• 제목/요약/키워드: EBM

검색결과 163건 처리시간 0.037초

미국의 PSA 진단검사 논쟁과 유연한 근거중심의학 (The PSA Testing Debate in the U.S and Flexible Evidence-Based Medicine)

  • 현재환
    • 과학기술학연구
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    • 제13권1호
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    • pp.77-109
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    • 2013
  • 현재 의료체계의 주된 변화로 근거중심의학(Evidence-based Medicine: EBM)의 전지구적확산을 꼽을 수 있다. 최근 STS 연구들은 EBM이 실제 의학 실행 속에서 어떻게 사용되고 작동하는지에 대한 검토를 수행했는데, 이 글은 이러한 맥락 속에서 전립선암 특이항원(Prostate-specific Antigen: PSA) 의 조기진단 검사 도구 사용 여부를 둘러싸고 미국에서 벌어진 논쟁을 추적한다. 본 연구는 EBM이 PSA 검사 조기진단의 지지자와 반대자 양측에서 논쟁의 자원으로 이용되었으며, 그 과정에서 '확고한 과학적 기준'을 제시할 것으로 기대되던 EBM의 과학적 증거 위계가 행위자들의 의도에 따라 사실상'유연하게' 해석되고 동원되었음을 보일 것이다. 나아가, 이 글은 현재 EBM이 PSA 검사 반대자를 지지하는 것처럼 보이는 일은 삶의 질이라는 가치가 EBM의 체계 내에 주요한 변수로 부상하는 역사적 맥락에 의해 만들어진 결과임을 드러낼 것이다. 본 사례 연구는 EBM 시대에 의료기술에 관한 논쟁을 검토하는 연구자들이 EBM이라는 대상을 주어진 것으로 간주하기 보다는 논쟁 속에서 맥락화하여 논쟁과 함께 분석해야 함을 시사한다.

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EBM E-learning: Feasible and Effective for Occupational Physicians in Different Countries

  • Hugenholtz, Nathalie I.R.;Slutter, Judith K.;Van Dijk, Frank J.H.;Nieuwenhuijsen, Karen
    • Safety and Health at Work
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    • 제3권3호
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    • pp.199-208
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    • 2012
  • Objectives: Although evidence-based medicine (EBM) is a useful method for integrating evidence into the decision-making process of occupational physicians, occupational physicians lack EBM knowledge and skills, and do not have the time to learn the EBM method. In order to enable them to educate themselves at the time and place they prefer, we designed an electronic EBM course. We studied the feasibility and utility of the course as well as its effectiveness in increasing EBM knowledge, skills, and behaviour. Methods: Occupational physicians from various countries were included in a within-subjects study. Measurements were conducted on participants' EBM knowledge, skills, behaviour, and determinants of behaviour at baseline, directly after finishing the course and 2 months later (n = 36). The feasibility and utility of the course were evaluated directly after the course (n = 42). Results: The course is applicable as an introductory course on EBM for occupational physicians in various countries. The course is effective in enhancing EBM knowledge and self-efficacy in practising EBM. No significant effect was found on EBM skills, behaviour, and determinants of behaviour. After the course, more occupational physicians use the international journals to solve a case. Conclusion: An electronic introductory EBM course is suitable for occupational physicians. Although it is an effective method for increasing EBM knowledge, it does not seem effective in improving skills and behaviour. We recommend integrating e-learning courses with blended learning, where it can be used side by side with other educational methods that are effective in changing behaviour.

EBM 기반구축을 위한 귀비탕(歸脾湯) 연구 문헌 분석 (Analysis of Studies on Guibi-tang(Guipitang) for Fundamental Establishment of Evidence Based Medicine(EBM))

  • 김정훈;이준경;하혜경;서창섭;이미영;이호영;정다영;이남헌;이진아;황대선;신현규
    • 동의신경정신과학회지
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    • 제20권3호
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    • pp.205-216
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    • 2009
  • Objectives : To establish the fundaments for EBM of Traditional Korean Medicine, the papers on Guibi-tang(Guipitang) which were frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. Methods : The papers were classified by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Results : Of total 39 papers were registered in domestic journals. Since 1980, publishments of papers have continuously increased. The papers on biological studies were 34 volumes, clinical studies were 5 volumes. Biological studies mainly showed the effects of anti-stress, anti-oxidant, hemostasis, anti-osteoporosis, gastroprotection, reproductive ability, brain cell activity, radioprotection. And clinical studies showed improvements of fearful throbbing, memory and orientation, insomnia, vericose vein, schizophrenia. Conclusions : Guibi-tang(Guipitang) could be used to fortify the spleen, nourish the heart and then control the blood. However biological studies need to be conducted in accordance with clinical study and further clinical studies on randomized controlled trials should be proceeded.

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EBM 기반구축을 위한 보중익기탕 실험 연구 분석 (Analysis of studies on Bojungikgi-tang(Buzhongyiqi-tang) to establish the fundament for Evidence Based Medicine (EBM))

  • 김정훈;이준경;신현규
    • 한국한의학연구원논문집
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    • 제17권2호
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    • pp.135-167
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    • 2011
  • Objective : To establish the fundament for EBM of Traditional Korean Medicine, the papers on Bojungikgitang(Buzhongyiqi-tang) frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international papers. Methods : The papers were classified by the registration of domestic or international journals, the year of publishment, experimental fields and the kinds of studies on biological activities. Results : Among 2005 volumes of papers on Bojungikgi-tang(Buzhongyiqi-tang), 219 volumes were selected according to selective criteria. 71 volumes were published in domestic journals, 52 volumes were in Chinese journal, 96 volumes were in Japanese journal. The papers on instrumental analyses reported the quantification of standard compounds of herbal medicines in Bojungikgi-tang(Buzhongyiqi-tang) using HPLC method. The papers on biological activities of Bojungikgi-tang(Buzhongyiqi-tang) showed mainly immune regulation, anti-infection, anti-cancer, gastrointestinal activity, neuropsychiatric regulation, anti-inflammation, hepatoprotection, musculoskeletal regulation. Among biological activities, papers on immume regulation were reported mostly. Conclusions : The efficacy of Bojungikgi-tang(Buzhongyiqi-tang) could be related to immune regulation, gastrointestinal activity, anti-fatigue and further study need to be preceeded to establish the fundament for EBM of Bojungikgitang(Buzhongyiqi-tang).

WoS와 SCOPUS에 등재된 국내 발행 학술지의 편집위원회 구성 분석 - 사회과학 분야를 중심으로 - (Analysis of the Composition of Editorial Board Members of Domestic Journals Listed in WoS and SCOPUS: Focusing on the Field of Social Science)

  • 이승민;오동근;여지숙
    • 한국문헌정보학회지
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    • 제54권4호
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    • pp.239-259
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    • 2020
  • 학술지의 질적 수준을 제고하고 국제적 이용도를 높이기 위한 방안 가운데 하나로 편집위원회 구성의 중요성이 높아지고 있다. 본 연구에서는 사회과학 분야의 국내 발행 학술지 가운데 WoS와 SCOPUS에 등재된 학술지를 대상으로 편집위원회(Editorial Board Member: EBM)의 구성을 분석하여 학술지의 국제화를 도모하기 위한 고려사항을 도출하였다. 연구 결과, 사회과학 분야 학술지의 국제화를 위해서는 이론과 실무의 융합을 도모할 수 있는 EBM의 구성, EBM의 업무 효율화를 위한 지역적 측면의 고려, 영어 기반의 학술 커뮤니케이션 효율화를 고려한 EBM의 구성, 학계와 현장을 연계할 수 있는 연구진의 EBM 참여 등을 고려해야 하는 것으로 분석되었다.

Prediction of 305 Days Milk Production from Early Records in Dairy Cattle Using an Empirical Bayes Method

  • Pereira, J.A.C.;Suzuki, M.;Hagiya, K.
    • Asian-Australasian Journal of Animal Sciences
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    • 제14권11호
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    • pp.1511-1515
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    • 2001
  • A prediction of 305 d milk production from early records using an empirical Bayes method (EBM) was performed. The EBM was compared with the best predicted estimation (BPE), test interval method (TIM), and the linearized Wood's model (LWM). Daily milk yields were obtained from 606 first lactation Japanese Holstein cows in three herds. From each file of 305 daily records, 10 random test day records with an interval of approximately one month were taken. The accuracies of these methods were compared using the absolute difference (AD) and the standard deviation (SD) of the differences between the actual and the estimated 305 d milk production. The results showed that in the early stage of the lactation, EBM was superior in obtaining the prediction with high accuracy. When all the herds were analyzed jointly, the AD during the first 5 test day records were on average 373, 590, 917 and 1,042 kg for EBM, BPE, TIM, and LWM, respectively. Corresponding SD for EBM, BPE, TIM, and LWM were on average 488, 733, 747 and 1,605 kg. When the herds were analyzed separately, the EBM predictions retained high accuracy. When more information on the actual lactation was added to the prediction, TIM and LWM gradually achieved better accuracies. Finally, in the last period of the lactation, the accuracy of both of the methods exceeded EBM and BPM. The AD for the last 2 samples analyzing all the herds jointly were on average 141, 142, 164, and 214 kg for LWM, TIM, EBM, and BPE, respectively. In the current practices of collecting monthly records, early prediction of future milk production may be more accurate using EBM. Alternatively, if enough information of the actual lactation is accumulated, TIM may obtain better accuracy in the latter stage of lactation.

EBM 기반구축을 위한 평위산 전임상 연구 문헌 분석 (Analysis of Studies on Pyeongwi-san to Establish the Fundament for Evidence Based Medicine)

  • 김정훈;이준경;신현규
    • 동의생리병리학회지
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    • 제24권5호
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    • pp.770-778
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    • 2010
  • To establish the fundament for EBM of Traditional Korean Medicine, the papers on Pyeongwi-san (Pingwei-san) frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international papers. The papers were classified by the registration of domestic or international journals, the year of publishment, experimental fields and the kinds of studies on biological activities. Of total 518 papers on Pyeongwi-san (Pingwei-san), 32 volumes were selected according to selection creteria. 20 volumes were published in domestic journals, 11 in Chinese journal and 1 in Japanese journal. The papers on instrumental analyses reported the quantification of standard compounds of herbal medicines in Pyeongwi-san (Pingwei-san) using HPLC, GC-MS. The papers on biological activities of Pyeongwi-san (Pingwei-san) showed improvement of gastrointestinal activity and water-electrolyte metabolism, immune regulation, anti-oxidant, anti-inflammatory, analgesic, anti-convulsant activities, hypnotic duration, blood pressure regulation, hepatic protection, congestive heart failure, anti-cancer activities. Further studies including gastrointestinal activity need to be preceeded to establish the fundament for EBM of Pyeongwi-san (Pingwei-san).

EBM 기반구축을 위한 사물탕 연구 문헌 분석 (Analysis of Studies on Samul-tang for Fundamental Establishment of Evidence Based Medicine)

  • 김정훈;이준경;하혜경;서창섭;이호영;정다영;이남헌;이진아;황대선;신현규
    • 동의생리병리학회지
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    • 제23권4호
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    • pp.779-788
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    • 2009
  • To establish the fundament for EBM of Traditional Korean Medicine, the papers on Samul-tang which was frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. The papers were classified by the registration of domestic or international journals, by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Of total 67 papers on Samul-tang, 58 volumes were registered in domestic journals and 9 volumes were in international journals of which 8 volumes were in SCI journals. Since 1978, publishments of papers have continuously increased. The papers on instrumental analyses were 6, biological studies were 58 volumes, clinical studies were 3. Instrumental analyses were preceeded with standard compounds(gallic acid, albiflorin, paeoniflorin, benzoic acid, ferulic acid, 5-HMF). And biological studies showed improvement of cardiovascular function and circulation, antianemia, brain protection, immunoregulation, antistress, radioprotection, antifatigue, antiinflammation and antiallergy, antioxidative effect. Through clinical studies, antifatigue, improvement of insomnia and osteoporosis were reported. Samul-tang could be used to tonify and activate blood. And further study on clinical field need to be conducted in accordance with biological study.

Spargue-Dawley 랫드를 이용한 구미강활탕의 급성독성 연구 (Acute Toxicity Study on Gumiganghwal-tang(Jiuweiqianghuo-tang) in Sprague-Dawley Rats)

  • 신인식;김정훈;하혜경;서창섭;이미영;이호영;이준경;이남헌;이진아;이설림;허정임;신현규
    • 대한한의학방제학회지
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    • 제18권1호
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    • pp.79-85
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    • 2010
  • Objectives : This study was conducted to evaluate the acute toxicity and safety of Gumiganghwal-tang (Jiuweiqianghou-tang) in Sprague-Dawley rats though the current regulatory guideline. Methods : The preliminary study showed that the single oral administration of Gumiganghwal-tang(Jiuweiqianghou-tang) did not induce any toxic effect at a dose level of 2000 mg/kg. Based on the results, 2000 mg/kg was selected as the limited dose. In this study, 10 rats of each sex were randomly assigned to two groups of 5 rats each and were administrated singly by gavage at dose levels of 0 and 2000 mg/kg. Mortalities, clinical signs, and body weight changes were monitored for the 15-day period following administration. At the end of observation period, all animals were sacrificed and complete gross postmortem examinations were performed. Results : Throughout the study period, no treatment-related deaths were observed. There were no adverse effects on clinical signs, body weight, and gross findings at all treatment groups. Conclusions : These results showed that the single oral adminstration of Gumiganghwal-tang(Jiuweiqianghou-tang) did not cause any toxic effect at the dose levels of 2000 mg/kg in rats. In conclusion, the $LD_{50}$ of Gumiganghwal-tang (Jiuweiqianghou-tang) was considered to be over 2000 mg/kg body for both sexes.

대표적인 태음인 처방의 면역 활성화 비교 연구 (Stimulation of the Immune Response by Herbal Formulas for Taeeumin)

  • 정다영;하혜경;이호영;이진아;이남헌;이준경;황대선;신현규
    • 사상체질의학회지
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    • 제22권3호
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    • pp.141-151
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    • 2010
  • 1. Objectives: Three herbal formulas (Yuldahanso-tang, Chungsimyonja-tang, and Taeeumjowi-tang) for Taeeumin were applied to investigate the immunological activities on antigen (Ag)-specific or Ag-non-specific immune responses in murine macrophage cell line (RAW 264.7) and ovalbumin (OVA)-immunized mice. 2. Methods: This study was carried out in nitric oxide (NO) synthesis in RAW 264.7 cells and cellular proliferation in mouse splenocytes according to three herbal formulas. C57BL/6 mice were immunized intraperitonially with OVA/aluminium ($100\;{\mu}g/200\;{\mu}g$/mouse) on day 1, 8, and 15. Three herbal formulas were administrated to mice orally for 3 weeks from day 1. On day 22, OVA-, lipopolysaccharide (LPS)-, and concanavalin A (Con A)-stimulated splenocyte proliferation and antibodies (OVA-specific antibodies of the IgG, IgG1, and total IgM classes) in plasma were measured. 3. Results: Yuldahanso-tang and Chungsimyonja-tang increased NO synthesis in RAW 264.7 cells. Three herbal formulas significantly enhanced cellular proliferation by LPS and Con A in splenocytes from OVA-immunized mice (p<.001). Three herbal formulas for Taeeumin also significantly enhanced plasma OVA-specific IgG, IgG1, and total IgM levels compared with the OVA/Alum group. 4. Conclusion: These results suggested that three herbal formulas for Taeeumin could be used as stimulator of immune response.