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

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International Cross-Sectional Survey among Healthcare Professionals on the Management of Cow's Milk Protein Allergy and Lactose Intolerance in Infants and Children

  • Madrazo, J Armando;Alrefaee, Fawaz;Chakrabarty, Anjan;de Leon, Julia C.;Geng, Lanlan;Gong, Sitang;Heine, Ralf G.;Jarvi, Anette;Ngamphaiboon, Jarungchit;Ong, Christina;Rogacion, Jossie M.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.3
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    • pp.263-275
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    • 2022
  • Purpose: The present international survey among healthcare providers aimed to collect data on theoretical knowledge and clinical practices in the diagnosis and management of cow's milk protein allergy (CMPA) and lactose intolerance (LI) in infants. Methods: A global survey was conducted in several countries with diverse health care settings. The survey consisted of multiple-choice questions in 3 main domains: (1) understanding and clinical practices around CMPA and LI; (2) case scenarios; and (3) disease-specific knowledge and potential educational needs. Results: Responses were available from 1,663 participants. About 62% of respondents were general practitioners or general pediatricians, and the remainder were pediatric allergists/gastroenterologists (18%) or other health practitioners (20%). The survey identified knowledge gaps regarding the types of CMPA (IgE-mediated vs. non-IgE-mediated) and the clinical overlap with LI. The survey suggested diverse clinical practices regarding the use of hypoallergenic formulas, as well as misconceptions about the prebiotic benefits of lactose in extensively hydrolyzed formulas in non-breastfed infants with CMPA. Responses to the two case scenarios highlighted varying levels of awareness of the relevant clinical practice guidelines. While respondents generally felt confident in managing infants with CMPA and LI, about 80% expressed an interest for further training in this area. Conclusion: The current survey identified some knowledge gaps and regional differences in the management of infants with CMPA or LI. Local educational activities among general and pediatric healthcare providers may increase the awareness of clinical practice guidelines for the diagnosis and treatment of both conditions and help improve clinical outcomes.

Development of Diagnostic Indicator for the Sasang Constitution Exterior-Interior Disease Based on Original Symptom (사상의학의 표리변증에 대한 소증 진단지표 개발연구: 소음인, 소양인, 태음인을 중심으로)

  • Park, Minyoung;Lee, Min-jung;Hwang, Minwoo
    • Journal of Sasang Constitutional Medicine
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    • v.32 no.4
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    • pp.65-85
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    • 2020
  • Objectives The aim of study was to suggest diagnostic indicator according to Exterior-Interior disease for the Sasang Constitution based on original symptom. Methods We investigated the literature(『Dongeuisusebowon sinchukbon』) and another study(Clinical Practice Guideline for Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm). As a result, we developed diagnostic indicator of original symptom for Exterior-Interior disease in Sasang Constitutional Medicine. Results and Conclusions Diagnosis of Exterior-Interior disease in Sasang Constitution was decided by heat and cold of original symptom. Detailed indicators of diagnosis in Exterior-Interior disease were heat/cold sensitivity, the degree of sweating, the amount of drinking water, thirst, face color and somatalgia.

Clinical Practice Patterns for Carpal Tunnel Syndrome in Korean Medicine: An Online Survey (손목터널증후군의 한의 임상 진료 현황 조사를 위한 온라인 설문조사)

  • Lee, Sang-Hyun;Park, Hye-Jin;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.1
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    • pp.73-89
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    • 2021
  • Objectives We conducted an online survey to understand the current status of Korean Medicine clinical practice related to carpal tunnel syndrome (CTS) to develop the CTS Korean Medicine Clinical Practice Guidelines (CPG). Methods A thoroughly reviewed questionnaire was distributed by e-mail to 21,719 Korean Medicine doctors between March 26 and April 30, 2021. All raw data were arranged and analyzed systematically. Results The response rate among the doctors was 4%. Of the respondents, 82.1% responded that it is necessary to develop the CTS Korean Medicine CPG. We also obtained data related to the specific diagnosis, treatment, and prognosis management methods used at various treatment sites for patients with CTS. Conclusions This online survey will be helpful in developing the CTS CPG, which will contribute to the standardization of guidelines and improvements in the reliability of Korean Medicine. Our findings will provide valuable data and resources for future clinical studies on CTS.

Clinical practice recommendations for Bangpungtongseong-san (Bofutsusho-san) and Bangkihwangki-tang(Boiogito) in obesity (비만치료 및 체중 감량에서 방풍통성산과 방기황기탕 사용에 대한 임상 권고안)

  • Park, Jung-Hyun;Kim, Ho-Jun
    • Journal of Korean Medicine for Obesity Research
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    • v.12 no.1
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    • pp.48-58
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    • 2012
  • Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.

A Survey on Korean Medicine Doctors' Recognition and Treatment for Developing Korean Medicine Clinical Practice Guideline of Coldness of Hands and Feet (한의표준임상진료지침 개발을 위한 수족냉증에 대한 한의사의 인식과 치료현황)

  • Lee, Dong-Nyung;Kim, Hyung-Jun;Yu, Jun-Sang
    • 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.

Review of the Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition (2017 과민성장증후군의 임상진료지침 개정안 소개)

  • Jung, Hye-Kyung
    • The Korean Journal of Gastroenterology
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    • v.72 no.5
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    • pp.252-257
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    • 2018
  • This guidance is an updated version of the irritable bowel syndrome (IBS) guidelines based on evidence-based medicine. IBS is a common chronic gastrointestinal syndrome that occurs in approximately 10% of the population and causes chronic abdominal pain as well as bowel habit changes, such as stool frequency or consistency. The final diagnosis of IBS is based on the exclusion of organic diseases that would explain the symptoms and the absence of endoscopic abnormalities. IBS can reduce the quality of life and cause a major disease burden, such as repeated examinations and continuous drug use, by mistaking organic diseases including malignancy. The major changes are as follows: 1) when to perform a colonoscopy under the impression of IBS; 2) effect of a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyol diet; 3) impact of probiotics in IBS; and 4) role of antibiotics in IBS. The Korean Society of Neurogastroenterology and Motility recently updated these guidelines to support physicians for qualified medical services and reduce the socioeconomic burden of IBS.

E-mail Survey for Developing Clinical Guideline Protocol on Acupuncture Treatment for Low Back Pain (요통에 관한 침구임상 진료지침 프로토콜 개발을 위한 전자우편 설문조사)

  • Lee, Seung-Hoon;Nam, Dong-Woo;Kang, Jung-Won;Kim, Eun-Jung;Kim, Hyun-Wook;Song, Ho-Sueb;Kim, Sun-Woong;Kim, Kap-Sung;Lee, Geon-Mok;Lee, Jae-Dong
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.115-131
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    • 2009
  • Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

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Current update on allergic rhinitis for Korean Medicine management (알레르기 비염의 한의학적 관리를 위한 최신 지견)

  • Jeung, Chang-Woon;Jo, Hee-Geun;Kim, Hye-Hwa;Song, Min-Yeong
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.29 no.4
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    • pp.95-113
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    • 2016
  • Objectives : The purpose of this review is to introduce the recent advance in allergic rhinitis and to provide help in establishing strategy and selection of drugs for Korean medical treatment of allergic rhinitis. Methods : We searched articles about allergic rhinitis comprehensively in PubMed, CNKI, JStage, KISTI. And in order to reflect clinical situation, we also reviewed some profession's writing for practitioners. Results : This review discussed allergic rhinitis's epidemiology, pathophysiology, diagnosis, treatment, prognosis. We found many standardized clinical practice guideline have been published in this field. And some guideline reflected accumulation of medical evidence on interventions in Korean medicine. It suggested that acupuncture, herbal medicine, herbal patch are useful to prevention and alleviate allergic symptoms. But some interventions have heterogeneity due to each nation's medical background. Conclusions : Acupuncture therapy is now recommended world widely for treating allergic rhinitis. But other interventions of Korean medicine are not well recognized in the same manner. We need more research to identify mechanism and rigorous clinical trials to clarify efficacy and safety of Korean medicine intervention.

Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

  • Yi, Dae Yong;Kim, Soon Chul;Lee, Ji Hyuk;Lee, Eun Hye;Kim, Jae Young;Kim, Yong Joo;Kang, Ki Soo;Hong, Jeana;Shim, Jung Ok;Lee, Yoon;Kang, Ben;Lee, Yeoun Joo;Kim, Mi Jin;Moon, Jin Soo;Koh, Hong;You, JeongAe;Kwak, Young-Sook;Lim, Hyunjung;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.1
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    • pp.1-27
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    • 2019
  • The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guideline for Growth Disorders (성장장애 한의표준임상진료지침 개발을 위한 한의사 인식조사)

  • Ahn, Hye Ri;Sim, Soo bo;Lee, Hye Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.1-15
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    • 2021
  • Objectives The purpose of this study is to provide data for development of the korean medicine (KM) clinical practice guidelines (CPG) for growth disorder (GD) by identifying the awareness and knowledge needs of KM doctors (KMD) through online survey. Methods Survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed 18 questions regarding the current status of clinical care for GD, clinician's knowledge level about GD, and other details that clinicians use during practice. The survey was conducted from January 2021 to March 2021. An online survey was conducted on 101 KMDs from the association of pediatrics of KM. Results According to the survey, 96 respondents (40.3%) said the causation of GD without growth hormone deficiency needs to be included in CPG. 96 (23.5%) of the respondents wishes to utilize percentile in diagnosis and evaluation of the growth assessment. 24.7% of the clinicians were using the herbal medicine treatment. Currently, when treating with KM for GD, herbal medicine (100%) is the most widely used, followed by acupuncture (77.6%), and moxibustion (36.7%). In terms of a complex treatment, growth therapy efficacy (26.8%) is shown to be the most important factor to consider and needed to be included in CPG for the complex treatment, and diet (22.3%) is also considered to be important in GD. Conclusions In this study, we were able to understand the clinical KMDs' perception of GD, knowledge level, and the requirements in the CPG. The results of this study will provide the basic data for development of CPG for GD.