• 제목/요약/키워드: Evidence-Based

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Economic Evaluation of Prostate Cancer Screening Test as a National Cancer Screening Program in South Korea

  • Shin, Sangjin;Kim, Youn Hee;Hwang, Jin Sub;Lee, Yoon Jae;Lee, Sang Moo;Ahn, Jeonghoon
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권8호
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    • pp.3383-3389
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    • 2014
  • Background: Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. Materials and Methods: A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. Results: As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Conclusions: Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

초등학생의 '증거' 사용에 따른 '과학적 정당화' 활동의 분석 (Analysis of Elementary Students' Scientific Justification Activities based on Evidence)

  • 장신호;정수진
    • 한국초등과학교육학회지:초등과학교육
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    • 제29권4호
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    • pp.414-426
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    • 2010
  • For this study, inquiry-based learning program was developed for promoting elementary students' scientific justification activities based on their uses of scientific evidences. The program was applied to the 5th grade science class to examine the types of evidences and major features of scientific justification activities. Analysis of the data showed that the evidences used by students were classified into knowledge-based evidence, experience-based evidence and authority-based evidence. As for students' justification features, this study reports three major cases: a case evolving evidence and justification to become more valid and logical, as inquiry activities progressed, other case maintaining less valid and illogical evidence and justification, and final case revealing passive and reluctant participation in the inquiry activities. Overall, students' participation in scientific justification process became more valid and relevant, while there were some students who were unable to make the relevant relations between evidences and claims they made. The educational implications were discussed to consider more effective ways to improve the scientific classroom environment through social knowledge construction.

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한약의 안전성 등급화를 통한 근거중심실용의학적 연구(1) - Aristolochic acid 함유 한약재를 중심으로 - (Introduction of evidence-based practical medicine through safety classification for herbal medicine(1))

  • 박영철;이선동
    • 대한한의학회지
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    • 제35권1호
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    • pp.114-123
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    • 2014
  • Objectives: Evidence-based medicine(EBM) advocates the use of up-to-date "best" scientific evidence from health care research as the basis for making medical decisions. EBM also has been applied to traditional Korean medicine(TKM), especially in the field of safety. Recently, the standard prescription for TKM by Korea Institute of Oriental Medicine was published based on toxic index from various toxicity tests. However, there are some limitations when the results from the study based on EBM are applied in clinics. To overcome these imitations, the term "evidence-based practical medicine" was developed and defined as clinically applicable results from the study based on EBM. And safety classification for TKM was suggested as an example of evidence-based practical medicine. Methods: For safety classification for TKM, the data for $LD_{50}$(50% lethal dose), which was transformed to theoretical $LD_1$(1% lethal dose), was analyzed as one of tools for EMB study and divided by maximum dose used in clinics. Results and Conclusions: As a result, human equivalent dose(HED)-based MOS(margin of safety) for korean traditional medicine was calculated and used for safety classification with 5 categories. These categories would be helpful for oriental medicine clinicians to decide the increase and decrease of dosage according to various factors such as patient's sensitivity, potential toxicity of herbal medicines, clinician's experience for better cure. Thus, this safety classification provides some evidences enough that evidence-based practical medicine should be not the same with EBM and defined differently from EBM.

근거 중심 치의학 - 2. 근거 수준과 비판적 평가

  • 홍순민
    • 대한치과의사협회지
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    • 제45권3호통권454호
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    • pp.169-181
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    • 2007
  • In this second part of series report on evidence-based dentistry, the level of evidence and the methods for critical appraisal are discussed. The epidemiologic studies, namely clinical studies have some bias per se, and the degree of bias is somewhat predetermined by the study design. The level of evidence can be defined as the reliability of the clinical study and it is dependent on the degree of bias. Thus, it is important to determine the type of the study and to understand its structure before critically appraising them. Systematic reviews of primary studies, randomized controlled trials, nonrandomized clinical trials, cohort studies, case-control studies, and case reports / series constitute the clinical studies and the level of evidence follows the order of the studies listed above. Critical appraisal is the most important procedure in evidence-based dentistry. It is done to determine the credibility of research papers and their usefulness in the clinician s own practice. Critical appraisal is consisted of multiple questions that are helpful for evaluating validity and usefulness of the studies concerning therapy, diagnosis, prognosis, and causation.

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임상 간호사들의 연구 관련 활동 실태 및 연구결과 활용의 장애 요인 (Nurses′ Research Activities and Barriers of Research Utilization)

  • 오의금;오현주;이윤정
    • 대한간호학회지
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    • 제34권5호
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    • pp.838-848
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    • 2004
  • Purpose: This study was to describe nurses' research activities, perceptions and performances of evidence-based practice and barriers to the use of research evidence in nursing practice in Korea. Method: A cross-sectional survey design was used. A questionnaire, except for Barriers Scale, was developed for the study. Data was collected from a convenient sample of 437 registered nurses working at research and education oriented university hospitals. Result: Nurses' research-related activities were relatively low compared to previous studies. Also perceptions and performances of evidence based nursing practice were low. Preferred informational resources for clinical decision making were identified as ward manuals/clinical guidelines, manager/senior nurses, and literature/research. The major barriers to research utilization were a lack of implication for practice along with inadequate facilitation to implement research evidence and difficulty understanding research written in English. Priorities of barriers factor were Administrator, Communication, Adopter, and Research. Conclusion: The findings provide directions for future training, education, and managerial policy to achieve successful evidence based nursing practice.

Prediction of network security based on DS evidence theory

  • Liu, Dan
    • ETRI Journal
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    • 제42권5호
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    • pp.799-804
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    • 2020
  • Network security situation prediction is difficult due to its strong uncertainty, but DS evidence theory performs well in solving the problem of uncertainty. Based on DS evidence theory, this study analyzed the prediction of the network security situation, designed a prediction model based on the improved DS evidence theory, and carried out a simulation experiment. The experimental results showed that the improved method could predict accurately in the case of a large conflict, and had strong anti-jamming abilities as compared with the original method. The experimental results prove the effectiveness of the improved method in the prediction of the network security situation and provide some theoretical basis for the further application of DS evidence theory.

근거중심실무 연계 중환자간호 실습교육의 적용 및 효과 (Effects of Evidence Based Practice Integrated Critical Care Clinical Practicum)

  • 박명화
    • 한국간호교육학회지
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    • 제17권3호
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    • pp.346-354
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    • 2011
  • Purpose: This study examines the effects of integrating Evidence Based Practice (EBP) into a critical care clinical practicum on nursing students' access and use of information resources and EBP competency. Methods: A one-group pretest-posttest design was used. Fifty senior nursing school students from a university participated. A critical care clinical practicum combined with EBP consisted of six full days of clinical practicum in intensive care units with EBP education. Group and individual training in EBP skills, lectures, small group discussion and conferences were provided. Data were analyzed using paired t tests for 50 participants. Results: The scores of evidence based practice competency increased significantly (p<.001) showing significant improvement in searching and classifying the evidence. Nursing students' access and use of research evidence improved (p=.004). Conclusion: This study showed that the integration of EBP into a clinical practicum was effective in improving accessibility and usefulness in research evidence such as guidelines and research articles, and increasing EBP competency in undergraduate students.

Comparative Efficacy and Safety of Long-acting Injectable and Oral Second-generation Antipsychotics for the Treatment of Schizophrenia: A Systematic Review and Meta-analysis

  • Park, Seon-Cheol;Choi, Mi Young;Choi, Jina;Park, Eunjung;Tchoe, Ha Jin;Suh, Jae Kyung;Kim, Young Hoon;Won, Seung Hee;Chung, Young-Chul;Bae, Kyung-Yeol;Lee, Sang-Kyu;Park, Chan Mi;Lee, Seung-Hwan
    • Clinical Psychopharmacology and Neuroscience
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    • 제16권4호
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    • pp.361-375
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    • 2018
  • We aimed to compare the efficacy and safety of long-acting injectable (LAI) and oral second-generation antipsychotics (SGAs) in treating schizophrenia by performing a systematic review and meta-analysis. MEDLINE, EMBASE, PsycINFO, CINAHL, and the Cochrane Library, as well as five Korean databases, were systemically searched to identify studies published from 2000 to 16 April 2015, which compared the efficacy and safety of LAI and oral SGAs. Using data from randomized controlled trials (RCTs), meta-analyses were conducted. In addition, the GRADE (the Grading of Recommendations, Assessment, Development and Evaluation) approach was applied to explicitly assess the quality of the evidence. A total of 30 studies including 17 RCTs and 13 observational studies were selected. The group treated with LAI SGAs was characterized by significantly lower relapse rates, longer times to relapse and fewer hospital days, but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs. Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia, LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms. Additionally, the use of LAI SGAs should be combined with appropriate measures to reduce dopamine $D_2$ antagonism-related symptoms.

근거중심 의약품 정책 결정; 극복하기 어려운 과제인가? 한국 전문가의 생생한 의견 (Evidence-based Pharmaceutical Policy-making; A Challenging Task? Vivid Voices from Korean Experts)

  • 이인향
    • 한국임상약학회지
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    • 제23권3호
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    • pp.185-196
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    • 2013
  • This study aims to explore the difficulties of evidence-based pharmaceutical policy-making in the Korean context where several pharmaceutical policies were introduced within a short period. Semi-structured in-depth interviews were performed with eight experts in the Korean pharmaceutical arena. The key challenge in Korean situation might be the apparent lack of available evidence caused by the limited resources, the lack of policy consistency and coordination ability in the authorities and distrust across stakeholders. To build an evidence-based tradition, it is essential to resolve the tangible lack. At once, more fundamental changes seem to be required in the intangible policy environments.