• Title/Summary/Keyword: Practice of medicine

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Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care (한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해)

  • Park, Yong-Sin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

A Preliminary Study for the Development of Clinical Practice Guidelines of Korean Medicine for Bladder Cancer (방광암(膀胱癌)의 한의학적 진료지침 개발을 위한 기초 연구)

  • Park, Tae-yeol;Yoo, Hwa-seong;Lee, Sang-hun
    • The Journal of Internal Korean Medicine
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    • v.37 no.6
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    • pp.911-928
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    • 2016
  • Objectives: This study presents Korean medicine clinical practice guidelines for bladder cancer, of which the 5-year survival rate has still been about 75% since the 1990s despite the rapid development of medical science. Methods: A consensus was reached by an expert committee composed of professors and researchers who specialize in Korean medicine on the basis of a literature review that included other countries' clinical guidelines and a textbook. Results: Traditional Chinese medicine clinical practice guidelines were published for the first time in 2014. In Korea, the medical system is different from China in that Korea has completely dualized Korean and Western medicine and a low availability of proprietary herbal medicines. Therefore, these Korean medicine clinical practice guidelines for treating bladder cancer based on the previously published guidelines of Chinese medicine will help first-line Korean medicine doctors. Conclusions: Further studies related to Korean medicine are necessary to develop more advanced Korean medicine clinical practice guidelines for treating bladder cancer.

Clinical Practice Guideline for Sasang Constitutional Medicine: The Examination of Sasangin Disease and Diagnosis for Sasang Constitution (사상체질병증 임상진료지침: 사상체질병증 검사 및 체질진단)

  • Kim, Sang-Hyuk;Lee, Siwoo;Lee, Jun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.110-124
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    • 2015
  • Objectives This study was purposed to develop the clinical practice guideline for examination of Sasangin disease and diagnosis for Sasang Constitution. Methods "Donguisusebowon" and many articles were reviewed and examined for developing clinical practice guidelines. And "Guideline for Educating Public Health Korean Medical Doctors on Diagnosis of Sasang Constitution" was basically used to develop clinical guidelines. Results & Conclusions By researching and discussing the examination of Sasangin disease and diagnosis for Sasang Constitution, we make the principle of the clinical practice guideline, including methods using body shape, facial shape, vocal characteristic and personality etc.

Medical Practice and the Fundamental Rights: Approaching by Constitutional Interpretation (의료행위와 기본권: 헌법 해석적 접근)

  • Chang, Cheoljoon
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.11-34
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    • 2014
  • Promulgation of the medical practice rule without specific definition in Medical Law has brought about many constitutional issues. The major issue is that the law has the government punish unlicensed medical practice without defining what it is. Instead, the law chooses a license-centered structure of criminal punishment for medical malpractice, saying "no one can practice medicine without the government-approved license." This regulation violates the rule of "void for vagueness" based on the principle of "nulla poena nullum crimen sine lege." Judicial interpretation should be required for a citizen to understand the Medical Law provision intuitively. In addition, the law infringes upon the freedom of occupation of the unlicensed and the licensed who wish to extend his or her practice area for "holistic medicine." The central issue of the law is that it was established under no ground of professionalism even though medical practice has been understood professional. The government has centrally controlled the medical field for its needs. Lastly, the current law violates the right of medical selection of the consumers of medicine. Because patients have the right of health and life, they have to hold the latitude of selection for medical treatments. Especially, they should have an opportunity for considering the Complementary and Alternative Medicine if they want. But under the current rules, this medicine is not permitted. To correct those problems, a new provision for the definition of medical practice should be adopted at once.

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A Review of Korean Medicine for Clinical Practice Guidelines for Cervical Cancer (자궁경부암의 한의학적 진료에 대한 고찰)

  • Jung, Hyun-Jung;Yoo, Hwa-seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.1
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    • pp.1-14
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    • 2016
  • The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass screening program. Cervical cancer prognosis is good due to an effective treatment such as surgery or radiation therapy, concurrent chemotherapy in the early stage. However, it is still a poor prognosis when advanced stage or recurrent. Some studies said that combined oriental and western medicine can improve the survival, quality of life, immune function, and decrease side effects in cervical cancer. In the western medical part, clinical practice guideline was published in 2006, 2007 and 2010 in Korea. In China, oriental medicine clinical practice guideline have been published in 2014. But there is no Korean medicine clinical practice guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for cervical cancer in Korea, and existing Korean medicine clinical practice guideline for Disease Analysis and Treatment (辨證論治). This study will be a meaningful study to establish clinical practice guidelines of Korean Medicine for cervical cancer.

Study for Clinicians' Perception on the Acupuncture Research and Ways to Symbiosis between Basic Research and Clinical Practice (침 연구에 대한 한의사의 인식과 연구방향에 대한 조사)

  • Kim, Song-Yi;Chae, Youn-Byoung;Lee, Hyang-Sook;Ko, Yu-Mi;Lee, Hye-Jung;Park, Hi-Joon
    • Korean Journal of Acupuncture
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    • v.29 no.2
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    • pp.224-238
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    • 2012
  • Objectives : From mechanism studies using animal models to high-level evidence based research such as randomized controlled trials or systematic reviews, various acupuncture studies have been performed. Nevertheless, the current research appears insufficient to satisfy clinicians' needs. We aimed at investigating clinicians' perception on the translational research and suggesting ways of symbiosis between basic research and clinical practice. Methods : Data were collected using a web-based questionnaire made available to Korean medicine doctors who were informed through social networking service or e-mail. The survey participants indicated their awareness of acupuncture research and their thoughts on the applicability of research in practice. Results : Forty-seven clinicians completed the survey. While most respondents agreed that acupuncture research is very important, only 40% of them answered that the results of acupuncture research are useful to their own practice. In more than half of those who responded to the survey, the current acupuncture research is not viewed as reflecting clinical practice very much. Respondents agreed that acupuncture research should be based on clinical practice, and they recognized the need to collect valid clinical data from real-world practice. Also, as many as 77% of clinicians had no scruple to participate in research programs. Conclusions : There is no doubt among practitioners that acupuncture research is necessary. More importantly, practice-based research remains essential in order to feed-back research outcomes to clinical practice. Communications and academic exchanges between clinicians and researchers can mutually benefit research and practice with better information, resulting in symbiosis.

A Preliminary Study for Development of Clinical Practice Guidelines of Korean Medicine in Breast Cancer (유방암 치료에 대한 한의 임상 가이드라인 개발을 위한 기초연구)

  • Lee, Kang-Wook;Yoo, Hwa-Seung;Lee, Jin-Sun;Lee, Nam-Hun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.2
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    • pp.47-66
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    • 2016
  • Objectives : The purpose of this study was to present the clinical practice guidelines for breast cancer through the analysis of existing clinical practice guidelines in Western and Chinese medicine. Methods : The literature search was performed regarding conventional and integrative medical treatment of breast cancer using Google Scholar, KIOM OASIS, PUBMED and Jisan library of Daejeon university. Results : Breast cancer is the fifth most common cancer in Korea. Recent studies revealed that combining conventional and integrative medical treatment can reduce the sequela of surgical operation and improve survival rate. However there isn’t still a systemic clinical guideline for breast cancer in korean medicine. This study will be a preliminary study to establish clinical practice guidelines of Korean Medicine for breast cancer.Conclusions : Further objective and systemic clinical studies related to Korean Medicine are needed to develope more advanced clinical practice guidelines of breast cancer.

Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Overview (소양인체질병증 임상진료지침: 총론)

  • Lee, Eui-Ju;Koh, Byung-Hee;Kim, Dal-Rae;Kim, Jong-Yeol;Kim, Jong-Won;Park, Seong-Sik;Song, Il-Byung;Song, Jeong-Mo;Ahn, Taek-Won;Jang, Hyun-Jin;Cho, Hwang-Sung
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.213-223
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    • 2014
  • Objectives This study was aimed to develop the clinical practice guideline for Soyangin symptomatology. It discussed the principle and method of application of clinical practice guideline for Soyangin symptomatology which focuses on symptomatology, not disease. Methods Based on the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Member of writing committee reviewed and examined "Donguisusebowon" and many articles for developing clinical practice guidelines. Draft of clinical practice guideline was reviewed by advisory committee and approved by Society of Sasang Constitutional Medicine. Results & Conclusions By researching and discussing the Soyangin symptomatology, we establish the evaluation criteria for diagnosis including classification, definition and develop diagnostic algorithm and treatment assessing tool.

A Study on the System of Collaborative Practice between Korean Traditional Medicine and Western Medicine for Dementia based on a Case Study (증례를 통해 본 치매의 한양방 협진 모델 연구)

  • Lee, Go-Eun;Yang, Hyun Duk;Jeon, Won Kyung;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.3
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    • pp.211-228
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    • 2013
  • Objectives : This report describes the diagnostic and therapeutic procedures of Collaborative Practice between Korean Traditional Medicine and Western Medicine for two dementia patients. Furthermore, through these cases, we suggest a model of collaborative practice between Korean traditional medicine and western medicine for the treatment of dementia. Methods : Two patients suffering from several symptoms related to dementia received collaborative practice between Korean traditional medicine and western medicine. Physicians of deparment which paient first visit interviewed patient and patient's guardians, discussed the symptoms and the status of the patient. Since then, the medical team made a differential diagnosis based on the results of brain imaging, hematology, urine test. and apprehended the status of dementia by the neuropsychological test. Korean traditional physicians examined the physical symptoms and identified the pattern of dementia in Korean traditional medicine. Following this, they decided on the method of acupuncture, moxibustion, cupping and herbal treatment. Western physicians decided on the type of medication after consideration of the patient's other medical conditions. Every intervention was decided by both Korean traditional physicians and western physicians after discussion. The medical team provided education on dementia and counseled the guardians. They also wrote the paper for using the long-term care insurance for the aged. Results : Two patients showed no improvement on the neuropsychologic and activity of daily living tests. However, the patients' subjective physical symptoms were improved. The collaborative practice between Korean traditional medicine and western medicine improved the patients' and guardians' satisfaction. Conclusions : Through these cases, we propose a model of collaborative practice between Korean traditional medicine and western medicine for dementia categorized diagnosis-test, treatment, prevention, management. More specifically, we supplement qigong and psychotherapy which was inadequate in these cases.