• Title/Summary/Keyword: clinical practice recommendation

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Analysis of Development and Application of Pattern Identification System -Based on Oriental Obesity Pattern Identification- (변증 진단 체계 개발 및 응용 연구 분석 -한방 비만변증을 중심으로-)

  • Park, Jung-Sik;Song, Yun-Kyung;Hwang, Eui-Hyoung;Chung, Won-Suk;Park, Won-Hyung;Cha, Yun-Yeop;Shin, Seung-Woo;Park, Tae-Yong;Jang, Bo-Hyoung;Kim, Ho-Jun;Ko, Seong-Gyu
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.2
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    • pp.107-114
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    • 2014
  • Objectives The purpose of this study is analyzing internal research trends of oriental obesity pattern identification in korean literature based on obesity pattern identification questionnaires, development and application of Pattern Identification System to help solve problems of future researches. Methods 6 Korean databases were searched for articles of oriental obesity pattern identification, irrespective of publication year and 13 studies were reviewed. An analytical method such as descriptive statistics and an actual number and percentage was used. Results We collected 13 studies. 4 studies were published in 2012 and 2008, the highest number of studies. 7 Clinical studies were the major research method. The Studies were classified according to the characteristics and design. 5 studies were about research of analysis and improvement of oriental obesity pattern identification questionnaire, the most number of studies. 4 studies were about research of observational studies in clinical on obesity pattern identification. 3 studies were about research of intervention studies in clinical on obesity pattern identification and 1 study was about clinical practice recommendation. Conclusions Establishment of obesity pattern identification system and its clinical application could lead to standardizing obesity pattern identification and clinical practice guideline. Applied on other diseases, obesity pattern identification system could also lead to improving treatment rate, contributing to the development of clinical practice guidelines and academic field of research.

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

  • Jung, Eun-Joo;Lee, Chae-Won;Baek, In-Hwan
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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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.

A study on work value factors and professional attitude factors of dental hygiene students in parts (일부 치위생과 학생의 직업가치요인과 전문직 태도요인에 관한 연구)

  • Jeong, Eun-Young;Kim, Jin-Kyoung
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.3
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    • pp.439-448
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    • 2013
  • Objectives : The objective of this study is to investigate the work value factors and the professional attitude factors of dental hygienists and provide basic data for dental hygiene curricula. Methods : A total of 329 dental hygiene students in 4 universities completed the questionnaire which consisted of 15 questions for the work value factors and 10 questions for the professional attitude factors. Correlation between the work value factors and the professional attitude factors was analyzed. Results : The "students with no clinical practice experience (4.34 points)" were seen to be statistically significant (p= .013) in the work value factors, as compared to the "students with clinical practice experience (4.19 points)". In accordance with the grade level (p= .000), conformity in aptitude (p= .022), satisfaction level for the major (p= .000), desired duration of career (p= .009), and presence of recommendation for dental hygiene department (p= .000), the professional attitude factors had statistically significant differences. The higher the scores of the work value factors of dental hygiene students, the higher the scores of the professional attitude factors appeared, there by showing a positive (+) correlation (r= .367). Conclusions : For the cultivation of work value factors and professional attitude factors for dental hygiene students, it is necessary to improve the educational system that reflects the operation of a counseling and mentoring by the utilization of structured personality type testing tools and an improvement of interpersonal relationships.

Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea (국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안)

  • Sung-Hyoun Cho;Jeong-Woo Lee
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.231-242
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    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.

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.

Sentinel Node Biopsy Examination for Breast Cancer in a Routine Laboratory Practice: Results of a Pilot Study

  • Khoo, Joon-Joon;Ng, Chen-Siew;Sabaratnam, Subathra;Arulanantham, Sarojah
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1149-1155
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    • 2016
  • Background: Examination of sentinel lymph node (SLN) biopsies provides accurate nodal staging for breast cancer and plays a key role in patient management. Procurement of SLNs and the methods used to process specimens are equally important. Increasing the level of detail in histopathological examination of SLNs increases detection of metastatic tumours but will also increase the burden of busy laboratories and thus may not be carried out routinely. Recommendation of a reasonable standard in SLN examination is required to ensure high sensitivity of results while maintaining a manageable practice workload. Materials and Methods: Twenty-four patients with clinically node-negative breast cancer were recruited. Combined radiotracer and blue dye methods were used for identification of SLNs. The nodes were thinly sliced and embedded. Serial sectioning and immunohistochemical (IHC) staining against AE1/AE3 were performed if initial H&E sections of the blocks were negative. Results: SLNs were successfully identified in all patients. Ten cases had nodal metastases with 7 detected in SLNs and 3 detected only in axillary nodes (false negative rate, FNR=30%). Some 5 out of 7 metastatic lesions in the SLNs (71.4%) were detected in initial sections of the thinly sliced tissue. Serial sectioning detected the remaining two cases with either micrometastases or isolated tumour cells (ITC). Conclusions: Thin slicing of tissue to 3-5mm thickness and serial sectioning improved the detection of micro and macro-metastases but the additional burden of serial sectioning gave low yield of micrometastases or ITC and may not be cost effective. IHC validation did not further increase sensitivity of detection. Therefore its use should only be limited to confirmation of suspicious lesions. False negative cases where SLNs were not involved could be due to skipped metastases to non-sentinel nodes or poor technique during procurement, resulting in missed detection of actual SLNs.

Electronic Risk Assessment System as an Appropriate Tool for the Prevention of Cancer: a Qualitative Study

  • Amoli, Amir hossein Javan;Maserat, Elham;Safdari, Reza;Zali, Mohammad Reza
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8595-8598
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    • 2016
  • Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

Relationships between the diabetes awareness and clinical indices/nutrient intakes in Korean adults: Based on the 2012-2013 Korea National Health and Nutrition Examination Survey Data

  • Lee, Seul;Park, Haeryun;Lee, Youngmi;Choi, Onjeong;Kim, Jiwon;Gray, Heewon L;Song, Kyunghee
    • Nutrition Research and Practice
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    • v.13 no.3
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    • pp.240-246
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    • 2019
  • BACKGROUND/OBJECTIVES: Diabetes is diagnosed after an average of 10-12 years of diabetic development. Strict glycemic control in diabetic patients promotes the normalization of blood glucose and reduces cardiovascular diseases (CVDs) and diabetic complications. Therefore, early diagnosis in non-aware individuals is very important. SUBJECTS/METHODS: Clinical indices and nutrient intakes in Korean diabetic adults aged 19-64 years were examined according to the awareness of diabetes, using 2012 and 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. The aware group was defined as individuals who were aware of having diabetes from diagnosis by physician before the survey and the non-aware group as individuals who were not aware of having diabetes. RESULTS: The average age was higher in the aware group compared to the non-aware group in both men (P = 0.002) and women (P = 0.004). The prevalences of hypertension and dyslipidemia were not different between the two groups, but the diagnosis rate was significantly lower in the non-aware group. In the non-aware group, total and LDL-cholesterol were significantly higher (P < 0.001), the risk for total cholesterol over 240 mg/dL was 3.4 times (95% CI: 1.58-7.52) higher (P = 0.002) and the risk for LDL-cholesterol over 160 mg/dL was 4.59 times (95% CI: 2.07-10.17) higher (P < 0.001). The calorie intake of the female non-aware group was significantly higher compared to the female aware group (P = 0.033). CONCLUSION: The results suggested that the recommendation of screening test is necessary even for young adults. Studies on the methodology for early diagnosis of diabetes are also needed.

Clinical Practice Guidelines for the Medical and Surgical Management of Primary Intracerebral Hemorrhage in Korea

  • Kim, Jeong Eun;Ko, Sang-Bae;Kang, Hyun-Seung;Seo, Dae-Hee;Park, Sukh-Que;Sheen, Seung Hun;Park, Hyun Sun;Kang, Sung Don;Kim, Jae Min;Oh, Chang Wan;Hong, Keun-Sik;Yu, Kyung-Ho;Heo, Ji Hoe;Kwon, Sun-Uck;Bae, Hee-Joon;Lee, Byung-Chul;Yoon, Byung-Woo;Park, In Sung;Rha, Joung-Ho
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.175-187
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    • 2014
  • The purpose of this clinical practice guideline (CPG) is to provide current and comprehensive recommendations for the medical and surgical management of primary intracerebral hemorrhage (ICH). Since the release of the first Korean CPGs for stroke, evidence has been accumulated in the management of ICH, such as intracranial pressure control and minimally invasive surgery, and it needs to be reflected in the updated version. The Quality Control Committee at the Korean Society of cerebrovascular Surgeons and the Writing Group at the Clinical Research Center for Stroke (CRCS) systematically reviewed relevant literature and major published guidelines between June 2007 and June 2013. Based on the published evidence, recommendations were synthesized, and the level of evidence and the grade of the recommendation were determined using the methods adapted from CRCS. A draft guideline was scrutinized by expert peer reviewers and also discussed at an expert consensus meeting until final agreement was achieved. CPGs based on scientific evidence are presented for the medical and surgical management of patients presenting with primary ICH. This CPG describes the current pertinent recommendations and suggests Korean recommendations for the medical and surgical management of a patient with primary ICH.

Legal Issues in Clinical Trial on Minor (미성년자 대상 임상시험에 관한 법적 문제점)

  • Song, Young-min
    • The Korean Society of Law and Medicine
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    • v.17 no.2
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    • pp.125-144
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    • 2016
  • All forms of Clinical trial should be fully equipped with protection systems for experimental subjects considering their uncertainty and various risks. Existing laws have some regulations in pharmaceutical affairs act and medical device act. Nonetheless, there is a limit to protect the subjects considering law objective to perform administration of medicine. Furthermore, the clinical trial on minor has no direct regulations in pharmaceutical affairs act, but prescribes certain portion in clinical trial assessment guideline on infants or medicine clinical trial management standard, however there is a limit because that is just recommendation not having legal effectiveness. The legislative solution would be possible for legal problems of clinical trial on minor by examining treatment system on minor in organ transplant act and clinical trial on minor in other foreign laws stronger than usual medical practice in terms of degree of human body invasion. I suppose that the control system of clinical trial being done focusing on the pharmaceutical affairs act, medical device act and other guidelines in existing laws system should be resolved by legislating 'trial subject protection law', in addition, this would be well balanced in organ transplant act on protection system of minor organ donors. Furthermore, the judgement on the consent ability and spontaneity in clinical trial on minor should be judged considering maturity and mentality of minor by clinical trial institutional review board based on legislative solution mentioned above.

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