• Title/Summary/Keyword: Methodological Quality

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Sensory Integration Interventions for Children with Autism Spectrum Disorder in Korea: A Systematic Review (국내 자폐스펙트럼장애 아동을 대상으로 제공되는 감각통합 중재방법: 체계적 고찰)

  • Park, Young-Ju
    • The Journal of Korean Academy of Sensory Integration
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    • v.20 no.3
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    • pp.48-59
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    • 2022
  • Objective : This study was intended to systematically consider the sensory integration intervention methods offered in Korea for children with autism spectrum disorder and to provide an evidence base for the application of sensory integration interventions. Methods : The subjects of this study were published studies in a national journal for the last 10 years from January 2011 to December 2020. The databases used for the search were RISS and DBpia. The search terms were 'autism', 'autism spectrum', 'sensory integration', and 'intervention'. A total of 10 studies were used in the analysis, which were analyzed at the qualitative and methodological quality of the research evidence and the results were presented according to the PICO (Patient, Intervention, Comparison, Outcome). Results : In the research analysis, the quality level of the evidence was highest at level IV, followed by level II. The methodological quality of the evidence was the most common for 'Good' research, followed 'Fair'. The study subjects were children with autism spectrum disorder and their parents, and the experimental design had the highest frequency of single-subject studies. Interventions have the highest number of studies confirming adaptive behavior and sensory modulation, and the evaluation tools used to measure interventions have the highest frequency of sensory profiles and Canadian occupational performance measures (COPM). All 10 studies used in the analysis showed positive improvements and statistically significant effects on various outcome values from sensory integration interventions. Conclusion : In the recent clinical environment, sensory integration interventions have been continuously conducted in children with autism spectrum disorder. In future research, it is necessary to conduct research on various sensory integration intervention methods and the high quality of the evidence for the application of sensory integration interventions.

A Development and Evaluation of Nursing KMS using QFD in Outpatient Departments (품질기능전개(Quality Function Deployment)를 활용한 외래 간호지식경영 시스템의 개발과 평가)

  • Lee, Han Na;Yun, Eun Kyoung
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.64-74
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    • 2014
  • Purpose: This study was done to develop and implement the Nursing KMS (knowledge management system) in order to improve knowledge sharing and creation among clinical nurses in outpatient departments. Methods: This study was a methodological research using the 'System Development Life Cycle': consisting of planning, analyzing, design, implementation, and evaluation. Quality Function Deployment (QFD) was applied to establish nurse requirements and to identify important design requirements. Participants were 32 nurses and for evaluation data were collected pre and post intervention at K Hospital in Seoul, a tertiary hospital with over 1,000 beds. Results: The Nursing KMS was built using a Linux-based operating system, Oracle DBMS, and Java 1.6 web programming tools. The system was implemented as a sub-system of the hospital information system. There was statistically significant differences in the sharing of knowledge but creating of knowledge was no statistically meaningful difference observed. In terms of satisfaction with the system, system efficiency ranked first followed by system convenience, information suitability and information usefulness. Conclusion: The results indicate that the use of Nursing KMS increases nurses' knowledge sharing and can contribute to increased quality of nursing knowledge and provide more opportunities for nurses to gain expertise from knowledge shared among nurses.

The Review on the Evidence-Based Study of Acupuncture - Systematic review and Meta-analysis - (침(鍼)의 근거중심적(根據中心的) 연구동향(硏究動向)에 관(關)한 고찰(考察) - Systematic review & Meta-analysis를 중심으로 -)

  • Back, Yong-Hyeon;Park, Dong-Seok;Kang, Sung-Keel
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.138-155
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    • 2002
  • Objective : The purpose of this study is to work on the problems and on the direction of the study regarding the evidence-based study of Acupuncture. Methods : We reviewed the PubMed electronic database. Eight articles of systematic review without meta-analysis and six articles without meta-analysis were selected. Results : In the study of eight articles of systematic review without meta-analysis, there were two articles on effectiveness of acupuncture and one on non-effectiveness of acupuncture. Four articles were about the changes according to the quality of randomized controlled trials. Also, one article was about the side-effect of acupuncture. In the study of six articles of systematic review with meta-analysis, there were two articles on Odds Ratio, two on Relative Risk, one on number-needed-to-treat, and two on 18 predefined methodological criteria. Conclusion : As the quality of RCTs was high, positive response decreased and as the quality of RCTs was low, positive response increased. For the study of evidence-based acupuncture, it is necessary that we conduct research on well-planned placebo acupuncture, large sample size, statistical method, method of searching and assessing literature and method of meta-analysis.

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Research on Geographic Variations in Health Services Utilization in the United States: A Critical Review and Implications (미국의 지역간 의료이용의 변이 연구: 비판적 검토와 함의)

  • Do, Young-Kyung
    • Health Policy and Management
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    • v.17 no.1
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    • pp.94-124
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    • 2007
  • This paper critically reviews three decades of research on geographic variations. in health services utilization in the United States, thereby drawing policy and research implications for Korea. The recent renewed interest in variations research in the United States, precipitated by studies on regional variations in Medicare expenditures, stems mainly from the policy implication that a substantial amount of Medicare expenditures could be saved without compromising quality and access. From the research perspective, this policy implication was made tenable by integrating micro- and macro-level analysis of variations in health services utilization. Still, theoretical limitations inherent in the research pose great challenges to developing effective strategies at the health system level. Variations research in the United States can serve as a case study as to how health services research has responded to efficiency and quality issues in an ever expanding health system Considering the current health policy and research environment in Korea, the following implications can be drawn. Variations research will help formulate a national policy agenda for health care quality and also advance the framework of approaches to health policy issues. For such purposes, both relevant descriptive and hypothesis-testing studies are needed. Further advancement in variations research will require interdisciplinary explorations and methodological sophistication. To the extent that Korean health policies will strive to achieve complex goals, variations research will increasingly prove to be useful.

Development of Evaluation Indicators for Integrated Home Care (통합가정방문급여 평가지표 개발)

  • Park, Jong Duk;Jung, Dukyoo
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.543-552
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    • 2014
  • Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

Methodological Development of Physical Environment Rating Scale for Interior Space of Child Care Facility (아동 보육시설 실내환경 평가 도구 개발)

  • 이수진
    • Korean Institute of Interior Design Journal
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    • no.33
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    • pp.27-35
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    • 2002
  • The qualify of preschool education is related to the qualify of the physical environment, This research is aiming to develop and validate the set of scales for the measurement of physical quality of the interior spaces in child care facilities. The research has been in three major phases: (1)the development of indicative sub-scales for the description, measurement and evaluation of the physical designed quality of early childhood environments (2)two rounds of iterative phases of reliability and validity testing of the scales through expert panels and observational field-testing and (3)implications for future research to be done. 13 sub-scales were developed, which are based on Moore's 15 design principal for child care environments. And each sub-scale includes several evaluation items based upon developmental theory, existing empirical literature, and Korean, Australian and American child care standards. This set of scales will (1)aid research on the effects of environmental variables on quality of child care facilities for infants, toddlers, and preschoolers; (2)permit evaluation of such environments to identify areas of needed improvement; and (3)provide information for policy makers, parents, administrators, and designers/architects.

A Meta-analysis of the Timed Up and Go test for Predicting Falls (낙상 위험 선별검사 Timed Up and Go test의 예측 타당도 메타분석)

  • Park, Seong-Hi;Lee, On-Seok
    • Quality Improvement in Health Care
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    • v.22 no.2
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    • pp.27-40
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    • 2016
  • Purpose: Globally, falls are a major public health problem. The study aimed to evaluate the predictive validity of the Timed Up and Go test (TUGT) as a screening tool for fall risk. Methods: An electronic search was performed Medline, EMBASE, CINAHL, Cochran Library, KoreaMed and the National Digital Science Library and other databases, using the following keywords: 'fall', 'fall risk assessment', 'fall screening', 'mobility scale', and 'risk assessment tool'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Thirteen studies were analyzed using meta-analysis with MetaDisc 1.4. Results: The selected 13 studies reporting predictive validity of TUGT of fall risks were meta-analyzed with a sample size of 1004 with high methodological quality. Overall predictive validity of TGUT was as follows. The pooled sensitivity 0.72 (95% confidence interval [CI]: 0.67-0.77), pooled specificity 0.58 (95% CI: 0.54-0.63) and sROC AUC was 0.75 respectively. Heterogeneity among studies was a moderate level in sensitivity. Conclusion: The TGUT's predictive validity for fall risk is at a moderate level. Although there is a limit to interpret the results for heterogeneity between the literature, TGUT is an appropriate tool to apply to all patients at a potential risk of accidental fall in a hospital or long-term care facility.

Review of Economic Evaluation Studies for Drug Reimbursement Decision (의약품 보험급여 결정을 위한 경제성평가 연구의 평가)

  • Choi Sang-Eun;Sullivan Sean D.
    • Health Policy and Management
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    • v.15 no.4
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    • pp.1-25
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    • 2005
  • Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

Chuna Manual Therapy for Pediatric Enuresis: A Systematic Review and Meta-analysis (소아 유뇨증에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석)

  • Kim, Gee-Heon;Lee, Nam-Woo;Shin, Byung-Cheul
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.12 no.2
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    • pp.15-29
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    • 2017
  • Objectives: To systematically review and evaluate the effectiveness of Chuna manual therapy (CMT) on Pediatric Enuresis. Methods: We searched 12 English, Chinese and Korean databases by using relevant search terms up to October 2017. Every randomized controlled trials (RCTs) of CMT for Pediatric Enuresis were considered for inclusion. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool. Results: Eleven RCTs with 1110 participants were included. The meta-analysis of 11 studies revealed that CMT had statistically significant effects for Pediatric Enuresis compared to other medications in terms of effective rate. Safety issues are minor. Conclusions: This systematic review suggests that CMT may have positive effects on Pediatric Enuresis and safe treatment as a non-pharmacological treatment, but evidence is limited. For a better quality review, more and high-quality RCTs with standardized interventions are needed to offer sufficient evidence on the effects of CMT for Pediatric Enuresis.

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Chuna Manual Therapy for Pediatric Functional Constipation : A Systematic Review (소아변비에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Park, In-Hwa;Park, Sun-Young;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.23-34
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    • 2018
  • Objectives : This review aims to evaluate the effects and the safety of Chuna manual therapy(CMT) for pediatric functional constipation. Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, RISS, KISS, NDSL, KMBASE, KISTI) and related 2 journals until October 2018. We included randomized controlled trials(RCTs) of testing CMT for pediatric functional constipation. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 16 RCTs were eligible in our inclusion criteria. The meta-analysis of 11 studies showed positive for use CMT for pediatric functional constipation. CMT significantly improved total efficancy rate compared with medications (P < 0.00001). Conclusions : There is evidence of CMT for pediatric functional constipation with meta-analysis. However, our systematic review has limited evidence to support CMT for pediatric functional constipation. because the quality of relevant trials is relatively poor. Further well-designed RCTs should be encouraged. the quality of relevant trials is relatively poor.