Imaging plays a key role in the management of brain tumors, including the diagnosis, prognosis, and treatment response assessment. Radiomics and deep learning approaches, along with various advanced physiologic imaging parameters, hold great potential for aiding radiological assessments in neuro-oncology. The ongoing development of new technology needs to be validated in clinical trials and incorporated into the clinical workflow. However, none of the potential neuro-oncological applications for radiomics and deep learning has yet been realized in clinical practice. In this review, we summarize the current applications of radiomics and deep learning in neuro-oncology and discuss challenges in relation to evidence-based medicine and reporting guidelines, as well as potential applications in clinical workflows and routine clinical practice.
Objectives The purpose of this study was to understand the public's perception of Korean medical treatment for growth disorders to develop Korean medicine clinical practice guidelines and critical pathways for growth disorders in children and adolescents. Methods A survey was conducted using an online platform targeting 252 adults aged 19 years from May 16, 2021 to May 17, 2021. The questionnaire consisted of questions about the demographic characteristics of respondents; overall perception, experience, and satisfaction with Korean medical treatment for growth disorders; willingness to use or recommend Korean medical treatment for growth disorders; and points for improvement. Results The overall perception of treatment for growth disorders was 3.30 ± 0.892 on a 5-point scale. Concerning the negative reasons, 54.4% of the respondents were concerned about safety; regarding the positive reason, expectations for overall health as well as height growth were the highest at 46.5%. Additionally, there was a high demand for information, such as providing safety information on treatment, presenting evidence for the efficacy of treatment, and standardized clinical process, as points requiring improvement. Conclusions To raise public perception of Korean medical treatment for growth disorders, it is necessary to satisfy the opinions of the public identified through this survey. Therefore, the development and utilization of Korean medicine clinical practice guidelines and critical pathways for growth disorders would play an important role.
Gu, Mee Ok;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong;Eun, Young
Journal of Korean Clinical Nursing Research
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v.17
no.3
/
pp.307-318
/
2011
Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.
There were no Korean evidence-based 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 and the recommendation grades were classified as either strong or weak. 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. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.
Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, world-wide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.
Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.
Cho, Eunbyul;Lee, Ju-Hyun;Kwon, O Sang;Hong, Jiseong;Cho, Nam Geun
Journal of Acupuncture Research
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v.38
no.3
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pp.219-226
/
2021
Background: The objective structured clinical examination (OSCE) is a widely used method to assess the clinical performance of students in clinical practice. Although OSCE has been used for undergraduate students of Korean medicine, this has not been widely reported. Methods: In 2020, the practical course for acupuncture and moxibustion medicine (acupuncture, electroacupuncture, pharmacopuncture, auricular acupuncture, and burning acupuncture) was taught using flipped learning, according to clinical practice guidelines, and assessed by the OSCE. The appropriateness of this model of education and its evaluation using OSCE were evaluated using a 5-point Likert scale, and the results were analyzed. Results: Of the respondents, 67% reported that the OSCE accurately reflected their competency, and 82% reported that online video lectures helped them to improve their clinical skills. The average adequacy score of the model was > 3.7/5, and the average adequacy score of the checklist used in the OSCE was > 4.1/5 for all 5 clinical application skills. The difference in the mean self-efficacy score between students who had taken the OSCE and those students who had not taken the OSCE, was highest in the burning acupuncture group (0.923). Conclusion: This study showed that students' satisfaction with the OSCE was high and flipped learning was an effective education model. In the future, models representing the human body or simulated patients should be used to evaluate students' skills and attitude.
Chang-woo Seon;Ye-jin Hong;Kyung-bok Park;Jeong-rock Kim;Dong-woo Nam;Ye-eun Kim;Min-jeong Kim
The Journal of Korean Medicine
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v.43
no.4
/
pp.33-51
/
2022
Objectives: This study aimed to understand the current status of clinical practice patterns of Korean medicine in the treatment of degenerative arthritis of the hip and finger joints using web-based survey. Methods: An e-mail questionnaire survey was conducted with the Korean Medicine Doctor(K.M.D) registered in the Korean Medicine Association. The survey data were analyzed using Microsoft Excel. Results: Although the response rate of the survey was low, the characteristics of the respondents generally reflected the characteristics of the study population. A total of 35.2% of the respondents had heard of the guidelines; however, they did not use them for medical treatment. The reason as answered by 32.8% of the respondents was "not enough treatment time to check the manual and apply it." More than half (78.80%) answered that they were treating patients with both degenerative hip and finger arthritis; however, the average monthly number of first-time patients was ≤5. A total of 379 (60.9%) respondents answered that "acupuncture is very important," which was the only one that exceeded the majority compared to other treatments. As a result of the safety investigation, "Acupuncture, herbal medicine, cupping" were considered high in safety, while "Pharmacopuncture and Bee venom acupuncture" were considered low in safety. Conclusions: This survey helped to determine the current clinical practice patterns of Korean medicine treatments, further providing basic data for CPGs for degenerative arthritis of the hip and finger joints.
Hwang, Ji Hye;Lee, Kwang Ho;Nam, Dong Woo;Yook, Tae-han;Song, Ho Sueb
Korean Journal of Acupuncture
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v.38
no.1
/
pp.16-31
/
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.
Objectives : This study was conducted to analyze the Korean Medicine treatment on Tension-type Headache (TTH) in Korean clinical studies. Methods : Articles were searched from four Korean databases(KISS, RISS, OASIS, ScienceON). Study type, publication year, demographic information of participants, intervention type and details, outcome measurements and treatment results of selected articles were analyzed. Results : 17 articles were selected among those published until January 15th 2023. 'Cheonghyulgangki-tang', acupuncture at 'GV20', moxibustion at 'CV12', pharmacopunture at 'GB20', 'ByeolGab' were most frequently used in treatment on TTH. 'Numeric Rating Scale(NRS)' and 'Visual Analog Scale(VAS)' were most frequently used in outcome measurements. All of the articles exhibited that Korean Medicine treatments improved symptoms of TTH. Conclusion : This study showed that various Korean Medicine treatments for TTH were effective. This finding could be used in clinical practice and build the basis for the direction of clinical practice guidelines in future, Nevertheless, this study has few limitations. Further systematic reviews and meta analyses of randomized controlled trials are required for more evidence on Korean Medicine.
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