• Title/Summary/Keyword: Evidence-based assessment

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International Trends of Digital Health and It's Political Implication for Health Technology Assessment (디지털헬스 정책환경의 국제 동향과 의료기술평가에 대한 시사점)

  • Choi, Solji;Cha, Sunmi;Yoo, Keunjoo;Hong, Seokwon;Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.95-99
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    • 2018
  • As technologies develop, the digital health sector is gradually expanding. Internationally, the global summit for Digital Health named Global Digital Health Partnership (GDHP) was launched in 2018. Many countries are participating in GDHP and share their policy experiences on digital health and find the ways to cooperate with participating countries (13 countries, including South Korea, and Hong Kong). This article reviewed the international trends in digital health policy environment and evidence assessment focusing on GDHP activities, and derived implications for health technology assessment of digital health. Consequently, to assess the intervention effects of digital health is very complex and the assessment should be considered multidimensional aspects (social, clinical, and technical). In addition the patient experience should be assessed qualitatively. Health technology assessment (HTA) should assess the effect of digital health policies to changes in health care systems resulting from the application of advanced technologies related to the 4th Industrial Revolution. Digital health is also related to new HTA, HTA of existing technologies, and R&D on the promising health technology. Therefore, it is necessary to review the trends of the technology's management policy consistently through the HTA of digital health.

Trend and Implication of Primary Care Evaluation in U.S. (미국의 일차의료 평가 동향 및 시사점: 미국의 리얼월드 평가 안내서를 중심으로)

  • Suh, Youshin;Kim, Hee-Sun;Yoo, Bit-Na;Kim, Jin-Hee;Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.88-94
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    • 2018
  • This review aims to provide implications for relevant domestic policies and researches from Patient-Centered Medical Home (PCMH), a reinforcement model for primary care and its evaluations in the United States. As chronic diseases became dominant, changes in the health care delivery system in which primary care is central was required. The United States initiated primary care-reinforcing policies based on the PCMH following the increased demand for evidence-based health care policies. The current activities of the United States such as sharing research tools used to evaluate primary care interventions and circulating evaluation findings provide examples to Korea. Systematic evaluations for primary care interventions are required and appropriate methods using various types of data to reflect the real-world settings should be prepared. It is necessary to conduct policy assessment studies of public interests considering regional context. Support for the researches to make and advance from the existing environment must be examined.

Roles of Health Technology Assessment for Better Health and Universal Health Coverage in Korea (우리나라 보건의료 발전을 위한 의료기술평가의 역할)

  • Lee, Young Sung
    • Health Policy and Management
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    • v.28 no.3
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    • pp.263-271
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    • 2018
  • Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea (국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안)

  • Sung-Hyoun Cho;Jeong-Woo Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.231-242
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    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.

Evaluation of Results and Workloads of the Horizon Scanning of the Emerging Health Technology in Korea (국내 신개발 유망의료기술 탐색활동 결과 및 업무량 분석)

  • Joo, Yea Il;Lee, Hyeong Il;Song, Yeong Chae;Park, Joo Yeon;Shin, Ho Gyun
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.156-161
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    • 2018
  • Objectives: To evaluate results and workloads of the horizon scanning of the emerging health technology since 2014 to 2016. Methods: In order to analyze the results of the emerging health technology, we identified the number of research procedure between 2014 and 2016. The sixteen findings were calculated annual workload by person, and categorized by medical phase, classification of disease, and healthcare technology. Results: An average of 5.67 personnel were involved over three years, assessment of each emerging healthcare technology was performed for each person of identifying 54 cases, filtering 2.4 cases, prioritizing 0.9 cases were performed. According to the mapping by healthcare technologies, nine medical devices (56.3%), six drugs (37.5%), and one material of the medical treatment (6.3%) were assessed. Among sixteen findings, fifteen cases were health technologies for treatment and only one case for diagnosis. Conclusion: Future plans of the horizon scanning of the emerging health technology is required appropriate manpower in charge each target number of assessment. And a legal basis should be provided for policy reflection rate. Furthermore, an evaluation criteria and procedures should be transparent to avoid a conflict of interest.

Impact of Student Assessment Activities on Claim and Evidence Formation in High School Argument-Based Inquiry (고등학교 논의기반 탐구 과학수업에서 학생 평가활동이 주장과 증거 형성에 미치는 영향)

  • Lee, Seonwoo;Nam, Jeonghee
    • Journal of the Korean Chemical Society
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    • v.62 no.3
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    • pp.203-213
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    • 2018
  • The purpose of this study was to investigate the impact of student assessment activities on claim and evidence formation in argument-based inquiry (ABI) for high school students. The participants of the study were 166 grade 10 students from six different classes in the same high school. The experimental group (84 students) was taught Argument-Based Inquiry with students' self and peer assessment activities. The comparative group (82 students) was taught without the activities. Over one semester students participated in five ABI programs that we developed. According to the analysis of the claim and evidence from groups, the experimental group had a significantly higher mean score than the comparative group. The result of analysis of students' assessment in the experimental group, the frequency about accurate and sufficient evidence revealed to be high and students assessed whether peers' claims fit with the evidence and whether peers' explanations of the evidence's validity was sufficient. Students' answers in the survey and interviews showed that the students though they could improve the accuracy of their ideas, appropriateness of their evidence, and the method of presenting evidence based on the assessment results.

Effects of Workplace Risk Assessment-based Ergonomic Intervention on Work-Related Muscular Skeletal Disorders: Systematic Literature Review and Meta-Analysis (작업장 유해요인조사에 기반한 인체공학적 중재가 작업 관련성 근골격계 질환의 증상에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Cho, Jung Young;Kim, Gaeun
    • Korean Journal of Occupational Health Nursing
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    • v.29 no.4
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    • pp.342-353
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    • 2020
  • Purpose: This study aimed to systematically review literature and conduct a meta-analysis to comprehensively identify and evaluate the effects of workplace risk assessment-based ergonomic intervention on work-related muscular-skeletal disorders in workers. Methods: We searched the Ovid-Medline, EMBASE, and Cochrane library and up to 2018 using search terms such as muscular-skeletal, disorder, impairment, work-related muscular-skeletal disorders, ergonomic, intervention, management with no language limitations; screened reference lists; and contacted experts in the field. Results: We identified 545 references and included 13 randomized controlled tests (3,368 workers). We judged nine studies to have a low risk of bias, while the other four studies have a high risk of bias. Conclusion: Ergonomic intervention based on risk assessment in the workplace did not significantly differ in terms of the intensity of pain or duration of workers in the workplace, but low-quality evidence decreased the frequency of musculoskeletal disorder pain in three to six months moderate-quality evidence and in six to nine months low-quality evidence. Besides, low-quality evidence to reduce discomfort and moderate-quality evidence to improve worker posture. Therefore, ergonomic intervention based on the assessment of risk factors in the workplace should be applied to reduce pain frequency and discomfort and improve workers posture among musculoskeletal disorders.

Quality Assessment Tools and Reporting Standards in Nursing Research (간호연구 질 평가 도구 및 보고지침 고찰)

  • Kim, Kyunghee;Kim, Joo Hyun;Lim, Kyung-Choon;Lee, Kyung-Sook;Jeong, Jae-Sim;Choe, Myoung-Ae;Chae, Young Ran
    • Journal of Korean Biological Nursing Science
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    • v.14 no.3
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    • pp.221-230
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    • 2012
  • Purpose: Quality of nursing research should be evaluated before it is applied as an evidence for evidence-based nursing practice. This study attempted to analyze and to compare tools for the quality assessment and reporting standards of nursing research using CONSORT and STROBE checklist by types of research design. Methods: We searched the tools for quality assessment in nursing research based on the National Evidence-based Healthcare Collaborating Agency (NECA) publication. Then, we analysed and compared the tools for quality evaluation by types of research design. Results: According to the analysis using CONSORT checklist, ROB shows coherence in 17 items, Jadad shows coherence in 3 items, SIGN (for RCT) shows coherence in 26 items, and Downs & Black shows coherence in 24 items. According to the analysis using STROBE checklist, MINORS shows coherence in 25 items, NOS shows coherence in 21 items, SIGN (for Cohort studies & Case-control studies) shows coherence in 29 items, and RoBANS shows coherence in 21 items. Conclusion: Based on our analysis, we recommend that nursing researchers should report according to the reporting standards of tools for quality evaluation. We hope that our analysis can be helpful to develop evidence-based nursing.

The Primary Process and Key Concepts of Economic Evaluation in Healthcare

  • Kim, Younhee;Kim, Yunjung;Lee, Hyeon-Jeong;Lee, Seulki;Park, Sun-Young;Oh, Sung-Hee;Jang, Suhyun;Lee, Taejin;Ahn, Jeonghoon;Shin, Sangjin
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.5
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    • pp.415-423
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    • 2022
  • Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

  • Guen Young Lee;Ji Young Hwang;Na Ra Kim;Yusuhn Kang;Miyoung Choi;Jimin Kim;Eun Ju Ha;Jung Hwa Baek
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.909-915
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    • 2019
  • The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.