• Title/Summary/Keyword: evidence

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International Trends of Digital Health and It's Political Implication for Health Technology Assessment (디지털헬스 정책환경의 국제 동향과 의료기술평가에 대한 시사점)

  • Choi, Solji;Cha, Sunmi;Yoo, Keunjoo;Hong, Seokwon;Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.95-99
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    • 2018
  • As technologies develop, the digital health sector is gradually expanding. Internationally, the global summit for Digital Health named Global Digital Health Partnership (GDHP) was launched in 2018. Many countries are participating in GDHP and share their policy experiences on digital health and find the ways to cooperate with participating countries (13 countries, including South Korea, and Hong Kong). This article reviewed the international trends in digital health policy environment and evidence assessment focusing on GDHP activities, and derived implications for health technology assessment of digital health. Consequently, to assess the intervention effects of digital health is very complex and the assessment should be considered multidimensional aspects (social, clinical, and technical). In addition the patient experience should be assessed qualitatively. Health technology assessment (HTA) should assess the effect of digital health policies to changes in health care systems resulting from the application of advanced technologies related to the 4th Industrial Revolution. Digital health is also related to new HTA, HTA of existing technologies, and R&D on the promising health technology. Therefore, it is necessary to review the trends of the technology's management policy consistently through the HTA of digital health.

Development of an Evidence-Based Clinical Practice Guideline of Korean Medicine for Stroke: A Study Protocol

  • Han, Chang-ho;Kim, Mikyung
    • The Journal of Korean Medicine
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    • v.39 no.4
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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.

The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis

  • Manchikanti, Laxmaiah;Knezevic, Emilija;Knezevic, Nebojsa Nick;Sanapati, Mahendra R.;Kaye, Alan D.;Thota, Srinivasa;Hirsch, Joshua A.
    • The Korean Journal of Pain
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    • v.34 no.3
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    • pp.346-368
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    • 2021
  • Background: Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management. Methods: An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis. The primary outcome measure was the proportion of patients with significant pain relief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months). Results: This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence. Conclusions: Based on the present systematic review, with one RCT and 5 non-randomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.

Influence of Physical Therapist and Work Environment on Evidence-Based Practice in South Korea

  • Shin, Kyung-Mi;Song, Chang-Ho
    • Physical Therapy Rehabilitation Science
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    • v.11 no.2
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    • pp.224-234
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    • 2022
  • Objective: The purpose of this study was to identify the practitioner and organizational characteristics that either detracted from or encouraged the use of evidence-based practice (EBP) by physical therapists. Design: A cross-sectional survey study Methods: Participants were 260 physical therapists currently practicing in South Korea. They completed a questionnaire designed to determine attitudes, beliefs, interest, self-efficacy and barriers to EBP, as well as demographic information about themselves and their practice settings. Logistic regression was used to examine relationships between socio-demographic and work environment characteristics and each practitioner factor. Results: Respondents agreed that the use of evidence in practice was necessary. Although 80% of them agreed that research findings are useful, 71% felt that a divide exists between research and practice. In terms of confidence in their skills, the ability to interpret results of statistical procedures ranked lowest. Despite internet access at work for 63% of respondents, only 14% were given protected work time to search and appraise the literature. Only 2% of respondents stated that their organization had a written requirement to use current evidence in their practice. The primary barrier to implementing EBP was a reported lack of time. Conclusions: In conclusion, most physical therapists stated they had a positive attitude toward EBP and were interested in learning or improving the skills necessary for implementation. Most recognized a need to increase the use of evidence in their daily practice, but a lack of ability to understand the results of research represents a significant barrier to implementing EBP.

The Characteristics of Evidence in Evidence-based Design Research and Their Implications to the Evidence-based Practice of Healthcare Architecture - Focused on Health Environments Research & Design Journal (근거기반설계 연구의 근거 특성과 의료건축의 근거기반실무를 위한 시사점 - HERD의 연구경향 분석을 중심으로)

  • Kim, Duksu
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.28 no.4
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    • pp.21-30
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    • 2022
  • Purpose: To prove the credibility of EBD, it is necessary to define concepts regarding the nature of credible knowledge and the hierarchy of evidence. In addition, the relationship between EBD and EBP needs to be addressed through a practical viewpoint. Methods: The systematic review is applied to define the nature of knowledge and the characteristics of research papers in architectural EBD while analyzing the field of study, knowledge focus and types of keywords of the first author. Results: As a whole, the types of research focus evaluated using the most frequent keywords include function(40.86%), specialized knowledge(30.52%), professional practice(21.37%), and health(5.78%). Empirical research(83.72%) is more likely to be found than theoretical research(13.95%). The EBD research papers ranked as top-tier are only 7(2.03%) among a total of 344, while the research papers ranked in the third to fourth tiers are 276(80.23%). Implications: There is a deficiency of reliable 1-2 tier research papers. From a practical viewpoint, it would be realistic to recommend that healthcare architects appropriately evaluate the quality of EBD research and apply it in practice, rather than to conduct EBD research themselves. This systematic review illustrates the nature of EBD research.

A Study on Efficient Evidence-Based Training(EBT) Application Method (Focusing on Approved Training Organization for Pilot) (효율적인 증거기반훈련(EBT) 적용방안에 관한 연구 (조종사 전문교육기관을 중심으로))

  • Hak-keun Kim;Kyu-wang Kim
    • Journal of Advanced Navigation Technology
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    • v.27 no.1
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    • pp.23-35
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    • 2023
  • Evidence-based training (EBT) improves a pilot's competency and confidence based on the data(Evidence) from actual aircraft accidents, incidents, operations, and training for safe operation in the fast-paced and large-scale air transportation field. It is a training/assessment program that strengthens resilience for problem solving. As a way to apply this evidence-based training(EBT) to the educational system of ATO and to resolve the problems, I propose 3 improvement plans. They are evaluation criteria that apply the core competencies of EBT to the educational evaluation system, the way to improve the system for standardization of practical test examiners and instructors and also the ways to use Flight Simulation Training Devices(FSTD).

The Role of Forensic Engineering in the Diagnosis of Electrocution Fatalities: Two Case Reports

  • Mohammad Alqassim;Raneem Ewiss;Hamdah Al Ali
    • Safety and Health at Work
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    • v.14 no.1
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    • pp.124-130
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    • 2023
  • The increase in the number of fatal electric accidents over the years has escalated the demand for specialized forensic engineers to determine their relevant technical causes. Likewise, the complexities associated with identifying the causes of electrocution accidents have prompted the General Department of Forensic Science and Criminology at Dubai Police to adopt a new methodology to diagnose electrocution accidents, consisting of an approach that involves medico-legal examination, electrical diagnosis of the evidence, and trace evidence analysis. This paper will discuss the application of the adopted method in further detail by unfolding two case reports. The first report outlines a case in which a worker got electrocuted at a construction site while attempting to turn on a lamp. The second case report involves the death of a technician in a workshop after trying to disconnect a washing machine from its plug. The methodology was utilized during the investigation of both cases, which were attended by the appointed forensic engineers and showed promising results.

Claim-Evidence Approach for the Opportunity of Scientific Argumentation

  • Park, Young-Shin
    • Journal of The Korean Association For Science Education
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    • v.26 no.5
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    • pp.620-636
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    • 2006
  • The purpose of this study was to analyze one science teacher's understanding of student argumentation and his explicit teaching strategies for implementing it in the classroom. One middle school science teacher, Mr. Field, and his students of 54 participated in this study. Data were collected through three semi-structured interviews, 60 hours of classroom observations, and two times of students' lab reports for eight weeks. Coding categories were developed describing the teacher's understanding of scientific argumentation and a description of the main teaching strategy, the Claim-Evidence Approach, was introduced. Toulmin's approach was employed to analyze student discourse as responses to see how much of this discourse was argumentative. The results indicated that Mr. Field defined scientific inquiry as the abilities of procedural skills through experimentation and of reasoning skills through argumentation. The Claim-Evidence Approach provided students with opportunities to develop their own claims based on their readings, design the investigation for evidence, and differentiate pieces of evidence from data to support their claims and refute others. During this approach, the teacher's role of scaffolding was critical to shift students' less extensive argumentation to more extensive argumentation through his prompts and questions. The different level of teacher's involvement, his explicit teaching strategy, and the students' scientific knowledge influenced the students' ability to develop and improve argumentation.

The Effects of Characteristics of Nurses on Knowledge and Nursing Performance Evaluation of Evidence Based Hemodialysis Nursing Practice in Hemodialysis Unit Nurses (혈액투석실에서 근무하는 간호사의 특성이 근거기반 혈액투석간호지식과 수행정도에 미치는 영향)

  • Lee, Hee Soo;Jung, Eun Sook;Choi, Kyong Ah;Yu, Seung Oh
    • Journal of Korean Clinical Nursing Research
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    • v.22 no.2
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    • pp.225-237
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    • 2016
  • Purpose: The purpose of this study was to identify the effects of characteristics of nurses on knowledge and nursing performance of evidence based hemodialysis nursing practice among hemodialysis unit nurses. Methods: The participants were 180 nurses working in hemodialysis unit for more than 6 months in 23 private and general hospitals in Seoul and Gyeonggido. Data were collected from March 30th to April 15t in 2016 and were analyzed using stepwise regression analysis, descriptive statistics, t-test and ANOVA. Results: Nurses' knowledge on evidence based hemodialysis nursing practice was $15.87{\pm}4.52$ out of 23 points. Type of hospitals working in and adherence to evidence based hemodialysis guidelines were significant factors to knowledge and these two factors explained 30.0%. Nurses' nursing performance on evidence-based hemodialysis nursing practice was 4.52 out of 5 points. The performace level was significantly related to total nurisng career and necessity of hemodialysis nursing education and these two factors explained 8.0%. Conclusion: A development of guideline and continuing education is necessary for improving knowledge and performance of evidence based hemodialysis nursing practice.

Review of Clinical Trials on Warming Acupuncture for Musculoskeletal Pain Diseases -A Systematic Review- (근골격계 통증성 질환에 대한 온침의 임상 연구 고찰 -계통적 고찰-)

  • Chung, Jie-Youn;Choi, Do-Young;Woo, Hyun-Su;Kang, Sung-Keel
    • Journal of Acupuncture Research
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    • v.26 no.4
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    • pp.11-18
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    • 2009
  • Objectives : The objective of this review was to evaluate clinical trials of warming acupuncture for musculoskeletal pain diseases, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects and to identify the effectiveness of the warming acupuncture. Methods : Seven databases and the Journal ZHONGGUO ZHENJIU(中國鍼灸) published between 2004-2008 were searched. Korean and Chinese randomized trials were evaluated for methodologic quality using the modified Jadad scale. Outcome measurements were pain, function and global improvement. The best-evidence synthesis was performed to determine the strength of evidence by control group. Results : Six clinical trials representing 564 patients with musculoskeletal pain diseases were identified. For pain and function, there was moderate evidence that warming acupuncture is more effective than manual acupuncture. For patient global assesment, there was limited evidence that warming acupuncture is more effective than manual acupuncture. However, for function, there was inconclusive evidence that warming acupuncture is more effective than acupuncture with TDP or western medicine or acupoint-injection treatment. Conclusions : The evidence suggests that warming acupuncture is more effective for musculoskeletal pain diseases than manual acupuncture, acupuncture with TDP, western medicine and acupoint-injection treatment. But the evidence is moderate to inclusive due to the low methodologic quality of the trials. Further clinical trials with high methodologic quality is required to investigate the effectiveness of warming acupuncture.

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