• Title/Summary/Keyword: Evidence Based Diagnosis

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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
    • Clinical and Experimental Pediatrics
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    • v.62 no.1
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    • pp.3-21
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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.

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.

Construction of Case-based System for the Cause Diagnosis of an Electrical Fires (전기화재 원인진단을 위한 사례기반 시스템 구축)

  • Lee, Jong-Ho;Kim, Doo-Hyun;Kim, Sung-Chul
    • Fire Science and Engineering
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    • v.21 no.2 s.66
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    • pp.42-47
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    • 2007
  • This paper presents the development of a case-based system for an electrical fire cause diagnosis system using the entity relation database. The relation database which provides a very simple but powerful way of representing data is widely used. The system focused on database construction and cause diagnosis can diagnose the causes of electrical fires easily and efficiently. In order to store and access to the information concerned with electrical fires, the key index items which identify electrical fires uniquely are derived out. The case-based system consists of a case which contains information from the past fires. The case-based system could present the cause of a newly occurred fire to be diagnosed by searching the case-based database for reasonable matching. The case-based system has not only searching functions with multiple attributes by using the collected various information(such as fire evidence, structure, and weather of a fire scene) but also more improved diagnosis functions which can be easily used for the electrical fire cause diagnosis system.

Potential Biomarkers for an Evidence-Based Diagnosis of Burning Mouth Syndrome

  • Won Jung;Kyung-Eun Lee
    • Journal of Oral Medicine and Pain
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    • v.48 no.4
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    • pp.131-136
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    • 2023
  • Burning mouth syndrome (BMS), a chronic pain disorder with an unclear etiology, is characterized by a burning sensation in the oral cavity. The absence of objective diagnostic methods for this condition complicates its diagnosis and treatment. Recently, efforts have been ongoing to find biomarkers for the diagnosis and evaluation of patients with BMS. Several studies have reported hematological changes, differences in salivary protein composition, and peripheral neuropathy in the affected oral tissues. This review summarizes the research regarding the objective changes observed in patients with BMS to identify potential diagnostic approaches.

Pharmacological Treatments for Dysthymic Disorder and Atypical Depression (기분부전장애와 비전형우울증의 약물치료)

  • Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.14-20
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    • 2007
  • Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

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Evidence-based Screening, Early Diagnosis and Treatment Strategy of Cervical Cancer for National Policy in Low-resource countries: Example of India

  • Saxena, Upma;Sauvaget, Catherine;Sankaranarayanan, Rengaswamy
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1699-1703
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    • 2012
  • Cervical cancer remains the most frequent cancer in women from the developing world. More than 88% of deaths occur in low-income countries, and it is predicted to climb to 91.5% by 2030. Although Pap-based screening programmes have shown to be effective in reducing the disease burden in high-resource countries, implementation and sustention of cytology-based programmes is quite challenging in low-resource settings. The present paper reviews evidence-based alternatives of screening methods, triaging algorithm, treatment of cervical precancerous lesions, and age-group at screening appropriate for low-income countries. Evidence shows that visual inspection methods using diluted acid acetic or Lugol's iodine, and HPV-DNA testing are more sensitive tests than the Pap-smear screening test. Visual inspection allows an immediate result and, when appropriate, may be immediately followed by cryotherapy, the so called "screen-and-treat" approach, achieved in a single visit, by trained nurses and midwives. Examples of cervical cancer prevention programmes in India and selected low-income countries are given.

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.

Clinical Guidelines for Hwabyung III. (Diagnosis and Assessment of Hwabyung) (화병 임상진료지침 III. (화병의 진단과 평가))

  • Jung, In Chul;Choi, Woo Chang;Lee, Sang Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.23-36
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    • 2013
  • Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

Benign Metastasizing Leiomyoma of Lung -A case report- (폐에 발생한 양성 전이성 근종-1례 보고-)

  • 박찬범;서종희;장윤희;문석환;조건현
    • Journal of Chest Surgery
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    • v.34 no.5
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    • pp.422-425
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    • 2001
  • We performed thoracoscopic resection for diagnosis in 41 year-old-female presenting with multiple pulmonary nodules in both lung fields, which was detected incidentally on routine chest x-ray and followed by additional exmaminations including chest CT scan and percutaneous needle aspiration biopsy under the presumptive diagnosis of metastatic cancer. During thoracoscopy, the result of the frozen section analysis of multiple masses revealed strong evidence of leiomyoma. In her past medical history, she had undergone myomectomy, and hysterectomy, 7 year ago and 10 year ago, respectively. Based on permanent, special staining of specimen, estrogen receptor assay and review of past specimen of uterine myoma the final diagnosis was benign metastasizing leiomyomata from uterine myoma, the report was very uncommon in Korean and English literatures. The patient has been followed up for 2 year without special therapy, such as hormonal therapy.

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Clinical presentation and specific stabilizing exercise management in Lumbar segmental instability (요추분절의 불안정성에 대한 임상적 소개와 안정성 운동관리)

  • Jung Yeon-Woo;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.15 no.1
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    • pp.155-170
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    • 2003
  • Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

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