• Journal of Trauma and Injury
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• v.33 no.1
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.6
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• pp.1749-1762
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• 2006

Medical disputes are increasing year by year in korean medical institutions as the frequency of patient's visiting korean medical institutions goes high and the reliability relations between korean medical doctors and patients are getting worse than the past. Frequently occurring accidents in korean medical acts fall into some categories such as medical treatment of acupuncture${\cdot}$moxibustion${\cdot}$cupping, korean herbal medication, korean medical physical therapy, wrong diagnosis. Frequently occurring accidents include these cases. Infection due to improper treatment process of acupunctrue or wet-cupping ; skin-burns caused by moxibustion, infrared therapy or haet therapy ;toxic hepatitis or kidney dysfunction induced by herbal medication ; progression of disease or missing of opportunity of timely transfer because of wrong diagnosis. It will prevent medical accidents to a great extent for korean medical doctors to have scientific diagnostic techniques and lab. test results at hand in korean medical institutions.

• Korean Journal of Acupuncture
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• v.38 no.1
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• pp.16-31
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• 2021

Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

• Journal of the Korean Society of Radiology
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• v.82 no.4
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• pp.817-825
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• 2021

Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.4
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• pp.129-143
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• 2021

Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

• Journal of Preventive Medicine and Public Health
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• v.52 no.4
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• pp.272-275
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• 2019

The 2018 National Guideline for Tuberculosis Control, which was published by the Korea Centers for Diseases Prevention and Control (KCDC), mandates conducting an epidemiological survey among close contacts of active tuberculosis patients at public institutions such as schools. In the procedure for these surveys, the tuberculin skin test (TST) is mandated as the screening test for latent tuberculosis infection in elementary school students. However, several guidelines recommend using the interferon-gamma releasing assay (IGRA) for contacts aged over 5 years with a Bacillus Calmette-$Gu{\acute{e}}rin$ vaccination history. The main reason for this is that IGRA has a higher specificity and lower false positive rate than TST. In addition, IGRA requires only a single visit to draw blood and the results are available within 24 hours. These advantages could promote cooperation from both parents and students in conducting these surveys. Thus, these findings regarding the benefits of IGRA for surveys of close contacts at elementary schools should be incorporated into the KCDC guideline.

• Journal of Korean Medicine for Obesity Research
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• v.7 no.2
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• pp.27-37
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• 2007

Background Clinical practice guidelines (CPG) are systematically developed statements to assist practitioners and patients on healthcare decisions. They provide recommendations for the average patient, which should take into account individual clinical judgment and the patient's values and expectations. Ephedra has sympathomimetic effect and has been used for weight loss worldwide. However, its safety is controversial especially in autonomic and cardiovascular systems. Therefore, the need of appropriate CPG for ephedra prescription in obesity was advocated in Korean Traditional Medicine. Methods The committee comprised of specialists of obesity, oriental herbology, oriental cardiology, constitutional medicine. The committee collected all relevant references about adverse effect and safety of ephedra in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study and observational study from international and domestic databases and paper journals. 11 English- and 5 Korean-language references were gathered and categorized by PICO (Patient, Intervention, Comparison, Outcome) method. We could not complete strength of recommendation which should be clarified according to the evidence grade estimation. Result The first version of CPG for ephedra prescription in obesity was issued by Korean Oriental Association for Study of Obesity. It includes topics of introduction, pharmacokinetics, side effects and adverse events, constitutional aspect and recommendations for dose, indication and contraindication. Conclusion There should be periodic upgrade of this CPG from now on. Although there are some drawbacks in this version of CPG, it has significance as the first CPG in Korean Traditional Medicine.

• Journal of Hospice and Palliative Care
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• v.23 no.3
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• pp.103-113
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• 2020

A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients' physical and mental symptoms, psychological support, appropriate decision-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.

• Korean Journal of Radiology
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• v.24 no.1
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• pp.6-9
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• 2023

• Journal of Oriental Neuropsychiatry
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• v.27 no.4
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• pp.235-248
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• 2016

Objectives: The aim of this review was to investigate whether evidence of complementary and alternative medicine (CAM) was reflected in clinical practice guidelines (CPGs) for insomnia based on relevant clinical trials. Methods: We conducted a systematic search on domestic and international CPG databases and medical databases. In addition, we conducted manual searches of relevant articles. Three authors independently searched and selected relevant studies; any disagreement was resolved by discussion. We extracted and analyzed the following data: published language, country, development group, participants, interventions, presence or absence of recommendations for CAM, level of evidence, grade of recommendation for CAM, and methods of development. Results: We identified 8,241 records from domestic and international databases, and 22 CPGs were included. Eleven of the 22 CPGs mentioned CAM interventions including herbal medicine, relaxation, acupuncture moxibustion, Tai Chi, meditation, hypnosis, biofeedback, Tuina, and external herbal medicine. However, most of the CPGs indicated 'no recommendation' or 'weak recommendation' for CAM interventions. Only Valeriana dageletiana Nakai and relaxation were considered to have experimental evidence. Valeriana dageletiana Nakai was recommended for improvement of sleep latency, sleep maintenance, total sleeping time, and sleep cycle. Relaxation was recommended as effective intervention for relieving physical and psychological arousal. Conclusions: Despite systematic reviews and randomized controlled trials on CAM for insomnia, most of the CPGs for insomnia did not reflect the evidence obtained. Further CPGs for insomnia should be developed by considering the current advanced studies in the field of CAM.