• Title/Summary/Keyword: Korean medicine clinical practice guidelines

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Management of Osteoporosis Medication after Osteoporotic Fracture

  • Young Kwang Oh;Nam Hoon Moon;Won Chul Shin
    • Hip & pelvis
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    • v.34 no.4
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    • pp.191-202
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    • 2022
  • The aim of this study was to provide helpful information for use in selection of an appropriate medication after osteoporotic fractures through conduct of a literature review. In addition, a review of the recommendations of several societies for prevention of subsequent fractures was performed and the appropriate choice of medication for treatment of atypical femur fractures was examined. Clinical perspective was obtained and an updated search of literature was conducted across PubMed and MEDLINE and relevant articles were selected. The articles were selected manually according to relevance, and the references for identified articles and reviews were also evaluated for relevance. The following areas are reviewed: Commonly prescribed osteoporosis medications: BPs (bisphosphonates), denosumab, and SERMs (selective estrogen receptor modulators) in antiresorptive medications and recombinant human parathyroid hormone teriparatide, recently approved Romosuzumab in anabolic agents, clinical practice guidelines for the management of osteoporosis, osteoporotic fracture, and atypical femur fracture. Most medications for treatment of osteoporosis do not delay fracture healing and the positive effect of teriparatide on fracture healing has been confirmed. In cases where an osteoporotic fracture is diagnosed, risk assessment should be performed for selection of very high-risk patients in order to prevent subsequent fractures, and administration of anabolic agents is recommended.

A Review of Clinical Studies about Acupuncture Therapy for Whiplash Associated Disorder (교통사고로 인한 편타 손상의 침 치료에 대한 임상연구의 국내외 동향)

  • Jeon, Jun-Young;Yoo, Duk-Joo;Maeng, Tae-Ho;Shim, Jae-Woo;Cho, Woo-Young;Kim, Hyungsuk;Lim, Woong-jin;Lee, Jong-soo
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.4
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    • pp.47-54
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    • 2015
  • Objectives This study aimed to research current trends of acupuncture treatment of whiplash associated disorder (WAD). Methods Clinical studies about acupuncture therapy on WAD were searched in 7 databases. The included studies were classified according to their publication dates, methods, interventions, outcome measures. Interventions were analyzed by accompanied intervention, acupoint, acupuncture retaining time and treatment period. Results 14 articles were included. The number of studies on acupuncture for WAD shows increasing tendency since 1990. The included studies consist of 6 randomized controlled trials (RCTs), 2 non-randomized controlled trials (nRCTs), 2 cohort studies, 1 before and after study, 1 case study and 2 case reports. Most studies used visual analogue scale (VAS) as primary outcome. Conclusions This review demonstrates that further clinical studies need to be carried out under the formal clinical practice guidelines of acupuncture therapy for WAD in order to support clinical treatment objectively.

Development of Parent Guidelines for Parent-Performed Developmental Screening Tests

  • Sung Sil Rah;Soon-Beom Hong;Ju Young Yoon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.34 no.2
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    • pp.141-149
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    • 2023
  • Objectives: Most developmental screening tests have been built as parent-performed questionnaires. However, they often do not guide parents on how to answer the questionnaire. This study aimed to develop easily applicable parent guidelines. Methods: We implemented the Delphi procedure with 20 panelists. The development of the initial questionnaire was based on the results of two surveys of parents and experts provided by a policy research report that investigated the item adequacy of the Korean Developmental Screening Test. Round one included 33 items comprising all possible measurements in six categories that were identified as difficult to understand or confusing. Round two merged and modified some items and included 32 items. We defined consensus as a median agreement value of one or less and convergence and stability values of 0.5 or less. The subjective usefulness of the parent guidelines was examined based on their previous test experiences. Results: Consensus was reached after the second round, reflecting the items with the highest level of accuracy in each category. Of the 167 parents who participated in the survey, 113 (67.7%) affirmed the usefulness of the guidelines, while 10 (6.0%) answered that they were not useful. Items that recommended a different scoring strategy in answering the questionnaire from their previous measurements were found to be more useful by the parents. Conclusion: The parent guidelines, composed of five bullet points, drew on the consensus of the experts. Further studies are required to assess whether these guidelines improve the accuracy of screening tests in clinical settings.

The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care (한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해)

  • Park, Yong-Sin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

Loin Pain Haematuria Syndrome - A Narrative Review of Pain Management Strategies

  • Grech, Andrew Kristian
    • The Korean Journal of Pain
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    • v.29 no.2
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    • pp.78-85
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    • 2016
  • Loin pain haematuria syndrome (LPHS) is an uncommon clinical entity that has divided renal physicians, pain practitioners, and even psychiatrists since its initial description. A relative paucity of data exists regarding the condition, with best practice guidelines lacking amid the existing threads of anecdotal experiences and variable follow-up observations. The aim of this article was to review the cumulative published experience of pain relief strategies for LPHS.

Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors (공중보건의의 고혈압 진단 및 치료과정 평가)

  • Song, Yun-Mi;Kim, Yoon;Cho, Hong-Jun;Jeong, Hoi-Suk;Kim, Yong-Ik
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.126-143
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    • 1996
  • Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

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Infectious and Non-infectious Complications of Peritoneal Dialysis in Children

  • Cho, Min Hyun
    • Childhood Kidney Diseases
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    • v.24 no.2
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    • pp.63-68
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    • 2020
  • Despite the many advantages of peritoneal dialysis (PD) in children with end-stage renal disease, there exist redoubtable complications of PD that should be overcome. To prevent and manage these complications, a multidisciplinary team should provide support highly tailored for each child and family, based on the standardized practice guidelines for the management of pediatric PD. In this review, we summarize the clinical manifestations and management of several complications of PD.

Review on ICF-related Research Trends in Korean Clinical Field

  • Song, Ju-Min
    • Journal of the Korean Society of Physical Medicine
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    • v.16 no.4
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    • pp.33-44
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    • 2021
  • PURPOSE: This study analyzed the research trends related to the International Classification of Functioning, Disability, and Health (ICF) to suggest an ICF utilization plan in the Korean clinical field. METHODS: In the RISS, KISS, NSDL, and PubMed databases, papers published between 2016 and July 2021 were collected by applying the search terms, 'ICF', 'international classification of functioning, disability and health', 'clinic', 'patient', and 'diagno'. The 44 papers selected were classified according to the analysis criteria, and the frequency and percentage were calculated. RESULTS: In domestic clinical trials, the frequency of ICF-related studies was in the order of physical therapy (n = 19) and occupational therapy (n = 14). The frequency of each study subject was observed in the order of studies related to a specific disease (n = 34) and prior studies (n = 7). The research topics were in the order of studies using ICF as a measurement tool (n = 21) and case studies with patients with specific diseases (n = 11). There were 18 studies using ICF codes and 14 papers applying the ICF domains. CONCLUSION: Over the last five years, ICF-related research in the domestic clinical field targeted patients with more diverse diseases in more expertise fields. Research for the unification of terms should be conducted for communication among various experts in clinical practice. To promote the use of ICF in the clinical field, it will be necessary to conduct research, such as the unification of terms, standardized education, development of ICF casebook, and development of ICF coding programs and guidelines.

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.

Noninvasive Testing for Colorectal Cancer Screening: Where Are We Now?

  • Jaeyoung Chun;Jie-Hyun Kim;Young Hoon Youn;Hyojin Park
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.85-92
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    • 2023
  • Colorectal cancer (CRC) is one of the most prevalent cancers and is the leading cause of cancer-related mortality worldwide. Based on the current screening guidelines by the American Cancer Society and Korean multi-society expert committee, CRC screening is recommended in asymptomatic adults starting at the age of 45 years. Fecal immunochemical test-based screening programs reduce the development of CRC and related mortality in the general population. However, this most popular CRC screening strategy demonstrates a crucial limitation due to modest diagnostic accuracy. Colonoscopy may be considered as an alternative primary method for CRC screening; however, its implementation can still be challenging due to concerns regarding invasiveness, low adherence, cost-effectiveness, and quality assurance. To overcome the limitations of current screening tests, innovative noninvasive tests for CRC screening have been developed with advances in molecular biology, genetics, epigenetics, and microbiomics for detecting CRC, which may enhance the approach to CRC screening and diagnosis in clinical practice in the near future. This review explores the emerging screening methods and discusses their potential for integration into current practice.