• 제목/요약/키워드: Evidence-based assessment

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

  • 최솔지;차선미;유근주;홍석원;박종연
    • 보건의료기술평가
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    • 제6권2호
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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.

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

  • 서유신;김희선;유빛나;김진희;박종연
    • 보건의료기술평가
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    • 제6권2호
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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.

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

  • 이영성
    • 보건행정학회지
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    • 제28권3호
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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.

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

  • 조성현;이정우
    • 대한통합의학회지
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    • 제11권2호
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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.

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

  • 주예일;이형일;송영채;박주연;신호균
    • 보건의료기술평가
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    • 제6권2호
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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.

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

  • 이선우;남정희
    • 대한화학회지
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    • 제62권3호
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    • pp.203-213
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    • 2018
  • 이 연구는 논의기반 탐구 과학수업에서 학생 평가활동이 고등학생들의 주장과 증거 형성에 어떠한 영향을 미치는지 알아보고자 하였다. 이를 위해 인문계 고등학교 1학년 166명을 대상으로 논의기반 탐구 과학수업을 실시하였으며, 실험집단 학생(84명)들은 모둠의 주장과 증거에 대한 평가 기회를 제공받았고 비교집단 학생(82명)들은 이 단계를 생략하였다. 학생 평가활동이 학생들의 주장과 증거 형성에 미치는 영향 알아보기 위해 학생들이 작성한 주장과 증거 그리고 학생 평가활동의 결과를 분석하였으며, 인터뷰와 설문조사를 통해 학생 평가활동의 타당성과 활용정도를 알아보았다. 연구 결과, 논의활동에서 증거를 형성하는 능력이 비교집단보다 실험집단이 통계적으로 유의미하게 높게 나타났으며, 실험집단 학생들이 비교집단 학생들보다 더 정확하고 충분한 증거를 제시하는 것으로 나타났다. 또한 실험집단 학생들은 평가활동을 통해 주장에 대한 증거가 적절한지, 증거가 충분한지, 제시된 증거 자료는 정확한지 대해 평가하며 지속적으로 평가결과를 피드백으로 활용하였음을 알 수 있었다. 학생들은 평가 결과가 대체적으로 타당하다고 인식하고 있으며, 평가 결과를 다음 활동에 반영하여 다양한 증거를 제시하는 능력이 향상되었다고 인식하고 있음을 알 수 있었다. 이를 통해 논의기반 탐구 과학수업에서 학생 평가활동이 학생들의 주장과 증거를 형성할 때 주장의 타당성과 정당성을 높이는 증거 형성에 효과적이라는 것을 알 수 있다.

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

  • 조정영;김가은
    • 한국직업건강간호학회지
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    • 제29권4호
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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.

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

  • 김경희;김주현;임경춘;이경숙;정재심;최명애;채영란
    • Journal of Korean Biological Nursing Science
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    • 제14권3호
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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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    • 제55권5호
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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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    • 제20권6호
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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.