• The Journal of Korean Obstetrics and Gynecology
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• v.35 no.4
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• pp.77-90
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• 2022

Objectives: This study was aimed to figure out korean medicine doctors' opinion and treatment of Korean medicine clinical practice guidelines (CPG) for premenstrual syndrome (PMS). Methods: We conducted a questionnaire survey targeting korean medicine doctors belonging to the Korean Association of Oriental Medicine by e-mail and text and analyzed the answers. Results: 1. The average monthly number of patients visiting the respondents' clinics for PMS was 2.7, the main age group was 20-30s (80.8%) and the treatments the patients given before were mostly western treatments such as painkiller and combined oral contraceptives. 2. The treatment period for PMS was mostly less than 3 months (69%), and the frequency of acupuncture treatment was the most twice per week (41.1%). 3. The most effective herbal medicine for affective symptoms was Soyo-san, and for physical symptoms was Gyejibokryung-hwan. The most commonly used acupuncture point was 三陰交 (SP6). 4. Other opinions of the clinicians about Korean medicine clinical practice guideline of PMS were the need for promotion of PMS, convenience of taking herbal medicines and price competitiveness. Conclusions: We figured out korean medicine doctors' opinion of PMS CPG, clinical diagnosis and treatment.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.2
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• pp.93-106
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• 2017

Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

• Journal of Korean Traditional Oncology
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• v.22 no.1
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• pp.37-48
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• 2017

Objectives: The purpose of this study was to suggest the direction for the development of a clinical practice guideline (CPG) for esophageal cancer (EC). Methods: We collected and analyzed CPGs and related data about esophageal cancer by searching the database of domestic and foreign articles. Results: There were little contents or proposals related to Korean Medicine (KM) or Traditional Chinese Medicine (TCM), those related to KM or TCM can be found only in "Guidelines of Diagnosis and Therapy in Oncology with Traditional Chinese Medicine (惡性腫瘤中醫診療指南)". They were symptom factors, syndrome differentiation (SD) and 'treatment process of esophageal cancer by combination of western medicine and Korean medicine'. Conclusions: The topics of the development Korean medicine CPG for EC are (1) the method and procedure about combination of western medicine and Korean medicine (2) the process of SD and diagnosis (3) safety and efficacy of the herbal medicine and preparation (4) availability and timing of the tools related to KM or TCM like acupuncture, moxibustion, massage, etc.

• Korean Journal of Clinical Pharmacy
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• v.25 no.3
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• pp.178-186
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• 2015

Objective: Clinical practice guidelines (CPGs) are systematically developed statements aimed at helping optimal care of the patient in a given clinical circumstance. Because of the increasing evidence that active implementation of CPGs improve health outcomes, there is a growing awareness of the importance of guideline development and dissemination. The objective of this study was to investigate the status of CPG development and availability of the CPGs in Korea. Method: We searched in the Web sites of 180 organizations to identify CPGs which were developed and/or published in Korea until 1 July 2014. The data of titles, published year, publisher, distributer, and accessibility at the internet web of all CPGs were collected and analyzed. Results: A total of 172 CPGs were developed and 80% had been released since 2009. Most (51.2%) were developed for management of 4 diseases: 28 for digestive system disease; 27 for infectious disease; 18 for endocrine and metabolic diseases; and 15 for neoplasms. Of the 172 CPGs, 150 CPGs were publicly available. Among the 150 CPGs, 78.7% (118/150) were developed by only one organization. Conclusion: To ensure the production of high-quality CPGs, it is necessary to collaborate with other relevant professional societies in guideline development process. In addition, stronger efforts on wider dissemination of CPGs must be employed at the country levels to promote implementation of CPGs in clinical settings.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.3
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• pp.92-116
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• 2017

Objectives: The purpose of this study were to researched a Korean medicine doctors' recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for $10.91{\pm}8.03week$. Conclusions: We researched a Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.2
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• pp.139-152
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• 2020

Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

• The Journal of Korean Medicine
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• v.36 no.1
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• pp.1-8
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• 2015

Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

• Journal of Sasang Constitutional Medicine
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• v.29 no.4
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• pp.317-325
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• 2017

Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). Methods Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUI, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

• Journal of Dental Anesthesia and Pain Medicine
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• v.16 no.1
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• pp.31-37
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• 2016

Background: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. Methods: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. Results: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. Conclusions: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes