• 제목/요약/키워드: Methodological improvement

검색결과 108건 처리시간 0.023초

비궤양성 소화불량에서 Helicobacter pylori 박멸치료후 증상개선에 대한 메타분석 (Meta Analysis of Symptom Improvement through Eradication of Helicobacter pylori in Patients with Non-ulcer Dyspepsia)

  • 엄상화;정귀원;신원창;조종래;손혜숙;배기택;김성준
    • Journal of Preventive Medicine and Public Health
    • /
    • 제32권4호
    • /
    • pp.427-434
    • /
    • 1999
  • Objectives: This study was conducted to determine, by reviewing the literature, whether treatment of Helicobacter pylori infection in patients with non-ulcer dyspepsia affects symptoms. Methods: We retrieved the literature using MEDLINE search, with nonulcer dyspepsia and Hericobacter pylori and treatment as key words, which were reported from 1984 to 1998, and manual literature search. The criteria for inclusion was as follows; 1) The paper should have confirmed nonulcer dyspepsia as case definition. 2) The paper should have peformed a randomized, blind trial. 3) Confirmation of Helicobacter pylori eradication should be done 4 weeks after treatment. 4) studies with no information on measurement of symptoms after treatment were not accepted. The percentage of patients with symptom improvement after eradication therapy for Helicobacter pylori infection was calculated. Cumulative odds ratio was compared by fixed effect model and random effect model as sensitivity and funnel plot was used to evaluate publication bias. Results: The overall effect size of symptom improvement was calculated by cumulative odds ratio. Cumulative odds ratio of random effect model was 4.16(95% CI: 1.55-11.19). Before integrating each effect sizes into common effect size, the homogeneity test was conducted and random effect model was selected(Cochran's Q=41.08 (d.f=10, p<0.001)). The heterogeneity across studies was evaluated and the different methodological aspects of studies led to differences between study results Conclusions: The results suggest that the eradication of Helicobacter pylori in patients with non-ulcer dyspepsia results more symptom improvement. In studios that shows the opposite results there are methodological aspects explaining the heterogeneity.

  • PDF

환경영향평가서 내 건강영향 항목 추가·평가의 방법론적 현황과 개선 (Methodological Status and Improvement of Additional Evaluation of Health Impact Items in Environmental Impact Assessment)

  • 하종식
    • 환경영향평가
    • /
    • 제29권6호
    • /
    • pp.453-466
    • /
    • 2020
  • 환경영향평가서 내 건강영향 항목 추가·평가는 특정 개발사업에 한하여 위생·공중보건 항목에 작성되어 검토되고 있다. 하지만 2011년 건강영향 항목 추가·평가 관련한 평가 매뉴얼이 발간된 이후에 부분적인 개선에도 불구하고 지속적인 방법론의 구체화 및 개선방안 마련을 요구하는 실정이다. 이에 본 기술논문은 평가 매뉴얼의 방법론적 개선방안을 제안하고자 위생·공중보건 항목의 협의의견을 바탕으로 세부적인 개선요구 사항을 파악하고 그간 연구내용을 고찰하여 이를 해결하기 위한 방안을 조사·제시하였다. 개선요구 사항으로는 저감방안, 사후관리, 영향예측, 평가, 현황조사 순서로 관련한 내용들이 전체 개발사업의 평가서에서 각각 93%, 85%, 80%, 74%, 67% 빈도로 제시되었다. 특히 저감방안 관련한 세부적인 개선요구 사항은 저감방안의 수립방향 설정과 금회 개발사업의 관리방안에 대한 내용이 대부분이었다. 현행 평가 매뉴얼 및 개선 요구사항의 빈도를 고려하여 위생·공중보건 항목의 구분별 주요 방법론에 대한 구체화 또는 개선방안을 제안하였다. 나아가 현행 평가 매뉴얼에는 제시되어 있지 않은 사업시행여부 관련한 종합적인 평가 방법론도 제안하였다.

소아과 질환에서 주양육자 대상의 질적연구 논문에 대한 COREQ (Consolidated Criteria for Reporting Qualitative Research) 가이드라인을 이용한 방법론적 질평가 (Methodological Assessment of Qualitative Research with Caregivers in Pediatric Disease by COREQ (Consolidated Criteria for Reporting Qualitative Research) Guideline)

  • 김혜진;전채헌;한예지;정문주;김현호;임정태
    • 대한한방소아과학회지
    • /
    • 제32권4호
    • /
    • pp.121-140
    • /
    • 2018
  • Objectives This research was aimed to analyze and assess the articles of qualitative research of Pediatrics by following Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods Two researchers analyzed and assessed the reports' quality and appropriateness based on COREQ guideline. The articles that failed to achieve consensus from the two researchers, the third researcher made a final decision. Results A total of fifty-six reports which used caregivers as participants, were selected and adopted qualitative research methods were chosen. In most qualitative studies, COREQ was not implemented. Some parts of the studies were poorly described and elaborated when reviewing them based on the COREQ guidelines. In the 'Research team and reflexivity', there was lack of description about the researcher. In the 'Study design', there were no detailed descriptions on the approaches they took in recruiting their study participants. There was not enough detail reflexivity participants who refused, and where the recruitment took place. There were also no records of whether there was a pilot test or a data saturation. In 'Analysis and findings' section, there were few articles mentioning Participant checking, and the main opinion of the participants were well analyzed in all the papers, but excluding opinions of few participants. Conclusions There are still many qualitative studies that have caregivers as participants, in the field of pediatrics. However, methodological skills are insufficient. The use of the COREQ guidelines should be further implemented for more robust and methodological improvement.

커뮤니티를 고려한 주거환경개선요소 설정 및 중요도 분석 (Importance Analysis and Establishment of Community-Based Residential Environment Improvement Items)

  • 김현진;구자훈;원제무
    • 한국주거학회논문집
    • /
    • 제20권6호
    • /
    • pp.127-134
    • /
    • 2009
  • This study initially analyzes the meaning of Community-Based Residential Environment Improvement. A residential environment improvement factor was determined through an analysis of the function, components, Planning techniques of the community, the evaluation criteria of the residential environment, and through relative literature documenting plans for the adjustment of urban and housing environments. In terms of the methodological approach, decisions were made based on the results of an expert focus-group-interview, a goodness-of-fit test, and by using the analytic network decision-making method from which the correlation among items can be considered. Results of this analysis show that the, order of importance of factors for a community-based residential environment is as follows: interactional character, cognitive character, and locational character. Furthermore, the most important aspect for each of these factors are the neighbor-hood relationship in terms of the interactional character, common consciousness for the cognitive character and place for locational character. The results of this study can be used by linking them with questionnaire items for basic resident research when a residential environment improvement project or a plan for the adjustment of urban and housing environments is planned.

Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob;Chorath, Kevin;Balar, Eesha;Xu, Katherine;Naik, Anusha;Moreira, Alvaro;Rajasekaran, Karthik
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제25권2호
    • /
    • pp.109-120
    • /
    • 2022
  • Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

수면장애에 대한 인지행동 치료 효과에 대한 체계적 문헌 고찰 개관 (Effectiveness of Cognitive Behavioral Therapy for Sleep Disorder: An overview of Systematic Review)

  • 이장원;여진주;김경식;현민경
    • 대한한의학회지
    • /
    • 제43권2호
    • /
    • pp.75-91
    • /
    • 2022
  • Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.

Development of Quality Management in the Republic of Kazakhstan

  • Jambul, Ainur;Dzhulayeva, Almazhan
    • Asian Journal of Business Environment
    • /
    • 제5권2호
    • /
    • pp.23-29
    • /
    • 2015
  • Purpose - This theoretical study develops practical recommendations for implementing a quality management system (QMS) in Kazakh organizations to ensure the effectiveness and safety of products and services. We discuss the improvement of Kazakhstan's quality standards based on the requirements of ISO 9000. Research design, data, and methodology - We provide methods for improving the quality standards system, ranging from research and development to the sale of products. We also propose to establish a special quality systems award to motivate enterprises toward product quality improvement. The study's methodological basis included Kazakhstan's legislative and regulatory Acts, and international and national standards defining QMS requirements for scientists worldwide to develop and implement a QMS for enterprises. Results - Aligning the QMS reduces Kazakh companies' costs for the detection and correction of defects, and the external and internal loss caused by the defects. Effective QMS also reduces management costs. Conclusion - This article can help increase the transparency of organizations for their leaders and (if necessary) the external environment, and improve the accuracy, quality, and timeliness of decision-making.

농촌 지역 보건소 일차의료의 질 평가 (Evaluating the Primary Care Quality of a Public Health Center in a Rural Area)

  • 변영관;최용준
    • 농촌의학ㆍ지역보건
    • /
    • 제42권1호
    • /
    • pp.24-35
    • /
    • 2017
  • 이 연구의 목적은 한국형 일차의료 평가 도구(KPCAT)를 이용하여 한 농촌 지역 보건소의 일차의료의 질을 평가하는 것이다. 또 이 연구에서는 KPCAT 적용 및 결과 해석과 관계된 몇 가지 방법론적 이슈를 검토하였다. 농촌 보건소 진료 의사에게 4회 이상 진료받은 환자 79명이 KPCAT 설문에 응답하였다. 응답자의 특성을 빈도와 백분율, 중앙값과 사분위 범위, 평균과 표준 편차로 제시하였다. 일차의료의 질은 KPCAT 총점과 영역별 점수의 중앙값과 사분위 범위로 제시하였고 최댓값과 최솟값, 기대 점수와 함께 방사형 도표로 제시하였다. KPCAT 문항별 점수와 중앙값과 사분위 범위, 기대 점수 이상 응답자 비율, 잘 모름 응답자 비율을 제시하였다. 연구 대상 농촌 지역 보건소 일차의료 질의 중앙값과 사분위 범위는 각각 45점, 16점이었다. KPCAT 영역별 점수 중앙값이 기대 점수에 이른 영역은 최초 접촉 하나였다. KPCAT 문항별 점수가 기대 점수 이상인 응답자 비율이 50% 미만인 문항은 포괄성 4문항 중 2개, 조정 기능 3문항 전부, 전인적 의료 5문항 중 2개, 가족 및 지역 사회 지향성 4문항 전부였다. 잘 모름 응답의 처리 방침 개선, 잘 모름 응답률이 높은 문항의 타당성 검토, 응답 척도의 내용과 점수의 일치 등이 방법론적 개선 과제였다. 농촌 지역 보건소 일차의료의 질은 개선할 여지가 많았다. 특히 조정 기능과 가족 및 지역 사회 지향성 영역의 개선 필요성이 두드러졌다. KPCAT의 방법론적 개선을 통하여 타당하고 신뢰성 있는 일차의료 평가가 이루어지기를 기대한다.