• Title/Summary/Keyword: Clinical practice guideline. Diagnosis

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A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy (임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사)

  • Heung-Sook Lee;Hyo-Jeong Jung;Su-Ji Choi;Dong-Il Kim
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.2
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

Update on polycystic ovary syndrome

  • Kim, Jin Ju
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.194-197
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    • 2021
  • Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

Summary of the Chronic Obstructive Pulmonary Disease Clinical Practice Guideline Revised in 2014 by the Korean Academy of Tuberculosis and Respiratory Disease

  • Yoon, Hyoung Kyu;Park, Yong-Bum;Rhee, Chin Kook;Lee, Jin Hwa;Oh, Yeon-Mok;Committee of the Korean COPD Guideline 2014
    • Tuberculosis and Respiratory Diseases
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    • v.80 no.3
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    • pp.230-240
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    • 2017
  • Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients both domestically and globally. The Korean clinical practice guideline for COPD was revised in 2014. It was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases, as well as participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. This revised guideline covers a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We drafted a guideline on COPD management by performing systematic reviews on the topic of management with the help of a meta-analysis expert. We expect this guideline will be helpful medical doctors treating patients with respiratory conditions, other health care professionals, and government personnel in South Korea.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

Development of a Clinical Practice Guideline : Benign Prostatic Hyperplasia (전립선비대증의 진료지침 개발)

  • Yu, Seung-Hum;Chai, Soo Eung;Kim, Chun-Bae;Kang, Myung Geun;Song, Jae Mann;Lee, Eun Sik;Lee, Jung Gu;Lee, Tchun Yong;Hong, Sung Joon
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.36-51
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    • 1997
  • Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

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A survey on Korean Medicine Doctors' Recognition and Treatment for Developing Korean Medicine Clinical Practice Guideline of Climacteric and Postmenopausal Syndrome (갱년기장애 및 폐경기후증후군 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료에 관한 실태조사)

  • Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.135-148
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    • 2017
  • Objectives: This study was aimed to develop a Korean medicine clinical practice guidelines (CPG) of Climacteric and Postmenopausal Syndrome Methods: We conducted a questionnaire survey targeting Korean medicine doctors belonging to the Association of Korean Obstetrics and gynecology by e-mail and analyzed the answers. On October 18, 2016, we sent questionnaires to 583 people, and on October 31, 2016, we sent questionnaires to 581 people again. A survey ended on November 15, 2016. A total of 56 responded. Results: 1. 91.07% of respondents knew the concepts and contents of CPG, and all respondents agreed about the necessity of CPG. 2. Most common symptom of climacteric and postmenopausal syndrome that 65.75% of the respondents answered was the hot flush 3. To diagnosis a climacteric and postmenopausal syndrome, 69.64% of the respondents used pattern identification diagnosis mainly. 4. 36.84% of the respondents answered that herbal medicine and acupuncture are the most effective treatments for climacteric and postmenopausal syndrome. The most commonly used herb medicine was Kamisoyo-san. Conclusions: We figured out Korean Medicine doctors' recognition of Korean medicine clinical practice guideline, clinical diagnosis, treatment on climacteric and postmenopausal syndrome to make the contents of the CPG reflecting the clinical situation. Further research will be needed in the future.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Greater Yin Symptomatology (소음인체질병증 임상진료지침: 태음병)

  • Hwang, Min-Woo;Park, Hye-Seon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.45-54
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Greater Yin Symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Greater Yin Symptomatology of Stomach Cold-based Interior Cold disease in Soeumin disease. Results & Conclusions CPG of Greater Yin symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Greater Yin symptomatology is classified into mild and moderate pattern by severity. Greater Yin Symptomatology Mild pattern is classified into Greater Yin Symptomatology accompanied abdominal pain and bowel irritability and Greater Yin pattern accompanied Epigastric stuffiness and fullness. And Greater Yin Symptomatology moderate pattern is classified into Greater Yin pattern accompanied Jaundice, Greater Yin pattern accompanied Edema and Greater Yin pattern by Yin toxin.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine : Congestive Hyperpsychotic symptomatology (소음인체질병증 임상진료지침 : 울광병)

  • Bae, Hyo-Sang;Kim, Yun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.27-36
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Congestive Hyperpsychotic symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, no article was selected and included in CPG for Congestive Hyperpsychotic symptomatology of Kidney Heat-based Exterior Heat disease in Soeumin disease. Results & Conclusions CPG of Congestive Hyperpsychotic symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Congestive Hyperpsychotic symptomatology is classified into mild and severe pattern by severity. Congestive Hyperpsychotic symptomatology mild pattern is classified into initial pattern. Congestive Hyperpsychotic symptomatology severe pattern is classified into intermediate and advanced pattern and Greater Yang disease Reverting Yin pattern.

Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline (2020년 개정 진료 치침에 따른 과민성폐렴의 진단)

  • Soojung Park;Yu-Whan Oh;Eun-Young Kang;Hwan Seok Yong;Cherry Kim;Ki Yeol Lee;Sung Ho Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.817-825
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    • 2021
  • Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

Clinical Practice Guideline for Korean Medicine for Ovarian Cancer (난소암 치료에 대한 한의 임상 가이드라인)

  • Kim, Kyung-Soon;Choi, Hong-Sik;Kim, Seung-Mo;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.37-50
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    • 2016
  • Ovarian cancer is the tenth most common cancer in Korean female, and the third most common cancer of female reproductive organ after breast cancer and uterine cervical cancer. In spite of develop of conventional treatment, high modality of ovarian cancer comes from difficulty of an early diagnosis. Recent studies revealed that combining conventional and integrative medical treatment can reduce the adverse effect of surgical operation, chemotherapy and radiotherapy. Also it can improve survival rate, quality of life. However there isn't still a systemic clinical protocol for ovarian cancer in Korean medicine. This study will be helpful to establish clinical practice guidelines of Korean Medicine for ovarian cancer. And further studies on integrative ovarian cancer treatment are needed to build the clinical practice guidelines of ovarian cancer.