopharyngeal cancer (NPC).Methods: Data related to western and oriental medical treatment of NPC were collected using various search engines such as Google Scholar, KIOM OASIS, PUBMED, and the library of Woosuk University.Results: In recent studies, applying combined oriental and western medicine has been shown to improve survival, quality of life, and immune function and to decrease side effects with respect to NPC. However, there still is no objective and systematic clinical guideline for NPC, so we have proposed one. This study will be meaningful in establishing clinical practice guidelines of Korean medicine for NPC.Conclusion: Further studies related to Korean medicine are needed to develop more advanced clinical practice NPC guidelines.

Clinical Practice Guidelines of Korean Medicine for Malignant Lymphoma (악성 림프종 치료에 대한 한의 임상진료지침)

  • Jung, Hyun-sik;Lee, Sang-hun;Yoo, Hwa-seung;Kim, Kyung-suk
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.453-466
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    • 2016
  • Objective: The purpose of this study was to present the clinical practice guideline of Korean medicine for malignant lymphoma.Background: Malignant lymphoma is the tenth most common cancer in Korea. The two main types of lymphoma are Hodgkin’s disease and non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphomas are more common, comprising nearly 95 percent of all lymphomas. In China, the traditional Chinese medicine clinical guidelines for malignant lymphoma were published in 2014. Therefore, there is growing need for a clinical practice guideline in Korea, which has not thus far existed. This clinical practice guideline was created by reviewing the Chinese clinical practice guideline and Korean clinical reports. This study will be helpful in understanding malignant lymphoma and in understanding its treatment in Korean medicine.Conclusion: Further clinical research on malignant lymphoma is needed to develop a more advanced clinical guideline.

Development of Evidence Based Clinical Practice Guideline to Improve Quality of Critical Care Nursing (중환자 간호실무 질 향상을 위한 근거중심 임상실무지침서의 개발)

  • Park, Myong-Hwa
    • Journal of Korean Critical Care Nursing
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    • v.2 no.2
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    • pp.68-78
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    • 2009
  • Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

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A Review of Korean Medicine for Clinical Practice Guidelines for Cervical Cancer (자궁경부암의 한의학적 진료에 대한 고찰)

  • Jung, Hyun-Jung;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.1
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    • pp.1-14
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    • 2016
  • The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass screening program. Cervical cancer prognosis is good due to an effective treatment such as surgery or radiation therapy, concurrent chemotherapy in the early stage. However, it is still a poor prognosis when advanced stage or recurrent. Some studies said that combined oriental and western medicine can improve the survival, quality of life, immune function, and decrease side effects in cervical cancer. In the western medical part, clinical practice guideline was published in 2006, 2007 and 2010 in Korea. In China, oriental medicine clinical practice guideline have been published in 2014. But there is no Korean medicine clinical practice guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for cervical cancer in Korea, and existing Korean medicine clinical practice guideline for Disease Analysis and Treatment (辨證論治). This study will be a meaningful study to establish clinical practice guidelines of Korean Medicine for cervical cancer.