• Title/Summary/Keyword: clinical practice guideline

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Evaluation of the Effect of Clinical Practice Guideline using Systematic Review (체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가)

  • Lee, Sun-Hee;Ha, Gwi-Yeom;Kim, Ju-Hye;Seo, Ju-Hyun;Kim, Hyun-Mi
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication (소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석)

  • Kim, Dong-Sook;Park, Choon-Seon;Jang, Sun-Mee
    • Korean Journal of Clinical Pharmacy
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    • v.18 no.2
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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.

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Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People (낙상위험요인 평가 및 낙상예방활동 임상진료지침)

  • Chun, Ja-Hae;Kim, Hyun-Ah;Kwak, Mi-Jeong;Kim, Hyuo-Sun;Park, Sun-Kyung;Kim, Moon-Sook;Choi, Ae-Lee;Hwang, Jee-In;Kim, Yoon-Sook
    • Quality Improvement in Health Care
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    • v.24 no.2
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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.

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.

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.

Korean Medicine Doctor's Perception in Korean Medicine Clinical Practice Guideline and Korean Medicine Cliniical Pathways (한의 표준임상진료지침 및 한의 표준임상경로에 대한 한의사의 인식)

  • Kim, Dongsu;Ahn, Hae In;Kwon, Soohyun;Ahn, Eunji;Kim, Namkwen
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.55-67
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    • 2022
  • Objectives : This study is aimed to survey Korean Medicine Doctors's perceptions in Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways for its spread(to increase utilization in clinical sites). Methods : The research population was set at 14,831 Korean medical institutions registered with the Health Insurance Review and Assessment Service for sampling representative of Korean Medicine Doctors, and the final 2,007 subjects were selected in consideration of the research period and budget. This survey was conducted based on a telephone survey, and in some cases, a fax or e-mail survey was also conducted together. Six questions were asked about the perception of 'Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways', and three questions about the characteristics of the respondent. Results : The rate of recognizing Korean Medicine Clinical Practice Guideline was 36.1%. Those who worked at Korean medicine hospitals, were under 39 years of age, and had less than 11-20 years of experience as an Korean medical doctor were more likely to be aware of it. Regarding the experience of using Korean Medicine Clinical Practice Guideline, the rate of 'not used in the past and not used now' was very high at 82.9%, but the intention to use it in the future was high at 60.7%. About the Korean Medicine Clinical Pathways, 79.9% of respondents answered that they did not know. 80.6% of respondents recognized the need for the development of clinical manuals such as Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways. Conclusion : Their low awareness of Korean Medicine Clinical Practice Guideline seems to affect its low utilization. Therefore, active education and public relations are required in the future.

Development of Clinical Practice Guideline for Hwabyung (1) - Purpose, Development Strategy and Procedure - (화병 임상진료지침 개발 연구 (1) - 목적과 개발 전략 및 절차 -)

  • Kim, Jong-Woo;Chung, Sun-Yong;Cho, Seung-Hun;Whang, Wei-Wan;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.143-152
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    • 2009
  • Objectives : Hwabyung is one of well-known mental health problems like depression in Korea and it's concept is generated from oriental medicine. We suggest that clinical practice guideline should reflect the Hwabyung's characteristics, clinical environment and Oriental medical doctor's need. Methods : We use the general development method of clinical practice guideline and also apply the oriental medicine's properties. Results : We need to refer to the western psychiatric field, especially the clinical guideline of depression. And we should base on the clinical survey and trial with the selected core subject considering oriental medicine's character. Conclusions : From this development, we expect the application of proper clinical decision by medical team, the objectification of oriental medicine, and the improvement of medical quality in the clinical field of oriental medicine.

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Clinical Practice Guideline on Prostate Cancer in Korean Medicine (전립선암 치료의 한방 임상 진료 지침)

  • Song, Bong-Keun;Lee, Eun-Jung;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.1-35
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    • 2016
  • Objectives : The aim of this preliminary study is to suggest a clinical approach on prostate cancer through the analysis of existing clinical practice guidelines or clinical studies. Materials and Methods : The data related on the treatment of prostate cancer were collected using various search engines such as Pub Med, KIOM OASIS, CNKI. Then, data were analyzed to evaluate the validity of recommendation of treatment. Results : Prostate cancer has the highest prevalence around the world. Recently, the incidence of prostate cancer in Korea is rapidly increasing. Especially, it was reported that incidence rate rose up to 80% by age 80 years. In recent studies, applying combined traditional and conventional medicine were reported to improve the survival, quality of life, immune function, and suppress of tumor growth in prostate cancer. However there has not been an objective and systemic clinical guideline for prostate cancer in Korean Medicine. Accordingly, it has been difficult for doctors to apply optimized therapeutic treatment in clinics. This study will show a preliminary approach to establish clinical practice guideline for prostate cancer of Korean Medicine. Conclusion : Further objective and systemic clinical studies by Korean Medicine are needed to develop more advanced clinical practice guidelines of prostate cancer.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Overview (소음인체질병증 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.1
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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.

Clinical Practice Guideline for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine: Overview (태음인·태양인체질병증 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.27 no.1
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    • pp.1-12
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    • 2015
  • Objectives This study was aimed to develop the clinical practice guideline for Taeeumin, Taeyangin symptomatology. This was the second clinical practice guideline, which focuses on symptomatology. 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 and Conclusions By researching and discussing the Taeeumin, Taeyangin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.