• 대한핵의학회지
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• 제35권4호
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• pp.224-230
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• 2001

EBM is "the conscientious, explicit and judicious use of current best evidence in mating decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research." EBM is the integration of clinical expertise, patient values, and the best evidence into the decision making process for patient care. The practice of EBM is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, or the etiology of disorders. The best evidence is usually found in clinically relevant research that has been conducted using sound methodology. Evidence-based medicine requires new skills of the clinician, including efficient literature-searching, and the application of formal rules of evidence in evaluating the clinical literature. Evidence-based medicine converts the abstract exercise of reading and appraising the literature into the pragmatic process of using the literature to benefit individual patients while simultaneously expanding the clinician's knowledge base. This review will briefly discuss about concepts of evidence medicine and method of critical appraisal of literatures.

• 셀메드
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• 제5권3호
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• pp.16.1-16.3
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• 2015

Evidence based medicine involves using both the individual clinician's expertise and the current best available external clinical evidence from systematic research in deciding on the appropriate care for individual patients. The current approach to evidence based practice in healthcare adds a third component which is patient values. Evidence based practice is thus a triad, in which the practitioner's expertise, research evidence and the patient's values are all given consideration. The balance to be struck between them depends on the individual case. The literature indicates that complementary medicine practitioners are moving away from traditional knowledge and towards the use of evidence based practice in their clinical discussions. In the context of the daily practice of complementary medicine practitioners and their continuing development of their knowledge base of evidence based practice, this short review discusses the good and bad of a review journal article.

• 대한두경부종양학회지
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• 제40권1호
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• pp.15-17
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• 2024

Clear cell carcinoma is a rare variant of salivary gland carcinoma, and its occurrence in the tongue base is even rarer. We present a case of a 55-year-old female patient with clear cell carcinoma of the tongue base. The patient initially presented with a 3-month history of palpable tongue mass, leading to her visit to the otolaryngology outpatient clinic. The patient underwent a complete resection of the tumor under general anesthesia. Postoperative follow-up imaging studies showed no evidence of recurrence. This case report highlights the diagnostic and management challenges associated with clear cell carcinoma of tongue base and demonstrates that a high index of suspicion is required to diagnose clear cell caricnoma, given its rarity and overlapping features with other clear cell neoplasms.

• 대한물리의학회지
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• 제2권2호
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• 대한한방부인과학회지
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• 제24권3호
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• pp.171-189
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• 2011

Objectives: Female Sexual Dysfuction(FSD) is a common gynecologic condition and its prevalence is more higher than men. Despite its high prevalence and clinical importance, research on FSD is not enough in both of oriental and western medicine. The purpose of this study is to review research tendency of recent oriental medicine studies on FSD and to suggest the following research on FSD. Methods: We searched oriental medicine papers related to FSD published in the last 10 years(2001-2011) through Korean Medicine Gynecology Society database, KISS, RISS, NDSL, CNKI(China National Knowledge Infrastructure), and Pubmed. Results: 26 papers were searched, then 18 papers of them were related to Traditional Chinese Medicine(TCM), 8 papers of them were related to Korean Medicine(KM). In classification according to paper type, 16 papers were clinical study, 1 paper was experimental study, 2 papers were bibliographic study, and 7 papers were the other study. Then 5 papers of clinical study was Randomized Controlled Trial(RCT). Conclusion: There was a lack of oriental medicine research on FSD. On the base of this study, so further research is needed. Especially, Clinical trials such as RCT have strong objective evidence power in the viewpoint of Evidence Based Medicine(EBM) are needed.

• Advances in Traditional Medicine
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• 제8권1호
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• pp.17-23
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• 2008

While full recognition of the practical value of Traditional Chinese Medicine is being endorsed, the current stand on the research methodology of this field should be worked out. Since modern medicine has already developed a logical system of research methodology basing on the principles of deduction, any research on any system of medicine need to take reference to what is most popularly used and commonly recommended. The best way to approach research on Chinese Medicine, therefore, would be one that would take full reference to the methodology being used in modern medicine, while at the same time respecting the traditional approach. This would enable traditional medicine to be elevated to the level of general modern recognition. Nevertheless, innate problems in traditional medicine are making its research difficult. The problems lie in difficulties to achieve uniform herb supply, principles of randomization and placebo arrangements, uncertain chemical structures and toxicology etc. A practical approach centered on carefully planned evidence-based clinical trials, with parallel studies on biological activities and herb authentication is being recommended.

• 한방재활의학과학회지
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• 제29권1호
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• pp.1-6
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• 2019

Objectives The purpose of this study is to provide an evidence base for the effectiveness of Chuna manual therapy (CMT) alone for cervicogenic dizziness. Methods We conducted a search up to October 2018 in 7 electronic databases. The randomized controlled trials (RCTs) that performed CMT for cervicogenic dizziness were included. The risk of bias was assessed using the Cochrane risk of bias tool. Results Ten RCTs met the inclusion criteria. The meta-analysis of 4 RCTs showed favorable results for the use of CMT alone compared to medication. Conclusions In 10 RCTs, we found that CMT was effective in cervicogenic dizziness. However, most of the included RCTs were unclear risk of bias. Therefore, well designed RCTs would be needed to obtain the stronger evidence level of CMT for cervicogenic dizziness.

• 척추신경추나의학회지
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• 제15권1호
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• pp.49-64
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• 2020

Objectives : The purpose of this study was to provide a clinical evidence base for the effectiveness of the muscle energy technique (MET) for cervicalgia. Methods : We conducted a search of 10 electronic databases up to April 2019. Randomized controlled trials (RCTs) that performed the MET for cervicalgia were included. The risk of bias was assessed using the Cochrane risk of bias (RoB) tool. Results : Six RCTs met the inclusion criteria. The literature review of these studies showed favorable results for the use of the MET in comparison to other manual medicines. Conclusions : In 6 RCTs, we found that the MET was effective in cervicalgia treatment. However, most of the included studies had an unclear risk of bias. Therefore, well-designed RCTs are necessary to obtain a higher evidence level of the MET use in cervicalgia.

• 의료법학
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• 제9권2호
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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.

• Asian Pacific Journal of Cancer Prevention
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• 제17권8호
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• pp.3697-3703
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• 2016

Hepatocellular carcinoma (HCC) is the most frequent type of malignant liver tumor and a high impact health problem worldwide. The prevalence of HCC is particularly high in many Asian and African countries. Some HCC patients have no symptoms prior to diagnosis and many of them therefore present at late stage and have a grave prognosis. The well-established causes of HCC are chronic hepatitis B virus (HBV) or chronic hepatitis C virus (HCV) infection or alcoholic cirrhosis and nonalcoholic steatohepatitis. The Barcelona Clinic Liver Cancer (BCLC) Staging System remains the most widely used for HCC management guidelines. To date, the treatments for HCC are still very challenging for physicians due to limited resources in many parts of the world, but many options of management have been proposed, including hepatic resection, liver transplantation, ablative therapy, chemoembolization, sorafnib and best supportive care. This review article describes the current evidence-based management of HCC with focus on early to advance stages that impact on patient overall survival.