• 제목/요약/키워드: clinical practice guidelines

검색결과 428건 처리시간 0.035초

The Value and Limitations of Guidelines, Expert Consensus, and Registries on the Management of Patients with Thoracic Aortic Disease

  • Pacini, Davide;Murana, Giacomo;Leone, Alessandro;Marco, Luca Di;Pantaleo, Antonio
    • Journal of Chest Surgery
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    • 제49권6호
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    • pp.413-420
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    • 2016
  • Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

뇌졸중 작업치료 지침의 질 평가 (Quality Evaluation of the Occupational Therapy Guidelines for Stroke)

  • 이은영;한대성;박지혁
    • 재활치료과학
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    • 제10권3호
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    • pp.57-69
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    • 2021
  • 목적 : 본 연구는 임상지침 중 뇌졸중 환자의 작업치료를 다룬 지침을 확인하고, 확인된 지침들의 질과 특성에 대해 알아보고자 하였다. 연구방법 : 본 연구는 2008년부터 2019년까지 국내·외의 재활 치료 지침을 살펴보았으며, 검색어는 'stroke', 'guideline', 'practice guideline', 'recommendation', 'protocol compliance', 'practice guideline', '뇌졸중 가이드라인', '뇌졸중 지침' 등으로 하였다. 결과 : 검색을 통해 총 708편의 논문이 검색되었고, 자료 선정 기준에 부합한 지침 8편을 최종적으로 선정하였다. 선정된 논문은 캐나다, 미국, 영국, 한국, 호주 등에서 개발한 지침이었으며. 8개의 지침 중 1개는 작업치료 지침이었고, 나머지 7개는 재활치료 지침이었다. 지침에서 다룬 내용을 총 36개의 주제로 분류하였으며, 이 중 호주 뇌졸중 재활치료 지침은 28개, 영국과 미국심장협회(AHA)의 지침은 24개, 한국에서 개발한 뇌졸중 재활치료 지침은 23개 등의 내용을 포함하고 있었다. 결론 : 본 연구에서는 기존의 뇌졸중 환자를 위한 작업치료 지침을 확인하고, 지침들의 질과 특성을 비교해 보았다. 이는 추후 뇌졸중 작업치료 지침 개발을 위한 중요한 기초자료가 될 수 있을 것으로 사료된다.

수술환자의 심부정맥혈전증 예방 지침 수용개작 (Development of the Prevention Guideline of Deep Vein Thrombosis in Patients with Surgery according to the Guideline Adaptation Process)

  • 윤지현;이인선;이경윤;장미자;이정민;남민선;박지현;황지원;송현주;조용애;권인각;김미영
    • 임상간호연구
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    • 제20권3호
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    • pp.337-347
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    • 2014
  • Purpose: Deep Vein Thrombosis (DVT) is the cause of fatal diseases such as pulmonary embolism, due to a prolonged immobility, surgery, paralysis, and injuries. This study aimed to develop an evidence-based practice guideline for DVT prevention and apply it to patients with surgery in diverse nursing sites in South Korea. Methods: A 24-staged processes of adaptation was carried out on the basis of "adaptation of nursing practical guidelines" developed by Gu et al., in 2012. Results: Developed nursing guidelines of DVT prevention are composed of 79 recommendations in 8 domains. The extent and ratings of each recommendation with its evidence were addressed along with the background information. Conclusion: The developed DVT prevention guideline is necessary to be added to the evidence-based practice guidelines for the fundamentals of nursing practice. The developed guideline is needed to be disseminated to diverse nursing clinical settings in order to prevent DVT and enhance the quality nursing care.

교통사고 상해증후군의 한의 임상진료 현황조사를 위한 웹기반 설문조사 (A Web-based Survey on Clinical Practice Patterns of Korean Medicine Treatment for Traffic Injuries)

  • 박인화;황의형;황만석;허인;김병준;임경태;신병철
    • 한방재활의학과학회지
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    • 제27권4호
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    • pp.131-145
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    • 2017
  • Objectives The purpose of this study is to understand current status of Korean Medicine treatment practice patterns for traffic injuries by web-based survey. Methods The structured questionnaire was distributed by a web based survey to 1,630 potential respondents by email from December 19th in 2016 to February 13th in 2017. All data were statistically analysed. Results The response rate was 79.4%. According to the analysis of the outcome of the survey, 88.0% of the participants felt necessity of the development of Korean medicine clinical practice guidelines (CPGs) for traffic injuries. Survey results showed cognitive degree about Korean Medicine CPGs' necessity, individual Korean medicine treatments and requirement for extending insurance coverage for patients with traffic injuries. Conclusions This survey study helps to determine current clinical practice patterns of Korea medicine treatments for traffic injuries. These results further anticipate to provide basic data for CPGs for traffic injuries.

Development of Evaluation Items for Physical Therapy Clinical Practice

  • Seung-Hwa Jung;Joo-hee An;Seul-Ki Han;Dae-Sung Park;Cheong Hoon Kim
    • Physical Therapy Rehabilitation Science
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    • 제13권1호
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    • pp.71-77
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    • 2024
  • Objective: The purpose of this study is to present practice guidelines on what physical therapy students must learn during clinical training and how to evaluate them. Design: Design & development research Methods: A Delphi survey was conducted with 16 experts. Experts who participated in the study were asked to respond to 15 musculoskeletal system, 14 nervous system, and 12 physical factor therapy items through an online survey with a 5-point Likert score for each item regarding suitability and importance. Results: As a result of defining the core basic physical therapy skills that students in the Department of Physical Therapy must learn through clinical practice and in the process of evaluating them, there was a strong opinion that among the specific fields of physical therapy, evaluation items related to the musculoskeletal system, nervous system, and cardiorespiratory system were important. On the contrary, physical factor therapy showed poor results. Conclusions: In a previous study, opinions on the specialty of physical therapists were collected from current physical therapists, and the field of physical factor therapy was evaluated low. I think this reflects the perception that treatment using electricity has been commonly used in the field of physical therapy for a long time and does not require deep expertise among clinicians. Physical therapy clinical practice guidelines and efficient operation plans for clinical practice were presented. Through this, it can be usefully applied in hospitals where physical therapy students undergo clinical training in the future.

손목터널증후군의 한의 임상 진료 현황 조사를 위한 온라인 설문조사 (Clinical Practice Patterns for Carpal Tunnel Syndrome in Korean Medicine: An Online Survey)

  • 이상현;박혜진;김현태;박선영;허인;황만석;신병철;황의형
    • 척추신경추나의학회지
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    • 제16권1호
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    • pp.73-89
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    • 2021
  • Objectives We conducted an online survey to understand the current status of Korean Medicine clinical practice related to carpal tunnel syndrome (CTS) to develop the CTS Korean Medicine Clinical Practice Guidelines (CPG). Methods A thoroughly reviewed questionnaire was distributed by e-mail to 21,719 Korean Medicine doctors between March 26 and April 30, 2021. All raw data were arranged and analyzed systematically. Results The response rate among the doctors was 4%. Of the respondents, 82.1% responded that it is necessary to develop the CTS Korean Medicine CPG. We also obtained data related to the specific diagnosis, treatment, and prognosis management methods used at various treatment sites for patients with CTS. Conclusions This online survey will be helpful in developing the CTS CPG, which will contribute to the standardization of guidelines and improvements in the reliability of Korean Medicine. Our findings will provide valuable data and resources for future clinical studies on CTS.

아토피피부염의 한의학 진료 지침 개발을 위한 사전 연구 (A study on the Development of Traditional Korean Medicine Clinical Practice Guideline for Atopic Dermatitis)

  • 윤영희;최인화
    • 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.

급성관상동맥 증후군 치료를 위한 국내·외 항혈소판제 약물요법 가이드라인 비교 연구 (A Comparative Study the USA, Europe and Korea Guidelines of Antiplatelet Therapy for Patients with Acute Coronary Syndrome)

  • 정은주;이채원;백인환
    • 한국임상약학회지
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    • 제25권3호
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    • pp.200-208
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    • 2015
  • Objective: Patients with acute coronary syndrome (ACS) are typically managed with dual antiplatelet therapy of acetylsalicylic acid (aspirin) and $P2Y_{12}$ receptor inhibitor. In this study, we discussed current and previous antiplatelet therapy guidelines and compared with guidelines of the USA (ACC/AHA), Europe (ESC) and Korea (KSC). Method: This study investigated from ACC/AHA Joint Guidelines (the USA), ESC Clinical Practice Guidelines (Europe) and Korea Society of Interventional Cardiology (Korea) web site, respectively. Results: It is significant that difference between the current and the previous guidelines was integration of terminology from clopidogrel to $P2Y_{12}$ receptor inhibitors since prasugrel and ticagrelor, new antiplatelet drugs, has been added. The other difference was all three guidelines has differences in dose of aspirin. The most notable difference was class of recommendation(COR) in $P2Y_{12}$ receptor inhibitors. ACC/AHA and Korean guidelines recommend clopidogrel, prasugrel, and ticagrelor with COR IB; whereas, ESC recommend prasugrel and ticagrelor with IB which is higher than clopidogrel with IC. Conclusion: This research addresses important movement to revise the Korean existing guideline recommendations. New Korean antiplatelet therapy guideline should be avoiding obvious differences in ACC/AHA and ESC guidelines and harmonizing international guidelines.

근거기반 중심정맥 주입요법 간호실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy)

  • 임경춘;정재심;김경숙;김현림;김현정;김동연;이미정;이주현
    • 임상간호연구
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    • 제29권1호
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

마황의 안전성에 대한 논란과 비만 치료에 있어서 마황 사용 지침의 필요성 (The Need for Clinical Practice Guidelines in Usage of Mahuang in Weight Loss)

  • 장인수;양창섭;황의형
    • 한방비만학회지
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    • 제7권1호
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    • pp.23-29
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    • 2007
  • Background : Mahuang (Ephedra sinica) has been used widely to treat respiratory disease in traditional medicine for over thousands years. Mahuang preparations contain approximately $0.75{\sim}1%$ ephedrine alkaloids. Recently in North America, the Eephedra alkaloids has aroused a controversy due to its adverse effects in those using whole extracts as "dietary supplements" for weight loss or athletic performance enhancement. Objective : To discuss the need for clinical practice guidelines on the use of Mahuang. Results and Conclusion : It is widely assumed that Mahuang is one of the useful medicines and is safe for human body. Most of scientific literatures support that the safety of Mahuang prescription in common dosage. However, it has been claimed that there were some warnings and apprehensions about the harmfulness of Mahuang as dietary supplements. This article does not negate the fact that it is necessary to pay more attention for use of Mahuang in clinical situations. We assert that the establishment of clinical practice guideline on the use of Mahuang, which is based on scientific materials and consensus, is required in traditional medicine.

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