• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 한국임상약학회지
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• 제18권2호
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• pp.124-131
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• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• 임상간호연구
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• 제21권2호
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• pp.196-206
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• 2015

Purpose: This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

• Tuberculosis and Respiratory Diseases
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• 제80권3호
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• pp.230-240
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• 2017

Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients both domestically and globally. The Korean clinical practice guideline for COPD was revised in 2014. It was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases, as well as participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. This revised guideline covers a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We drafted a guideline on COPD management by performing systematic reviews on the topic of management with the help of a meta-analysis expert. We expect this guideline will be helpful medical doctors treating patients with respiratory conditions, other health care professionals, and government personnel in South Korea.

• 한방안이비인후피부과학회지
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• 제25권2호
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• pp.38-48
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• 2012

Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

• 동의신경정신과학회지
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• 제24권spc1호
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• pp.23-36
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• 2013

Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

• 대한한방내과학회지
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• 제40권1호
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• pp.89-116
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• 2019

Objective: This study aimed to ascertain what should be considered in the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer," by analyzing existing guidelines and clinical trials. Methods: Committee for the development of a guideline, consisting of 6 Korean medicine doctors, reviewed guidelines and clinical trials on using herbal medicine for treating liver cancer. The trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparators, outcomes, and trial design. We then compared the results of our analysis with the guidelines to identify issues we must to consider when following the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer." Several guidelines for antitumor agents and clinical trials on herbal medicine were obtained from the Ministry of Food and Drug Safety homepage, etc. The search terms were as follows: "liver neoplasms"; "herbal medicine"; "medicine, Korean traditional"; and "medicine, Chinese Traditional.". Results: Ten articles were obtained from pubmed and Embase. There was no guideline for clinical trials on using herbal medicine for treating liver cancer. All the participants in the reviewed articles had primary liver cancer, and the type of intervention varied (e.g., decoction, patches, and capsules. The comparators included placebos and conventional treatments such as chemotherapy. The outcome assessment methods were tumor response, quality of life, survival, and liver function tests. Adverse events occuring during the trial were also evaluated. Conclusion: Findings were derived by reviewing existing guidelines and comparing them with clinical trials on liver cancer and herbal medicinal products. These results will be utilized in the development of the "Guideline for Clinical Trials with Herbal Medicinal Products for Liver Cancer."

• 대한한의학회지
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• 제40권3호
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• pp.59-75
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• 2019

Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

• 임상간호연구
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• 제26권2호
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• pp.154-163
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• 2020

Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.

• 사상체질의학회지
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• 제26권1호
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• pp.1-10
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• 2014

Objectives This study was aimed to develop the clinical practice guideline for Soeumin symptomatology. This was the first clinical practice guideline, which focuses on symptomatology, not disease. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among 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. Results & Conclusions By researching and discussing the Soeumin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.