• Title/Summary/Keyword: Methodological Quality

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Diagnostic Value of Rectal Bleeding in Predicting Colorectal Cancer: a Systematic Review

  • Tong, Gui-Xian;Chai, Jing;Cheng, Jing;Xia, Yi;Feng, Rui;Zhang, Lu;Wang, De-Bin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.1015-1021
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    • 2014
  • This study aimed at summarizing published study findings on the diagnostic value of rectal bleeding (RB) and informing clinical practice, preventive interventions and future research areas. We searched Medline and Embase for studies published by September 13, 2013 examining the risk of colorectal cancer in patients with RB using highly inclusive algorithms. Data for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and positive predictive value (PPV) of RB were extracted by two researchers and analyzed applying Meta-Disc (version 1.4) and Stata (version 11.0). Methodological quality of studies was assessed according to QUADAS. A total of 38 studies containing 5,626 colorectal cancer patients and 73,174 participants with RB were included. The pooled sensitivity and specificity were 0.47 (95% CI: 0.45-0.48) and 0.96 (95% CI: 0.96-0.96) respectively. The overall PPVs ranged from 0.01 to 0.21 with a pooled value of 0.06 (95% CI: 0.05-0.08). Being over the age of 60 years, change in bowel habit, weight loss, anaemia, colorectal cancer among first-degree relatives and feeling of incomplete evacuation of rectum appeared to increase the predictive value of RB. Although RB greatly increases the probability of diagnosing colorectal cancer, it alone may not be sufficient for proposing further sophisticated investigations. However, given the high specificity, subjects without RB may be ruled out of further investigations. Future studies should focus on strategies using RB as an "alarm" symptom and finding additional indications to justify whether there is a need for further investigations.

A Study on the Development of Satisfaction Index in the Medical Tourism of Foreign Tourist (외국인관광객의 의료관광 만족지표와 척도개발 연구)

  • Kim, Sa-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1663-1674
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    • 2013
  • The purpose of this study was a methodological research to develop an instrument to assess the medical tourism satisfaction of foreign tourist. A primary instrument with 63 questions was developed based on literature review. A group of experts revised individual questions and removed 9 irrelevant questions. This secondary instrument, then, was distriuted from Jury 1, 2012 to October 20, 2012. It was tested with 589 members of foreign tourist. After factor analysis on the final 42 questions, 7 factors were identified; quality of medical service, correspondance, tourism connection, sympathy, convenience, believability, and economical efficiency. The total variance explained was 60.9%. This instrument was statistically reliable and valid to measure medical tourism satisfaction of foreign tourist.

Seasonal Variation of Food Intake in Food Frequency Questionnaire among Workers in a Nuclear Power Plant (조사 계절에 따른 식품섭취빈도 조사의 평균 섭취 횟수와 섭취량 변화)

  • Yang, Jae-Jeong;Lim, Hyun-Sul;Ko, Kwang-Pil;Ahn, Youn-Jhin;Ahn, Yoon-Ok;Park, Sue-Kyung
    • Journal of Preventive Medicine and Public Health
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    • v.40 no.3
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    • pp.239-248
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    • 2007
  • Objectives : This study was conducted to investigate the systematic error, such as seasonal change or inadequate food items, in a food frequency questionnaire administered to workers in a Nuclear Power Plant, Korea. Methods : We performed three repeat-tests with 28 subjects on May 13, July 8 and Dec 16, 1992. Our food frequency questionnaire (FFQ) comprised 84 foods organized into 7 food-groups, and was composed of the items of usual intake frequency (8 categories) and the amount per intake (3 or 4 categories) over the previous year. We compared the means of intake frequency and the frequency of the portion-size according to each season using Repeated Measures ANOVA and Pearson's chisquare test with Fisher's exact test. Results : We found the significant seasonal changes of several food items in intake frequency measurement. These items were typical seasonal foods such as mandarin orange, plum and green vegetables, while the single questions consisted of inadequate food items such as thick beef or similar soup and various kimchi products. Significant seasonal changes in portion-size were found in only two items: cooked rice-brown and fresh frozen fishes. Conclusions : The systematic errors observed could caused loss of validity in the FFQ. Consideration should be given for seasonal variation in FFQ survey and methodological concerns are needed to improve the quality for measuring usual diet pattern.

Analysis of Nursing Studies about Stroke Research in Korea (뇌졸중에 관한 국내 간호학 논문의 분석)

  • Ham, Mi-Young;Choi, Kyung-Sook;Ryu, Eun-Jung
    • The Korean Journal of Rehabilitation Nursing
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    • v.3 no.2
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    • pp.154-168
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    • 2000
  • This study was done to analyze the trends of research on stroke in Korea, to suggest future direction, for research on stroke. This article reviewed 75 nursing research papers on stroke done since 1990 to 2000 by examining them according to the period of publication or presentation, research design, type of subjects, measurement variables, the intervention outcome of experimental research, and theme of qualitative research. The research were as follows : 1. 26 of 75 studies were composed of master thesis and dissertation of graduate school. There were 53 nonexperimental research, 15 experimental research, and 7 qualitative studies design. 2. Stroke patients subject' Characteristic were 44 and Family and Spouses of caregiver support were 28 of total studies. 3. Most measurement instruments used for research were translated and redesigned it into Korean that developed by foreigners, and development measurement instruments used Kang's ADL. 4. Family support and Social support was shown the frequently among correlational research. 5. Methodological research were development of an evaluation tool for the quality of nursing care in stroke patients, caregiver support of development of nursing intervention list, and Home care Nursing Intervention protocol, and development of client selection criteria based on the needs of services to be offered. 6. The experimental research of intervention were mostly education nursing intervention, rehabilitation program on functional recovery, support nursing intervention, and applying a home care protocol on the nursing care intervention. 7. Theme of qualitative research were family experience, home care in family experience, soobal experience, illness experience, hope of Stroke patients and so on. Phenomenologic methodology and Granded Theory was designed of Qualitative research. On the basis of the above finding the following recommendations are made: 1. It's necessary to develop a reliable and variable measurement tool for stroke patients and family care of stroke patients. 2. It's necessary to study the comparison of Nursing Studies of stroke research abroad, the replication to establish the effect of nursing intervention stroke patients and family care of stroke patients.

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Cephalometric predictors of treatment outcome with mandibular advancement devices in adult patients with obstructive sleep apnea: a systematic review

  • Alessandri-Bonetti, Giulio;Ippolito, Daniela Rita;Bartolucci, Maria Lavinia;D'Anto, Vincenzo;Incerti-Parenti, Serena
    • The korean journal of orthodontics
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    • v.45 no.6
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    • pp.308-321
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    • 2015
  • Objective: The efficacy of mandibular advancement devices (MADs) in the treatment of obstructive sleep apnea (OSA) ranges between 42% and 65%. However, it is still unclear which predictive factors can be used to select suitable patients for MAD treatment. This study aimed to systematically review the literature on the predictive value of cephalometric analysis for MAD treatment outcomes in adult OSA patients. Methods: The MEDLINE, Google Scholar, Scopus, and Cochrane Library databases were searched through December 2014. Reference lists from the retrieved publications were also examined. English language studies published in international peer-reviewed journals concerning the predictive value of cephalometric analysis for MAD treatment outcome were considered for inclusion. Two review authors independently assessed eligibility, extracted data, and ascertained the quality of the studies. Results: Fifteen eligible studies were identified. Most of the skeletal, dental, and soft tissue cephalometric measurements examined were widely recognized as not prognostic for MAD treatment outcome; however, controversial and limited data were found on the predictive role of certain cephalometric measurements including cranial base angle, mandibular plane angle, hyoid to mandibular plane distance, posterior nasal spine to soft-palate tip distance, anterior nasal spine to epiglottis base distance, and tongue/oral cross sectional area ratio thus justifying additional studies on these parameters. Conclusions: Currently available evidence is inadequate for identification of cephalometric parameters capable of reliably discriminating between poor and good responders to MAD treatment. To guide further research, methodological weaknesses of the currently available studies were highlighted and possible reasons for their discordant results were analyzed.

Ginseng for Reducing the Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

  • Hur, Myung-Haeng;Lee, Myeong-Soo;Yang, Hye-Jeong;Kim, Chan;Bae, Ik-Lyul;Ernst, Edzard
    • Journal of Ginseng Research
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    • v.34 no.4
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    • pp.342-347
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    • 2010
  • Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

Log Usage Analysis: What it Discloses about Use, Information Seeking and Trustworthiness

  • Nicholas, David;Clark, David;Jamali, Hamid R.;Watkinson, Anthony
    • International Journal of Knowledge Content Development & Technology
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    • v.4 no.1
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    • pp.23-37
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    • 2014
  • The Trust and Authority in Scholarly Communications in the Light of the Digital Transition research project1) was a study which investigated the behaviours and attitudes of academic researchers as producers and consumers of scholarly information resources in respect to how they determine authority and trustworthiness. The research questions for the study arose out of CIBER's studies of the virtual scholar. This paper focuses on elements of this study, mainly an analysis of a scholarly publisher's usage logs, which was undertaken at the start of the project in order to build an evidence base, which would help calibrate the main methodological tools used by the project: interviews and questionnaire. The specific purpose of the log study was to identify and assess the digital usage behaviours that potentially raise trustworthiness and authority questions. Results from the self-report part of the study were additionally used to explain the logs. The main findings were that: 1) logs provide a good indicator of use and information seeking behaviour, albeit in respect to just a part of the information seeking journey; 2) the 'lite' form of information seeking behaviour observed in the logs is a sign of users trying to make their mind up in the face of a tsunami of information as to what is relevant and to be trusted; 3) Google and Google Scholar are the discovery platforms of choice for academic researchers, which partly points to the fact that they are influenced in what they use and read by ease of access; 4) usage is not a suitable proxy for quality. The paper also provides contextual data from CIBER's previous studies.

A Systematic Review and Meta-analysis of Manual Therapy for Temporomandibular Disorder (턱관절장애에 대한 수기요법의 체계적 문헌 고찰과 메타분석)

  • Kim, Hong-Guk;Ryoo, Dek-Woo;Jeong, Seong-Mok;Kim, Sung-Jin;Baek, Seung-Won;Lee, Chang-Hee;Yoon, Jin-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.1
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    • pp.13-27
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    • 2017
  • Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

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Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Attitude Type about Smoking of Smoking Middle School Students (흡연 중학생의 흡연에 대한 태도 유형)

  • Moon, Sun-Young;Choi, Yang-Hee;Oh, Bok-Chang;Kim, Shin-Jeong;Han, Kyoung-Soon
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.481-492
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    • 2002
  • The purpose of this study was to understand and analyze the subjective structure of attitude The method was based on a Q-Methodological approach. The results of this study, there were four categories of smoking middle school students' attitude about smoking. The first type named Self Belief type that this type didn't sensible of their surrounding persons when they were smoking and they also were responsible for strong opinion at their behavior. The second type named Other's Awareness type that they were seen the behaviors they always have to see other person when they were smoked, but if they didn't smoke or have tobaccos they feel heavy and are restless. The third type named Solving of Anxiety type. They first used to smoke when they wanted to solve their anxiety, stress, awkwardness and angry. The fourth type named A Sense of Belonging Group type. This type followed if their friends were smoking they also did it with them. As to grasping of their motivation to smoking of middle school of students with smoking, they felt some intimacy and same quality each other. In consideration of various types of attitude about smoking, it was very necessary important to grasp the meaning because we were known about attitude, belief etc. And then Through getting hold of the meaning, we could understand with their thought and value of Students in middle school. Besides, as a substitute for the students were depending on smoking purposelessly will fix right self-confidence.

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