• 임상간호연구
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• 제29권1호
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• pp.12-23
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• 2023

Purpose: This study was conducted to update the previous evidence-based nursing clinical practice guidelines for pressure injury. Methods: The guideline was revised in 22 steps based on the international standards. Results: The updated nursing practice guideline for pressure injury consisted of four domains and 494 recommendations. The numbers of recommendations in each domain was: 31 hospital policy, 64 assessment, 386 prevention and management, and 13 education. The recommended grade was 10.3% for A, 13.8% for B, and 75.9% for C. Of these, the major revision was done in 40 recommendations (8.1%). A total of 55 recommendations (11.0%) were newly added. 25 recommendations had minor revisions such as changes or additions for some words, and only one recommendation was deleted. Conclusion: The revised nursing practice guidelines for pressure injury are expected to serve as an evidence-based practice guideline for pressure injury in Korea. This guideline will provide healthcare providers, patients, and caregivers with information to help prevent and manage pressure injuries, leading to improving patient outcomes.

• Journal of Digestive Cancer Research
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• 제4권1호
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• pp.10-16
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• 2016

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

• 대한한의학회지
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• 제39권4호
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• pp.30-39
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• 2018

Introduction: The aim of this study protocol is to share and disclose the methodology used to develop an evidence-based clinical practice guideline (CPG) of therapeutic interventions used in Korean medicine for patients with stroke. Methods: The CPG development process will consist of two phases. In phase I, a development committee will be established, and they will decide the key questions to be answered. A systematic review and meta-analysis will be performed to answer these key questions by searching relevant randomized controlled trials and systematic reviews. Draft recommendations will be developed according to the evidence level and recommendation grades primarily determined using the GRADE methodology. Panels comprised of external experts will be formed, and surveys and a face-to-face meeting will be conducted to reach a consensus on the recommendations. A preliminary guideline will be created after final review by the development committee. In phase II, we will conduct clinical trials and economic analysis to supplement the lack of evidence found in the phase I. Conclusion: The CPG is expected to help doctors practicing Korean medicine in clinics or hospitals with making decisions based on the most reliable evidence, ultimately leading to the provision of optimal care for patients with stroke.

• 대한예방한의학회지
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• 제20권1호
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• pp.55-64
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• 2016

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.31-37
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• 2016

Background: The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. Methods: The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. Results: A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. Conclusions: As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes

• 한국임상약학회지
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• 제21권4호
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• pp.319-331
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• 2011

Purpose: The purpose of this study is to evaluate current criteria for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on the systemic therapy used in the treatment of advanced or metastatic renal cell carcinoma (RCC), by reviewing all available clinical evidences including a variety of clinical practice guidelines. Methods: We searched clinical databases and collected data from published phase 1 through 3 randomized clinical trials on all systemic therapies used in RCC, including novel targeted therapies. Additionally, current clinical practice guidelines on the management of kidney cancer or RCC were reviewed. Based on the collected data we evaluated the appropriateness of the HIRA criteria for insurance coverage on the systemic therapy of RCC whether they are evidence-based and up to date. Results: On the basis of the collected data we concluded that there was a need for a revision in HIRA criteria for systemic therapy of RCC. Despite recent emerging therapeutic advances and changes in therapeutic strategies of management of RCC, some of anticancer regimens were inappropriately listed even though they were not proven to provide efficacy or safety superior to those of other therapies. We thus proposed an updated recommendation based on current clinical evidences. Conclusion: Systemic therapy of RCC is being rapidly changed with the advancement of understanding of the molecular biology of cancer. Consequently newly developed targeted therapies are becoming the standard therapy in the management of medically or surgically unresectable advanced or metastatic RCC. To provide effective and safe therapy to patients with RCC, the criteria for insurance coverage should be made carefully taking into consideration of most up-to-date and high-quality clinical evidences, and should be continuously reviewed so as to reflect evidence-based clinical practice.

• 대한한의학회지
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• 제40권2호
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• pp.1-16
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• 2019

Objectives: The purpose of this study was to increase the utilization of Korean Medicine Clinical Practice Guidelines(KMCGP) for ankle sprain by investigating the recognition of guideline developed in 2015 and evaluating the current status of treatment. Methods: An e - mail questionnaire survey was conducted for Korean medicine doctor(K.M.D) registered in Korean Medicine Association. Survey data were analyzed through Excel. Results: The most common Korean medicine treatments used in clinic were acupuncture(adjacent points)(28.5%), cupping therapy(19.7%) and pharmacopuncture(9.8%). The treatments with high patient satisfaction were acupuncture (adjacent points)(27.9%), moxibustion(22.4%) and herbal medicine(10.4%). Herbal medicine(17.9%), tuina(10.7%) and embedding therapy(9.2%) were difficult to perform during treatment because of cost. In the case of a later revision, respondents most thought it is necessary to update evidence and adjust recommendation ratings. A majority of all respondents said they would like to know about the revised guideline through the Internet. In the expected revision effect, the first order was 'presentation of standardized treatment method', the second was 'establishing the basis of Korean medicine treatment', and the third was 'strengthening the status of Korean medicine as therapeutic medicine'. Many respondents wished to add exercise therapy. In order to increase the utilization rate of the guideline, many respondents thought it should be included in textbooks and 90.6% of respondents answered that they would use more than 50% of the revised guideline. Conclusion: It is necessary to update evidence and adjust recommendation ratings and to promote KMCGP. At the same time treatment methods should be taught to K.M.D

• 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.

• 디지털융복합연구
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• 제11권2호
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• pp.365-374
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• 2013

본 연구는 간호학생들을 대상으로 흡연지식 및 태도, 그리고 금연권고를 조사하고 금연권고에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 일개 광역시 3개 대학교 간호학과에 재학 중인 간호학생 529명을 대상으로 구조화된 설문지를 이용하여 2012년 10월 1일부터 10월 30일까지 자료를 수집하였다. 연구결과, 간호학생의 금연권고는 학년별, 거주지, 주관적 건강지각, 흡연에 대한 인식, 흡연력 사정 경험, 금연권고 경험, 금연중재교육 참여의사에서 통계적으로 유의한 차이를 보였다. 간호학생들의 금연권고는 흡연지식과 흡연태도와 통계적으로 유의한 상관관계를 보였고 금연권고에 영향을 미치는 요인들은 금연중재교육 참여의사, 흡연태도, 흡연지식, 금연권고 경험으로, 금연권고를 15.5% 설명하였다. 결론적으로 간호학생들이 임상 환자를 대상으로 금연권고를 적극적으로 실천하기 위해서는 학부에서 환자들을 위한 금연중재교육을 실시하여 바람직한 흡연태도와 흡연지식을 증가시키고 임상실습시 금연권고 경험을 갖도록 하는 것이 필요할 것이다.

• 한국임상약학회지
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• 제21권3호
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• pp.193-207
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• 2011

Purpose: The purpose of this study is to assess appropriateness of current standard for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on chemotherapy used in the treatment of advanced non-small cell lung cancer (NSCLC), by reviewing a variety of clinical evidences, and thereby, if needed, to propose an updated evidence-based recommendations. Methods: We collected data from HIRA regarding on the insurance standard which includes the scope and conditions for coverage on systemic chemotherapy of NSCLC. We performed a search for clinical databases and examined the most current clinical evidence from clinical literature including various clinical practice guidelines. Based on the collected data the appropriateness of HIRA standard for insurance coverage of chemotherapy of NSCLC was assessed. Results: Collected data demonstrated that HIRA standard did not reflect the most current clinical practice and evidence. Some were inappropriately listed in HIRA formulary and accepted as a chemotherapy being covered by insurance, despite the lack of evidences of clinical efficacy or superiority over other chemotherapeutic agents or regimens. In addition, there seems to be a need for a modification on the standard for insurance coverage of certain newer chemotherapeutic agents based on the current accumulated data showing their clinical efficacy and benefits in the selected group of NSCLC patients. Therefore, we concluded that current HIRA standard for insurance coverage on chemotherapy of NSCLC needs to be revised and we proposed an updated recommendation based on these latest clinical evidences. Conclusion: The standard for insurance coverage of chemotherapy should be continually examined its appropriateness based on the most recent clinical evidences in a timely manner so as to provide the most effective and safe therapy to cancer patients.