• Title/Summary/Keyword: Clinical assessment

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Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • 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.

Clinical Assessment of Pain and Sensory Function in Peripheral Nerve Injury and Recovery: A Systematic Review of Literature

  • John, Albin A.;Rossettie, Stephen;Rafael, John;Cox, Cameron T.;Ducic, Ivica;Mackay, Brendan J.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.427-439
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    • 2022
  • Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

A Review of Clinical Trials for Development of Assessment Criteria for Chronic Low Back Pain (만성 요통에 대한 한의학적 평가척도 개발을 위한 임상연구 실태조사)

  • Kim, Ji-Hye;Nam, Dong-Woo;Kang, Jung-Won;Kim, Eun-Jung;Kim, Kap-Sung;Kang, Sung-Keel;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.26 no.6
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    • pp.215-224
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    • 2009
  • Objectives : Low back pain is the most prevalent condition for receiving Korean traditional medical treatment. The aim of this review is to provide fundamental data for development of low back pain classification and assessment criteria which can be used in clinical trials and clinical practice. Methods : Domestic and international clinical studies on oriental medicine treatment for low back pain were searched through on-line databases. The searched articles were reviewed and the evaluation tools used in the studies were investigated. Results : A total of 38 possibly relevant articles in Pubmed were identified, of which 34 articles included assessment criteria for low back pain. And 38 articles were reviewed in the Journal of Korean Oriental Medicine and the Journal of Korean Acupuncture & Moxibustion Society. 29 articles used pain scales, 24 used functional scales, and 20 among 34 articles in PubMed used both pain and functional scales. The majority of articles which published in Korea used worthless assessment scales of simple grades. There was no articles which used assessment scales related to the concepts of Korean traditional medicine. Conclusions : Our review of articles suggests that we would use both pain and functional scales. Future assessment scales should include the concepts of Korean traditional medicine.

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Retrospective Drug Utilization Review of Antibiotics for Respiratory Tract Infection(RTI) in Ambulatory Outpatient Care (외래 호흡기계 질환에서 항생제 사용에 대한 후향적 평가방안)

  • Kim, Dong-Sook;Bae, Green;Kim, Su-Kyeong;Lee, Hak-Seon;Kim, Yoon Jin;Lee, SukHyang
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.291-303
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    • 2012
  • As respiratory tract infections (RTI) account for about 60% of all antibiotic prescriptions in outpatient care setting, there are significant concerns about emerging resistance that are largely due to the excessive or inappropriate use of antibacterial agents for viral respiratory infections. This study was aimed to develop retrospective drug utilization review (DUR) program of antibiotics for RTIs using Delphi methods. Retrospective DUR criteria of antibiotics for RTIs were identified based on clinical practice guidelines and opinion of experts. Expert panel members were clinical doctors and pharmacists and Delphi method was applied by survey on 16 members of panels. The claim data from Korean Health Insurance Review & Assessment (HIRA) were used to examine trends in outpatient antibiotic prescription between Janunary to December of 2008. As results, Quality index for RTI was assessed for the claim type, antibiotics use of quantity, duration, number and cost. Antibiotic prescription rate for RTIs, Defined Daily Dose (DDD), and duration of antibiotics use were more recognized as significant quality index by experts' opinion. Use of first line agents suggested by guidelines was low and duration of antibiotics use was shorter compared to the recommendations. Antibiotics were over prescribed for RITs. However, dose and duration of antibiotics were under-used.

Systematic Review of Assessment Tools for Praxis Ability of Sensory Integrative Function : Provide Range of Assessment Tools in Foreign and Domestic Normal Children (실행능력 평가도구에 대한 체계적 고찰 : 정상아동에서 국내.외 평가도구별 수행범위 제시)

  • Hong, Eunkyoung;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.41-56
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    • 2013
  • Objective : The purpose of this study tried to present the performed average and range through systematic review about assessment tools that measures the praxis ability of sensory integrative function for foreign and domestic normal children. Methods: With making use of Medline, PubMed, Ovid, Eric, the Library of Congress, National Science and Technology Information Center, Kiss, RISS, and the Google search engine, we searched the name of assessment tool on the basis of the framework of the theory of sensory integration. Target paper was thesis and Journal published from January 2000 to April 2011. Results: Total of 24 papers were retrieved, used assessment tools were Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), Bruininks-Oseretsky Test of Motor Proficiency, Short Form (BOTMP-SF), Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Short Form (BOT-2-SF), Clinical Observations of Motor and Postural Skills (COMPS), Motor Assessment Battery for Children (MABC), Clinical Test of Sensory Interaction with Balance (CTSIB), and subtest of Sensory Integration and Praxis Test (SIPT). We presented the average and range of assessment tools applied to normal children in each country. Conclusion: A performed result in other cultural and domestic normal children which this study presented will provide a standard in comparison with performance of children with disabilities who are the actual clinical evaluation.

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Assessment of Appropriateness of Criteria for Insurance Coverage on Systemic Therapy used in Renal Cell Carcinoma (신세포암에 사용되는 전신 항암요법의 요양급여기준에 관한 고찰)

  • Kim, Jeong-Yeon;Park, Eun-Ji;Bae, Min-Kyung;Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.319-331
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    • 2011
  • Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

e-Portfolios for Learning and Assessment in Medical Education (학습 및 평가관리를 위한 e-포트폴리오의 구축과 활용)

  • Kim, Kyong-Jee
    • Korean Medical Education Review
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    • v.16 no.1
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    • pp.7-10
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    • 2014
  • Portfolios have gained attention in medical education as a tool for promoting student learning and assessment since Miller's call for better tools for assessing students' clinical competencies. This paper reviews the development and use of e-portfolios for promoting learning and assessment in medical schools, both domestically in Korea and internationally. This review finds that some specific features need to be incorporated into e-portfolio systems for medical education and that these systems can be used to manage student learning in clinical clerkships and to support competency-based assessment. The author asserts that the e-portfolio is key to promoting competency-based education and suggests practical tips for effective development and use of e-portfolios in Korean medical schools.

A Study on the Development of Diagnostic Tools for Sasang Constitutional Patterns (사상체질병증 진단도구 개발 연구)

  • Lee, Hyeri;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.3
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    • pp.95-126
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    • 2021
  • Objectives The purpose of this study was to develop diagnostic tools for Sasang Constitutional patterns based on the middle classification of the Sasang Constitutional patterns. Methods Diagnosis and assessment indicators of Soeumin, Soyangin, Taeeumin, and Taeyangin patterns were extracted based on the 『Clinical Practice Guideline for Sasang Constitutional Medicine Symptomatology』 and 『Donguisusebowon』. An online survey was conducted on the 'importance of diagnosis and assessment indicators' by the Sasang Constitutional Medicine expert group. Results Based on the expert consultation results, the importance weight for each diagnosis and assessment indicators symptom was calculated, and the importance was ranked to develop diagnostic tools for Soeumin, Soyangin, Taeeumin, and Taeyangin patterns. Diagnostic tool consisted of 58 questions for Soeumin patterns, 68 questions for Soyangin patterns, 81 questions for Taeeumin patterns, and 42 questions for Taeyangin patterns. The final total score was calculated by reflecting each response score and the weight of each question. Conclusions The developed 'Diagnostic Tools for Sasang Constitutional patterns' can be used to make an effective and objective diagnosis in the clinical site. In the future, if the reliability and validity of these diagnostic tools are tested through clinical study, it will be possible to improve clinical applicability and contribute to standardization of diagnosis.

Evaluation of the Effects of Feedback and Remediation after Formative Assessment in the Introduction to Clinical Medicine (임상실습 입문교육에서 형성평가 후 되먹임 및 재시험의 효과)

  • Lee, Yong Jig;Choi, Son Hwan
    • Korean Medical Education Review
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    • v.18 no.1
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    • pp.38-43
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    • 2016
  • The authors investigated the effect of feedback and remediation after formative assessment (FRFA) by comparing the FRFA score and that of summative assessment (SA) in a course on clinical skills. In March 2015, 33 subjects underwent evaluation of their ability to perform a complex clinical skill using a real-time ready-made mobile assessment form tool, and through e-mail they were supplied with their feedback and final score (the pass group earned 2 points; the intermediate group earned 1 point; the nonpass group earned 0 points) followed by their self-reflection. The nonpass group underwent a re-test and e-mail feedback again until they passed the test, given the ease of performance. In December 2015, the 33 subjects took a 10-item SA, and one of the 10 items addressed a similar clinical skill. The difference between the first score on the FRFA and the score on the SA was evaluated statistically (p=0.05) through data analysis, variance distribution, correlation analysis, and linear regression analysis using SPSS software ver. 16. The increase from the score on the SA to that on the FRFA was statistically significant ($4.5{\pm}9.29$) in the pass group and the intermediate group, and was $29.7{\pm}11.49$ in the nonpass group of the formative evaluation (p<0.001). Using an FRFA could decrease the range in the standard deviation of the score and increase the minimum score among the subjects.

Study on the Development of Diagnosis and Assessment Instrument for the Original Symptom of Taeeumin (태음인 소증 진단평가도구 개발 연구)

  • Kwon, Jin-Hyeok;Lee, Jun-Hee
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.1
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    • pp.57-89
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    • 2021
  • Objectives This study is aimed to develop a standard instrument of diagnosis and assessment for the original symptom of Taeeumin. Methods 1. Based on the clinical practice guidelines, the works of Dong-mu, and the expert clinical judgment of the research team, the items to be used in the instrument of diagnosis and assessment for the original symptom of Taeeumin were extracted, and translation was proceeded in plain Korean for easy application and feasible use in daily clinical practice. As a result, candidate items for the diagnosis and assessment tool were derived. 2. An online questionnaire survey was conducted on the candidate items derived through the above process to the expert advisory group for (1) inclusion/exclusion as diagnosis and assessment index (2) evaluation of importance and (3) the validity of translation. Results & Conclusions Through survey of expert advisory group, the number of candidate items were reduced and the preliminary weights were assigned. And based on this, was developed. There were a total of 9 items for Exterior Cold[Wiwanhan] original symptom diagnosis and assessment tool, 21 items for Interior Heat[Ganyeol] original symptom, 15 items for Exterior Disease Unfavorable Patterns[Wiwanhan-paejo] original symptom, and 17 items for Interior Disease Unfavorable Patterns[Ganyeol-paejo] original symptom, and the weights were reflected in each response score so that the final total score could be calculated.