• Title/Summary/Keyword: Evidence-based Medicine

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Application of Health Care Big data and Necessity of Traditional Korean Medicine Data Registry (보건의료 빅데이터를 활용한 연구방법 및 한의학 레지스트리의 필요성)

  • Han, Kyungsun;Ha, In-Hyuk;Lee, Jun-Hwan
    • Journal of Korean Medicine for Obesity Research
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    • v.17 no.1
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    • pp.46-53
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    • 2017
  • Health care big data is thought to be a promising field of interest for disease prediction, providing the basis of medical treatment and comparing effectiveness of different treatments. Korean government has begun an effort on releasing public health big data to improve the quality and safety of medical care and to provide information to health care professionals. By studying population based big data, interesting outcomes are expected in many aspects. To initiate research using health care big data, it is crucial to understand the characteristics of the data. In this review, we analyzed cases from inside and outside the country using clinical data registry. Based on successful cases, we suggest research method for evidence-based Korean medicine. This will provide better understanding about health care big data and necessity of Korean medicine data registry network.

Establishing research priorities of FDG PET in oncology indications using Delphi technique (델파이법을 활용한 종양분야 FDG PET의 경제성 평가 연구 우선순위 선정)

  • Do Young Kyung;Lee Jin Yong;Kim Young-Ik;Kwon Young Hoon;Lee Sang-Il;Kim Chang-Yup
    • Health Policy and Management
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    • v.14 no.3
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    • pp.45-65
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    • 2004
  • The rapid increase in PET devices and its utilization in Korea necessitates relevant health insurance policies based on scientific evidence, including economic evaluation of PET in clinical conditions. However, there is very little amount of evidence regarding PET, and the first step would be to establish research priorities to give a momentum for research and assure efficient use of research capacities. To this end, we conducted a two-round Delphi study, which produced stable consensus on about top 10 oncology indications for research, which included lymphoma staging, colorectal cancer recurrence/restaging, lung cancer staging, and other conditions. The results were largely consistent with current U.S. Medicare reimbursement indications and are expected to lead to relevant researches and evidence-based health policies on PET reimbursement and regulation.

Clinical Practice Guidelines for Gastric Cancer in Korea: An Evidence-Based Approach

  • Lee, Jun Haeng;Kim, Jae G.;Jung, Hye-Kyung;Kim, Jung Hoon;Jeong, Woo Kyoung;Jeon, Tae Joo;Kim, Joon Mee;Kim, Young Il;Ryu, Keun Won;Kong, Seong-Ho;Kim, Hyoung-Il;Jung, Hwoon-Yong;Kim, Yong Sik;Zang, Dae Young;Cho, Jae Yong;Park, Joon Oh;Lim, Do Hoon;Jung, Eun Sun;Ahn, Hyeong Sik;Kim, Hyun Jung
    • Journal of Gastric Cancer
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    • v.14 no.2
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    • pp.87-104
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    • 2014
  • Although gastric cancer is quite common in Korea, the treatment outcome is relatively favorable compared to those in western countries. However, there are currently no Korean multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework: the evidence levels were based on a systematic review of the literature, and the recommendation grades were classified as either strong or weak. The applicability of the guidelines was considered to meet patients' view and preferences in the context of Korea. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. An external review of the guidelines was conducted during the finalization phase.

Whole Brain Radiotherapy Combined with Stereotactic Radiotherapy Versus Stereotactic Radiotherapy Alone for Brain Metastases: a Meta-analysis

  • Duan, Lei;Zeng, Rong;Yang, Ke-Hu;Tian, Jin-Hui;Wu, Xiao-Lu;Dai, Qiang;Niu, Xiao-Dong;Ma, Di-Wa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.911-915
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    • 2014
  • Aim: This study was to evaluate the effect of whole brain radiation (WBRT) combined with stereotactic radiotherapy (SRS) versus stereotactic radiotherapy alone for patients with brain metastases using a meta-analysis. Materials and Methods: We searched PubMed, EMBASE, Cochrane Library from their inception up to October 2013. Randomized controlled trials involving whole brain radiation combined with stereotactic radiotherapy versus stereotactic radiotherapy alone for brain metastases were included. Statistical analyses were performed using RevMan5.2 software. Results: Four randomized controlled trials including 903 patients were included. The meta-analysis showed statistically significant lowering of the local recurrence rate (OR=0.29, 95%CI: 0.17~0.49), new brain metastasis rate (OR=0.45, 95%CI: 0.28~0.71) and symptomatic late neurologic radiation toxicity rate (OR=3.92, 95%CI: 1.37~11.20) in the combined group. No statistically significant difference existed in the 1-year survival rate (OR=0.78, 95%CI: 0.60~1.03). Conclusions: The results indicate that whole brain radiotherapy combined with stereotactic radiotherapy has advantages in local recurrence and new brain metastasis rates, but stereotactic radiotherapy alone is associated with better neurological function. However, as the samples included were not large, more high-quality, large-sample size studies are necessary for confirmation.

Korean Surgical Practice Guideline for Pancreatic Cancer 2022: A summary of evidence-based surgical approaches

  • Seung Eun Lee;Sung-Sik Han;Chang Moo Kang;Wooil Kwon;Kwang Yeol Paik;Ki Byung Song;Jae Do Yang;Jun Chul Chung;Chi-Young Jeong;Sun-Whe Kim;Committee of the Korean Surgical Practice Guideline for Pancreatic Cancer
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.26 no.1
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    • pp.1-16
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    • 2022
  • Pancreatic cancer is the eighth most common cancer and the fifth most common cause of cancer-related deaths in Korea. Despite the increasing incidence and high mortality rate of pancreatic cancer, there are no appropriate surgical practice guidelines for the current domestic medical situation. To enable standardization of management and facilitate improvements in surgical outcome, a total of 10 pancreatic surgical experts who are members of Korean Association of Hepato-Biliary-Pancreatic Surgery have developed new recommendations that integrate the most up-to-date, evidence-based research findings and expert opinions. This is an English version of the Korean Surgical Practice Guideline for Pancreatic Cancer 2022. This guideline includes 13 surgical questions and 15 statements. Due to the lack of high-level evidence, strong recommendation is almost impossible. However, we believe that this guideline will help surgeons understand the current status of evidence and suggest what to investigate further to establish more solid recommendations in the future.

The direction of the study regarding the treatment of Rheumatoid Arthritis (최근 RA와 관련된 임상 및 실험 논문의 경향)

  • Kim, Yung-tae;Lee, Jae-dong;Lee, Yun-ho
    • Journal of Acupuncture Research
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    • v.19 no.5
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    • pp.189-198
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    • 2002
  • Objective : To research the trend of the study related to rheumatoid arthritis(RA) and to establish the hereafter direction of the study on RA. Methods : We have selected 12 medical report about RA in Arthritis & Rheumatism and Journal of Rheumatology recently, reviewed them, and investigated their methods. Results & Conclusions : The pattern of study was as follows: physical & serologic research in 2 articles, immunologic research in 7 articles, and genetic research in 3 articles. There is now evidence of the benefit of treatment early in the disease course and evidence of the impact of treatment on outcomes. New classes of therapeutic agents have also been introduced. Wherever possible, these revised guidelines are evidence-based. By the above results, it would be needed further research on RA mechanism related immunologic and genetic process.

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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.

Current Research for Complementary and Alternative Medicine for Cancer - Based on the Data of MEDLINE - (보완대체의학의 암치료 연구 현황 - MEDLINE을 중심으로 -)

  • Kwon, Chang-Hyun;Yoo, Hwa-Seung;Lee, Yeon-Weol;Cho, Chong-Kwan
    • Journal of Korean Traditional Oncology
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    • v.10 no.1
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    • pp.57-74
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    • 2005
  • Objectives : Many cancer patients use therapies promoted as literal alternative and complementary medicine to conventional medical care. So the health provider has to guide it by appropriate clinical guideline. The purpose is to indicate the international research tool of korean medical oncology for related investigators and help to make the clinical guideline for korean oncology. Method : We reviewed complementary and alternative therapies for cancer and cancer-related symptoms by searching MEDLINE, and using the name and synonyms of the therapy. Publications on complementary medicine were identified by searching the Cochrane Library. Results and Conclusion : Most complementary and alternative medicine used by cancer patients have demonstrable, important benefits, including decreased symptoms and better quality of life. We have to standardize the scientific research protocol for korean oncology and build evidence based medicine in the future.

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The Possibility of Managing Diseases Caused by Particulate Matter(PM10) with Chinese and Korean Medicines - Emphasis on Medical Prevention and Treatment - (미세먼지(霧霾)가 발생하는 질병과 중의학, 한의학의 관리가능성 - 예방과 치료를 중심으로-)

  • Koh, WonJoon;Ahn, JeongHoon;Lee, Sundong
    • Journal of Society of Preventive Korean Medicine
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    • v.22 no.1
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    • pp.69-80
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    • 2018
  • Objectives : This paper examines the effects of Particulate Matter on human bodies and the possibility of treating them with Chinese or Korean medicines. Methods : This paper categorizes the diseases caused by Particulate Matter, as well as the causes, pathology, prevention methods, and effectiveness of treatments by Chinese and Korean medicines. Based on these results, it analyzes whether such diseases can be managed by Chinese and Korean medicine. Results : Particulate Matter is known to affect respiratory organs, skin, circulatory system, nervous system, gestational diabetes, and other parts of the human body. While studies show evidence that treatments by Chinese and Korean medicines can reduce symptoms of some diseases and improve bodily functions that are damaged by Particulate Matter, there is no statistically significant evidence that they can provide fundamental treatments nor treat irreversible damages. Conclusion : Currently, there is no definite evidence that Chinese and Korean medicine can treat symptoms and diseases caused by Particulate Matter. Therefore, some Korean medicine doctors' arguments that Korean medicine is effective in treating such diseases are problematic, and thus, there is a need for much research in this field.