• Title/Summary/Keyword: clinical practice guideline

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A Prioritizing for the Evidence-Based Nursing Practice Guidelines Development (국내 근거기반 임상간호실무지침 주제의 우선순위 결정)

  • Gu, Mee Ock;Cho, Myoung Sook;Cho, Yong Ae;Jeong, Jae Sim;Eun, Young;Jeong, Ihn Sook;Park, Jeong Sook;Kim, Hea Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.39-51
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    • 2012
  • Purpose: Thisstudy was conducted with an aim to get a kind of prioritiesin developing the evidence-based nursing practice guidelines in fields. Methods: This study utilized a two-round Delphi surveys from November to December, 2010 with self-administered questionnaires which had a scale ranged from 0 to 9. A total of 95 head nurses working at the forty different general hospitals was asked to evaluate the priorities in four criteria; patient coverage, certainty, improvement in patient outcome and in nursing practice (first round) and 65 head nurses were asked to decide the importance of the criteria afterwards (second round). Results: The relative importance of 4 criteria was 22.3% in patient coverage, 26.5% in certainty, 23.5% in improvement of patient outcome, and 27.7% in improvement of nursing practice as the results of the 1st round and 20.6%, 26.6%, 24.8%, and 28.0% for the 2nd round, respectively. Top five nursing practices showed high scores after considering the relative importances of the 4 criteria were medication, intravenous therapy, checking vital sign, pain management, and diagnostic test or procedures care. Conclusion: It is recommended to take into account of the priorities that were found in this study when someone intends to develop a evidence-based nursing practice guideline.

Appraisal of Guidelines for Research & Evaluation II Appraisal of Clinical Practice Guidelines for Traffic Injuries (Appraisal of Guidelines for Research & Evaluation (AGREE) II를 이용한 교통사고 상해증후군의 국내·외 기개발 임상진료지침의 평가)

  • Park, Kyeong-Won;Lee, Jun-Seok;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.129-143
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    • 2021
  • Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guideline for Growth Disorders (성장장애 한의표준임상진료지침 개발을 위한 한의사 인식조사)

  • Ahn, Hye Ri;Sim, Soo bo;Lee, Hye Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.1-15
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    • 2021
  • Objectives The purpose of this study is to provide data for development of the korean medicine (KM) clinical practice guidelines (CPG) for growth disorder (GD) by identifying the awareness and knowledge needs of KM doctors (KMD) through online survey. Methods Survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed 18 questions regarding the current status of clinical care for GD, clinician's knowledge level about GD, and other details that clinicians use during practice. The survey was conducted from January 2021 to March 2021. An online survey was conducted on 101 KMDs from the association of pediatrics of KM. Results According to the survey, 96 respondents (40.3%) said the causation of GD without growth hormone deficiency needs to be included in CPG. 96 (23.5%) of the respondents wishes to utilize percentile in diagnosis and evaluation of the growth assessment. 24.7% of the clinicians were using the herbal medicine treatment. Currently, when treating with KM for GD, herbal medicine (100%) is the most widely used, followed by acupuncture (77.6%), and moxibustion (36.7%). In terms of a complex treatment, growth therapy efficacy (26.8%) is shown to be the most important factor to consider and needed to be included in CPG for the complex treatment, and diet (22.3%) is also considered to be important in GD. Conclusions In this study, we were able to understand the clinical KMDs' perception of GD, knowledge level, and the requirements in the CPG. The results of this study will provide the basic data for development of CPG for GD.

A Survey on Korean Medicine Doctors' Recognition for Developing Korean Medicine Clinical Practice Guidelines for Gastric Cancer (위암 한의표준임상진료지침 개발을 위한 한의사 인식조사)

  • Dong-hyeon Kim;Jong-hee Kim;Ji-hye Park;Hwa-seung Yoo;So-jung Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.466-484
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    • 2023
  • Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

Clinical practice recommendations for Bangpungtongseong-san (Bofutsusho-san) and Bangkihwangki-tang(Boiogito) in obesity (비만치료 및 체중 감량에서 방풍통성산과 방기황기탕 사용에 대한 임상 권고안)

  • Park, Jung-Hyun;Kim, Ho-Jun
    • Journal of Korean Medicine for Obesity Research
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    • v.12 no.1
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    • pp.48-58
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    • 2012
  • Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.

Basic Principles of the Validation for Good Laboratory Practice Institutes

  • Cho, Kyu-Hyuk;Kim, Jin-Sung;Jeon, Man-Soo;Lee, Kyu-Hong;Chung, Moon-Koo;Song, Chang-Woo
    • Toxicological Research
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    • v.25 no.1
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    • pp.1-8
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    • 2009
  • Validation specifies and coordinates all relevant activities to ensure compliance with good laboratory practices (GLP) according to suitable international standards. This includes validation activities of past, present and future for the best possible actions to ensure the integrity of non-clinical laboratory data. Recently, validation has become increasingly important, not only in good manufacturing practice (GMP) institutions but also in GLP facilities. In accordance with the guideline for GLP regulations, all equipments used to generate, measure, or assess data should undergo validation to ensure that this equipment is of appropriate design and capacity and that it will consistently function as intended. Therefore, the implantation of validation processes is considered to be an essential step in a global institution. This review describes the procedures and documentations required for validation of GLP. It introduces basic elements such as the validation master plan, risk assessment, gap analysis, design qualification, installation qualification, operational qualification, performance qualification, calibration, traceability, and revalidation.

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
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    • v.25 no.2
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    • pp.109-120
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    • 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.

Utilization of Psychological Tools for Critical Pathway Based Mental Evaluation and Diagnosis (CP 기반 정신 평가 및 진단을 위한 심리검사의 활용)

  • Sunggyu, Hong;Hyun Woo, Lee;Sun-Yong, Chung;Jong-Woo, Kim
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.4
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    • pp.377-388
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    • 2022
  • Objectives: For diagnosis and evaluation, evaluation tools are needed. Various tools can be used to diagnose and evaluate mental disorders. Among them, psychological tests are widely used. For Korean Standard Classification of Diseases (KCD) diagnosis, psychological tests are also required. Currently developed critical pathway (CP) presented tools for diagnosis and evaluation of mental disorders. The CP suggests the use of tools based on the Clinical Practice Guideline (CPG). Therefore, CPG-based tools should be able to be used in the clinical scene of Korean Medicine for diagnosing and evaluating mental disorders according to CP. Methods: Tools suggested by CPs are summarized. The degree of utilization of tools in CPGs is also summarized. A review was conducted by Korean Medicine neuropsychiatrist experts on tools and user's usage plan. Results: As a result, developed CPs suggested using 19 tools for anxiety disorder, 13 tools for insomnia), 12 tools for Hwabyeong, and 9 tools for dementia. In CPG, 48, 34, 44, and 44 tools were used for anxiety disorder, insomnia, Hwabyeong, and dementia, respectively. Among tools presented in CP, HAM-A, HAM-D, CGI, SAS, and TESS for anxiety disorder, CPG, ISI, and PSQI for insomnia disorder, CPG, STAI, and STAXI for Hwabyeong were frequently used in CPG. For dementia CPG, MoCA, MMSE, HDS, ADL, and ADAS-cog were frequently used. Among them, MoCA, ADL, and ADAS-cog were suggested tools in CP. Conclusions: As a result of analyzing tools suggested and used in the developed CPs and CPGs, it was verified that various tools were used in each study. Most of them were symptom and behavioral evaluation scales. Therefore, symptoms and behavior evaluation scales used more frequently should be able to be used in the clinical scene of Korean Medicine.

Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

  • Se-Eun Kim;Byung-Su Yoo
    • Korean Circulation Journal
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    • v.53 no.5
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    • pp.294-312
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    • 2023
  • Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology

  • Soon Ho Yoon;Sang Min Lee;Chul Hwan Park;Jong Hyuk Lee;Hyungjin Kim;Kum Ju Chae;Kwang Nam Jin;Kyung Hee Lee;Jung Im Kim;Jung Hee Hong;Eui Jin Hwang;Heekyung Kim;Young Joo Suh;Samina Park;Young Sik Park;Dong-Wan Kim;Miyoung Choi;Chang Min Park
    • Korean Journal of Radiology
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    • v.22 no.2
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    • pp.263-280
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    • 2021
  • Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.