• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.4
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• pp.97-104
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• 2016

Purpose: Facilities for infection prevention according to the characteristics of the patients, caregivers and medical personnel are needed in the patient triage room of the emergency department as a space for the first medical examination and classification of the patients. This study focus on the patient tirage room with the highest frequency of use in the emergency department to prevent the hospital acquired infection of the emergency department. Methods:: This study analyzed the facilities standard needed for the infection prevention through interviews with the medical personnel and analyses on the facilities standard/cases of foreign hospitals and facilities standard at home and abroad Results: And based on this, it attempted to present improvement measures by analyzing the line of circulation and space used by infected patients in a hospital designated in the regional emergency medical center among hospitals whose emergency department overcrowding index is high. Implications: The facilities standard for the infection prevention among the courses for patient classification of the emergency medical centers could be identified and implemented to prevent infection.

• The Korean Society of Law and Medicine
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• v.24 no.3
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• pp.125-153
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• 2023

The Supreme Court's en banc decision on December 12, 2022 (docket number 2016Do21314) presented a new standard for determining whether the use of diagnostic medical devices by Korean medical doctors constitutes oriental medical doctors constitutes unlicensed medical practice. Based on this standard, it was determined that the use of ultrasound by Korean medical doctors was not an unlicensed medical practice. Supreme Court's Decision 2016Du51405 on August 18, 2023, is the first case in which a new standard was applied to determine that an Korean medical doctor's use of electroencephalography to diagnose Parkinson's disease and dementia was not an unlicensed medical practice. The Supreme Court abolished the previous standard that Western medical knowledge and technology should not be required for Korean medical doctors to use medical devices. However, it was unclear whether Western medical diagnosis of Korean medical doctors using diagnostic medical devices would be viewed as an an auxiliary method of diagnosis. Parkinson's disease and dementia are Western medical diagnoses. The Supreme Court judged that the Western medical diagnosis of Korean medical doctors was not an unlicensed medical practice. This clearly explains what an auxiliary method of diagnosis means. In addition, the Supreme Court excluded the principles of development and production of electroencephalography from its judgment criteria. Automatic extraction and automatic reading of test results were also excluded. The criminal court's view that the meaning of oriental medical practice should be clearly and strictly interpreted from the perspective of an oriental doctor, and it was clarified that diagnostic medical devices were excluded from criminal punishment unless it was clear that they were not related to the principle of oriental medical practice. As a result, the Supreme Court made it clear that the use of diagnostic medical devices is excluded from criminal punishment unless it is clear that they are not related to the principles of Korean medicine.

• Korean Journal of Radiology
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• v.24 no.2
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• pp.155-165
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• 2023

Objective: Little is known about the effects of using different expert-determined reference standards when evaluating the performance of deep learning-based automatic detection (DLAD) models and their added value to radiologists. We assessed the concordance of expert-determined standards with a clinical gold standard (herein, pathological confirmation) and the effects of different expert-determined reference standards on the estimates of radiologists' diagnostic performance to detect malignant pulmonary nodules on chest radiographs with and without the assistance of a DLAD model. Materials and Methods: This study included chest radiographs from 50 patients with pathologically proven lung cancer and 50 controls. Five expert-determined standards were constructed using the interpretations of 10 experts: individual judgment by the most experienced expert, majority vote, consensus judgments of two and three experts, and a latent class analysis (LCA) model. In separate reader tests, additional 10 radiologists independently interpreted the radiographs and then assisted with the DLAD model. Their diagnostic performance was estimated using the clinical gold standard and various expert-determined standards as the reference standard, and the results were compared using the t test with Bonferroni correction. Results: The LCA model (sensitivity, 72.6%; specificity, 100%) was most similar to the clinical gold standard. When expert-determined standards were used, the sensitivities of radiologists and DLAD model alone were overestimated, and their specificities were underestimated (all p-values < 0.05). DLAD assistance diminished the overestimation of sensitivity but exaggerated the underestimation of specificity (all p-values < 0.001). The DLAD model improved sensitivity and specificity to a greater extent when using the clinical gold standard than when using the expert-determined standards (all p-values < 0.001), except for sensitivity with the LCA model (p = 0.094). Conclusion: The LCA model was most similar to the clinical gold standard for malignant pulmonary nodule detection on chest radiographs. Expert-determined standards caused bias in measuring the diagnostic performance of the artificial intelligence model.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.209-235
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• 2010

According to the development of medical technology, new medical treatments have been dramatically increased as an inevitable consequence, however, it is not easy for medical workers to learn the knowledge that is necessary for new medical treatments and their additions in the medical services. Therefore, it could not be helped increasing the guidelines for applying new medical treatments, and then, the problem would come out whether to attribute the medical negligence to the doctors who did not follow the guidelines when the patient became worse because of his non-compliance. Nevertheless, there is no document to review the problem mentioned above and also no definite precedents. Thus, the civil lawful character and obligation of guidelines on the lawsuit against the medical default have been examined in this studies. The medical negligence is defined as usual doctors violate the care obligation which is demanded for them to follow when they treat patients under the proper medical standard in those days. It is resonable to assume that the matter of guidelines is to decide the level of the care obligation, that means the care which is required of the rational doctors under same circumstances, and in general, the experts' testimonies should be needed in this case. In addition, the issue comes out whether the guidelines can be the standard of the judgement of the medical negligence. Finally, I suppose, the evaluation of the issue depends on who makes the guidelines, what materials are based on, and also depends on whether there is another guidelines in the same disease, what the purpose of guidelines is to save the medical costs or to realize the appropriate medical services, in addition, it depends on how often renew the guidelines, and how wide is the usage of guidelines.

• The Journal of Korean Medicine
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• v.31 no.1
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• pp.122-129
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• 2010

Objective: To investigate institutional review boards and approved clinical trials of Oriental medical hospitals in Korea Methods: We e-mailed 16 Oriental medical hospitals a survey consisting of questions that addressed two topics, institutional review boards and the clinical trials they approved. The first part included questions about whether each hospital had an institutional review board, that board's staffing and education, reviews, and expedited reviews. The clinical trials portion covered the number and types of approved clinical trials, treatment methods, whether an investigator or a sponsor initiated the trials, diseases, time frame, and clinical trial fee. Results: We received a response to our e-mail from 14 hospitals, all of which had an institutional review board. The average number of institutional review board members was 13.57. Of these Oriental medical hospitals, 70% and 49% said that they regularly educated their institutional review board staff and clinical trial, investigators, respectively. 79% of the hospitals claimed to conduct regular reviews, and 50% said that they did so monthly. The number of approved clinical trials increased sharply from 11 in 2005 to 102 in 2008. 68% of these clinical trials were randomized, and the most-used treatment methods were herbal medicine (35%) and acupuncture (29%). The most common target diseases were circulatory (19%), urinogenital (14%), and musculoskeletal (13%) disease. Conclusions: Despite the rapid increase in clinical research in oriental medical hospitals, many more efforts including raising IRB quality, varying research diseases and increasing clinical trials in the hospitals located in non-metropolitan area, should be made.

• Journal of the Korean Society of Industry Convergence
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• v.25 no.6_2
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• pp.1083-1090
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• 2022

Since renal cell carcinoma(RCC) has various examination and treatment methods according to clinical stage and histopathological characteristics, it is required to determine accurate and efficient treatment methods in the clinical field. However, the process of collecting and processing RCC medical data is difficult and complex, so there is currently no AI-based clinical decision support system for RCC treatments worldwide. In this study, we propose a clinical decision support system that helps clinicians decide on a precision treatment to each patient. RCC standard big database is built by collecting structured and unstructured data from the standard common data model and electronic medical information system. Based on this, various machine learning classification algorithms are applied to support a better clinical decision making.

• The Journal of the Korean life insurance medical association
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• v.7 no.1
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• pp.180-188
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• 1988

A study on the standard cardiothoracic ratio calculated from the photofluorography film of chest in a total of 8,030 insured persons(3,449 men and 4,581 women) was undertaken. The results were as follows: 1) The linear regression equations were formed from the 99% confidence ilmits of actually measured average cardiothoracic ratio by weight index. The cardiothoracic ratios by weight index estimated by above mentioned equations, namely theoretic values of cardiothoracic ratio, should be regarded as the standard cardiothoracic ratios. 2) It seems that the standard cardiothoracic ratio${\pm}10%$ deviation should be regarded as the normal limits of cardiothoracic ratio. 3) The tables of standard cardiothoracic ratio by weight index and the normal limits of cardiothoracic ratio by weight index were presented. 4) The average weight index and cardiothoracic ratio in all males and females were 0.993 and 43.3%, and 0.997 and 46.3% respectively. 5) In order to evaluate the cardiothoracic ratio more accurately, the establishment of the standard cardiothoracic ratio by build is considered to be reasonable.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.87-99
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• 2022

Purpose: This study aimed to provide basic data for the improvement of the standards related to the performance improvement of the firefighting equipment standards for special ambulances. Methods: Among the domestic firefighting equipment standards, the special ambulance standard was compared with the NFPA 1917 standard for the United States automobile ambulance 2019 and European Union European standard EN 1789 medical vehicle and its equipment, a road ambulance. Results: Anti-skid performance based on indoor noise standards, performance standards for interior lights, seat belt warning device, child car seat fixing device, safety handle, auxiliary footrest, and flooring materials should be supplemented. Conclusion: It is necessary to strengthen the production and performance standards for improvement to a level corresponding to the national standards, such as the United States and European Union.

• Korean journal of medical education
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• v.30 no.4
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• pp.283-294
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• 2018

Since medical education programs in Korea and Japan seem to mutually influence each other, this review article provides a history of Japanese medical education, focusing on the way in which it influenced and was influenced by Korean medical education. In the late 19th century, the University of Tokyo established the core medical school, disseminating its scholarship and system to other medical schools. In the early 20th century, the balance between the quality and quantity of medical education became a new issue; in response, Japan developed different levels of medical school, ranging from imperial universities to medical colleges and medical vocational schools. After World War II, all of Japan's medical schools became part of the university system, which was heavily regulated by the Ministry of Education (MOE) Standard for the Establishment of Universities. In 1991, MOE deregulated the Standard; since 2000, several new systems have been established to regulate medical schools. These new approaches have included the Model Core Curriculum, 2-year mandatory postgraduate training, and a medical education accreditation system. Currently, most medical schools are nervous, as a result of tighter regulatory systems that include an accreditation system for undergraduate education and a specialty training system for postgraduate education.

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.54-63
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• 2017

Purpose: The purpose of this study was to compare the working status and Standard Shiftwork Index (SSI) between night shift-fixed nurses and rotating shift nurses. Methods: Participants were 367 nurses working as registered nurses at 7 different medical institutions. The data were collected from August 8, 2016 to September 30, 2016. Results: Night shift fixed nurses were more satisfied with work schedule than rotating shift nurses. Rotating shift nurses reported higher SSI scores, such as chronic fatigue, musculoskeletal problems, than night shift fixed nurses. In SSI's sub-items, rotating shift nurses reported higher scores, such as the amount of sleep, feeling well after sleep, heartburn or stomach-ache and heartbeat irregularities, than night shift fixed nurses. Conclusion: The results indicated that night shift fixed system might be an effective method to improve nurses' work satisfaction. It is necessary to figure out any suitable night shift fixed system based on the characteristics of each nursing organization. The SSI might be an useful tool to measure the nurses' satisfaction in reference to their work shift.