• 제목/요약/키워드: Recommendations (guidelines)

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A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Adapting Oral Health Care Guidelines for Nursing Home Residents in South Korea (요양시설노인을 위한 구강간호 임상실무지침 수용개작)

  • Park, Myung-Sook;Smi, Choi-Kwon;Han, Jung-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.18 no.1
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    • pp.1-10
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    • 2015
  • Purpose: This study attempted to adapt evidence-based oral health care guidelines for nursing home residents in South Korea. Methods: The manual for guideline adaptation, version 2.0, developed by the Korean National Evidence-based Healthcare Collaborating Agency was applied. On the basis of a comprehensive literature review of current research and multidisciplinary panel discussion on adapting such guidelines, we developed evidence- based guidelines for oral health at nursing homes. Results: The guidelines have three domains: oral assessment, oral hygiene care, and support and facilities. Oral assessment includes recommendations on the frequency of and tools for conducting oral health assessment. Oral hygiene care involves recommendations for care of natural teeth, denture care, xerostomia, and behavioral problems. Support and facilities refer to six components of the support system provided by facilities to encourage oral hygiene care among nursing home residents. Conclusion: These adapted guidelines could be an effective method to improve oral hygiene among nursing home residents.

Perception of Gastrointestinal Endoscopy Personnel on Society Recommendations on Personal Protective Equipment, Case Selection, and Scope Cleaning During Covid-19 Pandemic: An International Survey Study

  • Parit Mekaroonkamol;Kasenee Tiankanon;Rapat Pittayanon;Wiriyaporn Ridtitid;Fariha Shams;Ghias Un Nabi Tayyab;Julia Massaad;Saurabh Chawla;Stanley Khoo;Siriboon Attasaranya;Nonthalee Pausawasdi;Qiang Cai;Thawee Ratanachu-ek;Pradermchai Kongkham;Rungsun Rerknimitr
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.215-225
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    • 2022
  • Background/Aims: The Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them. Methods: A validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables. Results: Despite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039). Conclusions: Using appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

The changing of fitness and exercise guidelines for old adults (노인들의 체력 변화와 운동의 제언)

  • Yoon, Byung-Kon
    • Journal of Life Science
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    • v.17 no.6 s.86
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    • pp.867-872
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    • 2007
  • The aging is related to numerous changes in our body system which declines functional ability. The functional ability in advanced age can be evaluated by the 4 components of fitness (cardiorespiratory endurance, muscular strength and endurance, flexibility and body composition). The understanding and knowledge of changing 4 components of fitness and the role of exercise on the process of aging is of paramount importance. Despite exercise and physical activity have been shown to delay the process of aging, the exercise guidelines and recommendations for old adults are not well published. This review is to presents the age-related changes in each component of fitness and to present current guidelines and recommendations for exercise in older adults.

Developmental procedures for the clinical practice guidelines for conscious sedation in dentistry for the Korean Academy of Dental Sciences

  • An, So-Youn;Seo, Kwang-Suk;Kim, Seungoh;Kim, Jongbin;Lee, Deok-Won;Hwang, Kyung-Gyun;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.4
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    • pp.253-261
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    • 2016
  • Background: Evidence-based clinical practice guidelines (CPGs) are defined as "statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations." This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. Method: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs. Existing guidelines, relevant systematic reviews, policy documents, legislation, or other recommendations were reviewed and appraised. To supplement this information, key questions were formulated by the Guideline Development Group and used as the basis for designing systematic literature search strategies to identify literature that may address these questions. Guideline documents were evaluated through a review of domestic and international databases for the development of a renewing of existing conscious sedation guidelines for dentistry. Clinical practice guidelines were critically appraised for their methodologies using Appraisal of guidelines for research and evaluation (AGREE) II. Results: A total of 12 existing CPGs were included and 13 recommendations were made in a range of general, adult, and pediatric areas. Conclusion: The clinical practice guidelines for conscious sedation will be reviewed in 5 years' time for further updates to reflect significant changes in the field.

Development of Evidence-based Nursing Practice Guidelines for Febrile Children in Emergency Room (응급실 내원 발열 소아환자의 열관리를 위한 근거중심 간호실무 가이드라인 개발)

  • Jeong, Min-Jin;Shin, Hyun-A;Kim, Yun-Hee;Lee, Jee-Hyang;Lee, Seung-Ja;Song, Mi-Ra
    • Child Health Nursing Research
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    • v.18 no.4
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    • pp.214-221
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    • 2012
  • Purpose: The purpose of this study was to develop evidence-based nursing practice guidelines for the care of febrile children in the emergency room and to evaluate the guidelines by applying them to practice. Methods: This study was conducted using a methodological design. referring to the Scottish intercollegiate guideline network, draft of guidelines were developed based on the recommendations found from the critical literature analysis. Then, the draft was modified by an expert group and a pilot application. The final draft was evaluated by the expert group using appraisal of guidelines for research and evaluation. Finally, the final guideline and algorithm were completed. Results: The guideline includes 39 recommendations for the care of febrile children in the emergency room. Conclusion: The clinical guidelines developed through this research can be utilized as systematic and scientific guidelines for the care of febrile children in the emergency room. In addition, the research results will contribute to improving care services.

Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

  • Kim, Yeon Dong;Moon, Hyun Seog
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.254-264
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    • 2015
  • Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

Guideline for Prevention of Constipation in Korean Elderly - Local Adaptation of the $NGC^{TM}$ Guideline for Prevention of Constipation in the Old Adult Population - (한국 노인의 변비예방 지침 - $NGC^{TM}$ 노인의 변이예방 가이드라인을 변용한 -)

  • Park, Tae-Nam
    • Research in Community and Public Health Nursing
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    • v.17 no.3
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    • pp.315-325
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    • 2006
  • Purpose: The Purpose of this study was to build up guidelines for preventing constipation in the Korean elderly based on the National Guideline $Clearinghouse^{TM}$ Guideline. Method: The process is composed of four steps: first. the composition of an expert group; second, the evaluation by the expert group about the appropriateness and applicability of each recommendation in the guideline; third, systematic literature review for evidence searching; and fourth. the formation of guidelines for Preventing constipation in the Korean elderly according to experts' opinions and literature review. Result: The appropriateness and applicability of each recommendation showed high scores, but the score of applicability was lower than that of appropriateness. The reasons for lower score of applicability were lack of cognition on the importance of constipation management and lack of recent information and evidence-based knowledge on constipation. There were some inadequate recommendations in Korean clinical setting. So the modified and replaced recommendations were added to the guidelines for preventing constipation in the old adult population to improve the applicability in Korea. Conclusion: The results of this study can be used as fundamental baseline data for future study to develope guidelines for management of constipation in the elderly and will be adapted locally for Korean clinical setting.

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Development of an evidence-based clinical imaging diagnostic guideline for implant planning: Joint recommendations of the Korean Academy of Oral and Maxillofacial Radiology and National Evidence-based Healthcare Collaborating Agency

  • Kim, Min-Ji;Lee, Sam-Sun;Choi, Miyoung;Ha, Eun Ju;Lee, Chena;Kim, Jo-Eun;Heo, Min-Suk
    • Imaging Science in Dentistry
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    • v.50 no.1
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    • pp.45-52
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    • 2020
  • Purpose: This study was conducted to develop an evidence-based clinical imaging diagnostic guideline for implant planning, taking into account efficacy, benefits, and risks. Materials and Methods: The guideline development process employed the adaptation methodology used for Korean clinical imaging guidelines(K-CIG). Core databases(Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched for guidelines. The retrieved articles were analyzed by 2 reviewers, and articles were selected using well-established inclusion criteria. Results: The search identified 294 articles, of which 3 were selected as relevant guidelines. Based on those 3 guidelines, 3 recommendations for implant planning were derived. Conclusion: We recommend radiography or cone-beam computed tomography (CBCT) scanning for individual patients judged to require a cross-sectional image after reading of a panoramic X-ray image and a conventional intraoral radiological image. Various steps should be taken to raise awareness of these recommendations among clinicians and the public, and K-CIG should be regularly reviewed and revised.