• 의학교육논단
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• 제18권3호
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• pp.145-149
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• 2016

Outcome-based learning is a global trend in medical education. The Korean Association of Medical Colleges (KAMC) has been developing learning objectives for basic medical education (BME) in Korea. In 2012, KAMC published the 1st edition of "Learning outcomes of basic medical education: Clinical competency-centered" in order to promote outcome-based medical education. KAMC has recently revised and updated the learning outcomes of basic medical education in the clinical competency-centered 2nd edition to reflect the suggestions of all medical schools in Korea and improve application of the published learning outcomes for BME in the field of medical education. KAMC has been making efforts to integrate clinical competency-centered learning outcomes with scientific concepts and principle-centered learning outcomes in addition to basic clinical skills and performance in BME.

• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.173-181
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• 2022

Background: Healing of the tendon itself is not always related to successful clinical outcomes after rotator cuff repair. It was hypothesized that certain radiologic factors affecting clinical outcomes could exist in case of the retear after arthroscopic rotator cuff repair (ARCR) and the radiologic factors could help predict clinical process. The purpose of this study was to identify the radiologic factors associated with clinical outcomes of the retear after ARCR. Methods: Between January 2012 and December 2019, among patients with sufficient footprint coverage for ARCR, 96 patients with Sugaya classification 4 or higher retear on follow-up magnetic resonance imaging were included. The association between clinical outcomes such as American Shoulder and Elbow Surgeons (ASES) score, Constant score and range of motion and radiologic variables such as initial tear dimension, retear dimension, variance of tear dimension, critical shoulder angle, acromial index, and acromiohumeral distance was analyzed. Results: Preoperatively, the ASES and Constant scores were 59.81±17.02 and 64.30±15.27, respectively. And at the last follow-up, they improved to 81.56±16.29 and 78.62±14.16, respectively (p<0.01 and p<0.01). In multiple linear regression analysis, the variance of the mediolateral dimension of tear had statistically significant association with the ASES and Constant scores (p<0.01 and p=0.01). Conclusions: In patients with the retear after ARCR, the variance in the mediolateral dimension of tear had significantly negative association with the clinical outcomes. This could be considered to be reference as relative criteria and needed more sample and mechanical study.

• 한국임상약학회지
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• 제29권3호
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

• Journal of Korean Neurosurgical Society
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• 제40권3호
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• pp.169-174
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• 2006

Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.

• Clinical and Experimental Reproductive Medicine
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• 제50권1호
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• pp.63-68
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• 2023

Objective: This study compared the outcomes of single blastocyst transfer cycles, using day- 5 poor-quality blastocysts and day-6 high-quality blastocysts. Methods: We analyzed 462 frozen-thawed embryo transfer (FET) cycles performed at our center from January 2014 to December 2019. The cycles were divided into two groups: a day-5 poor-quality blastocyst transfer group (group A) and a day-6 high-quality blastocyst transfer group (group B). The clinical outcomes were tested. Results: In groups A and B, respectively, the clinical pregnancy rate (CPR; 61.65% vs. 67.17%, p=0.258), implantation rate (IR; 61.65% vs. 67.17%, p=0.258), and live birth rate (LBR; 69.51% vs. 77.83%, p=0.134) showed no significant differences. Moreover, when day-3 embryo quality was considered, the CPR, IR, and LBR were also similar in group A and group B (p>0.05). Conclusion: The clinical outcomes of day-5 poor-quality blastocysts and day-6 high-quality blastocysts were similar, suggesting that the developmental speed of the embryo might be more important than embryo quality for the clinical outcomes of single blastocyst transfer in FET cycles.

• Journal of Korean Neurosurgical Society
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• 제47권2호
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• pp.95-101
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• 2010

Objective : Clinical, radiographic, and outcomes assessments, focusing on complications, were performed in patients who underwent pedicle subtraction osteotomy (PSO) to assess correction effectiveness, fusion stability, procedural safety, neurological outcomes, complication rates, and overall patient outcomes. Methods : We analyzed data obtained from 13 consecutive PSO-treated patients presenting with fixed sagittal imbalances from 1999 to 2006. A single spine surgeon performed all operations. The median follow-up period was 73 months (range 41-114 months). Events during peri operative course and complications were closely monitored and carefully reviewed. Radiographs were obtained and measurements were done before surgery, immediately after surgery, and at the most recent follow-up examinations. Clinical outcomes were assessed using the Oswestry Disability Index and subjective satisfaction evaluation. Results : Following surgery, lumbar lordosis increased from $-14.1^{\circ}{\pm}20.5^{\circ}$ to $-46.3^{\circ}{\pm}12.8^{\circ}$ (p<0.0001). and the C7 plumb line improved from $115{\pm}43\;mm$ to $32{\pm}38\;mm$ (p<0.0001). There were 16 surgery-related complications in 8 patients; 3 intraoperative, 3 perioperative, and 10 late-onset postoperative. The prevalence of proximal junctional kyphosis (PJK) was 23% (3 of 13 patients). However, clinical outcomes were not adversely affected by PJK. Intraoperative blood loss averaged 2,984 mL. The C7 plumb line values and postoperative complications were closely correlated with clinical results. Conclusion : Intraoperative or postoperative complications are relatively common following PSO. Most late-onset complications in PSO patients were related to PJK and instrumentation failure. Correcting the C7 plumb line value with minimal operative complications seemed to lead to better clinical results.

• 한국의료질향상학회지
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• 제5권1호
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• pp.152-165
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• 1998

Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

• Journal of Chest Surgery
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• 제56권6호
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• pp.435-444
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• 2023

Background: Edwards Intuity is recognized as a relatively contraindicated bioprosthesis for bicuspid aortic valve disease. This study compared the early echocardiographic and clinical outcomes of rapid-deployment aortic valve replacement for bicuspid versus tricuspid aortic valves. Methods: Of 278 patients who underwent rapid-deployment aortic valve replacement using Intuity at Seoul National University Hospital, 252 patients were enrolled after excluding those with pure aortic regurgitation, prosthetic valve failure, endocarditis, and quadricuspid valves. The bicuspid and tricuspid groups included 147 and 105 patients, respectively. Early outcomes and the incidence of paravalvular leak were compared between the groups. A subgroup analysis compared the outcomes for type 0 versus type 1 or 2 bicuspid valves. Results: The bicuspid group had more male and younger patients. Comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease, were less prevalent in the bicuspid group. Early echocardiographic evaluations demonstrated that the incidence of ≥mild paravalvular leak did not differ significantly between the groups (5.5% vs. 1.0% in the bicuspid vs. tricuspid groups, p=0.09), and the early clinical outcomes were also comparable between the groups. In the subgroup analysis between type 0 and type 1 or 2 bicuspid valves, the incidence of mild or greater paravalvular leak (2.4% vs. 6.7% in type 0 vs. type 1 or 2, p=0.34) and clinical outcomes were comparable. Conclusion: Rapid-deployment aortic valve replacement for bicuspid aortic valves demonstrated comparable early echocardiographic and clinical outcomes to those for tricuspid aortic valves, and the outcomes were also satisfactory for type 0 bicuspid aortic valves.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.218-218
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• 2009

The clinical outcomes of arthroscopic Intra-articular Repair for an Isolated Partial Articular-Surface Tear of the Subscapularis Tendon

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.10-17
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• 2014

Background: The aim of this study was to assess the clinical outcomes after treatment of proximal humeral fractures with locking plates, and to determine which factors influence the clinical and radiological outcomes. Methods: Fifty six patients who were treated with locking plates for proximal humeral fractures and had been followed for more than 1 year were enrolled in this study. We performed functional evaluation using the Constant score and analyzed radiographic results. The following factors that may potentially influence the clinical outcomes were assessed: age, gender, type of fracture, presence of medial metaphyseal comminution, bone mineral density, anatomical reduction, restoration of medial mechanical support, and postoperative complications. Results: The mean Constant score was 70.1 points at the final follow-up. Female gender, 4-part fractures, AO type-C fractures, and fractures with medial metaphyseal comminution were associated with a poor clinical outcome. On the other hand, restoration of medial mechanical support and accurate anatomical reduction had a positive influence on clinical outcomes. Postoperative complications resulted in 3 patients (intra-articular screw perforation: 1 patient, varus deformity with screw loosening: 1 patient, nonunion: 1 patient). Conclusions: When treating proximal humeral fractures with locking plate fixation, following factors: a female gender, Neer type 4-part fracture, AO type C fracture, and medial metaphyseal comminution are important risk factors that surgeons should take into consideration. Factors that contribute to better clinical outcomes of operative treatment for humeral fractures are accurate anatomical reduction and restoration of medial mechanical support.