• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.26.1-26.10
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• 2018

Background: This study aimed to evaluate the mechanical, biological, and esthetic stability of a zirconium abutment according to evidence-based dentistry. Main text: An electronic search was performed. Domestic studies were found using the keywords "zirconia abutments" and "zirconium abutment" in KMbase, KoreaMed, and the National Assembly Library, and international studies were found using the same keywords in PubMed. All identified studies were divided by evidence level from the viewpoint of the research type utilizing the evidence-based review manual. A total of 102 domestic studies (with Korean language) were found, and 9 of these studies were selected. In these nine studies, 3 had evidence level 3 and 6 had evidence level 4. A total of 97 international studies (with English language) were found, and 19 were selected. Among these 19 studies, 5 had evidence level 2 and 7 had evidence level 3, whereas the remainder had evidence level 4. According to the studies, zirconium abutments are mechanically, biologically, and esthetically stable, but the evidence level of these studies is low, and the follow-up duration is no longer than 5 years. Conclusions: All examined studies verified the mechanical stability of zirconium abutments for a period no longer than 5 years. Therefore, a long-term clinical observation is needed. Zirconium abutments are thought to be biologically stable, but they are not superior to titanium abutments. As the esthetic stability of such abutments had a low evidence level in the studies that examined here, a much higher evidence level is needed.

• CELLMED
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• v.6 no.3
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• The Journal of the Korean dental association
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• v.45 no.3 s.454
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• pp.169-181
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• 2007

In this second part of series report on evidence-based dentistry, the level of evidence and the methods for critical appraisal are discussed. The epidemiologic studies, namely clinical studies have some bias per se, and the degree of bias is somewhat predetermined by the study design. The level of evidence can be defined as the reliability of the clinical study and it is dependent on the degree of bias. Thus, it is important to determine the type of the study and to understand its structure before critically appraising them. Systematic reviews of primary studies, randomized controlled trials, nonrandomized clinical trials, cohort studies, case-control studies, and case reports / series constitute the clinical studies and the level of evidence follows the order of the studies listed above. Critical appraisal is the most important procedure in evidence-based dentistry. It is done to determine the credibility of research papers and their usefulness in the clinician s own practice. Critical appraisal is consisted of multiple questions that are helpful for evaluating validity and usefulness of the studies concerning therapy, diagnosis, prognosis, and causation.

• Archives of Plastic Surgery
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• v.42 no.4
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• pp.411-418
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• 2015

Background The plastic surgery literature is vast, consisting of a plethora of diverse articles written by a myriad of illustrious authors. Despite this considerable archive of published material, it remains nebulous as to which precise papers have had the greatest impact on our specialty. The aim of this study was to identify the most cited papers in the plastic surgery literature and perform a citation analysis paying particular attention to the evidence levels of the clinical studies. Methods We identified the 50 most cited papers published in the 20 highest impact plastic surgery journals through the Web of Science. The articles were ranked in order of number of citations acquired and level of evidence assessed. Results The top 50 cited papers were published in six different journals between the years 1957 and 2007. Forty-two of the papers in the top 50 were considered as level IV or V evidence. No level I or II evidence was present in the top 50 list. The average level of evidence of the top 50 papers was 4.28. Conclusions In the plastic surgery literature, no positive correlation exists between a high number of citations and a high level of evidence. Anatomical reconstructive challenges tend to be the main focus of plastic surgery rather than pathologic diseases and consequently, papers with lower levels of evidence are relatively more valuable in plastic surgery than many other specialties.

• 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.

• Journal of The Korean Association For Science Education
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• v.28 no.5
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• pp.495-505
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• 2008

The purpose of this study was to analyze the level of evidence used in gifted elementary students' argumentation. The subjects were 15, 5th and 6th grade students selected in the Science Education Institute for Gifted Youth in K University. After the argumentation task was given to students 2 weeks ago, the students grouped themselves in the affirmative and negative and took part in a debate for 2 hours. Their argumentation process was observed, recorded and transcribed for analysis. Transcribed data was given a Protocol Number according to priority and was examined to find out what were the characteristics when students participated in the task. The evidence used in argumentation was graded from level 1 to level 6 according to Perella's Hierarchy of Evidence and the rate of frequency classified by the level was expressed in graph. Students used Level 1- Level 2 evidence above 50% without for or against task. They had weak argumentation making use of low-level evidence such as individual experience, opinion and another person's experience rather than objective evidences. On the other hand, students commented on the lack of opponent's evidence when they could not trust an opponent's evidence. If one team asked the other to present more evidence but could not, they disregarded the question and turned to another topic. And in cases where the opponent team refuted with evidences of high level, the other team just repeated their claim or evaded the rebuttal. The students tended to complete the argument without the same conclusions with some interruptions. The results show that we need an educational programs including scientific argumentation for science-gifted elementary school students.

• Korean Journal of Adult Nursing
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• v.24 no.3
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• pp.232-243
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• 2012

Purpose: This study was to identify the level of knowledge and performances on evidence-based infection control and influencing factors on performance among nurses in intensive care unit. Methods: A descriptive cross-sectional survey design was used. Two hundred thirty-nine nurses at intensive care units were conveniently recruited from seven hospitals located in Seoul and Kyounggi province. Data were collected with a questionnaire survey about evidence-based infection control. Data were analyzed using SPSS/WIN 17.0 program. Results: Both level of knowledge (mean 9.15 out of 19) on preventing ventilator-associated pneumonia and central venous catheter induced bloodstream infection, and performance on evidence-based infection control (1.94 out of 4) were moderate. Performance of evidence-based practice for infection control was related to reading research articles regularly, professional satisfaction, and taken education course. Conclusion: These results indicate that systematic and organizational strategies for enhancing evidence-based infection control are needed to improve quality of intensive nursing care.

• Journal of Information Processing Systems
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• v.15 no.5
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• pp.1243-1257
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• 2019

As current algorithms unable to perform effective fusion processing of unknown complex radar signals lacking database, and the result is unstable, this paper presents a multi-level fusion processing algorithm for complex radar signals based on evidence theory as a solution to this problem. Specifically, the real-time database is initially established, accompanied by similarity model based on parameter type, and then similarity matrix is calculated. D-S evidence theory is subsequently applied to exercise fusion processing on the similarity of parameters concerning each signal and the trust value concerning target framework of each signal in order. The signals are ultimately combined and perfected. The results of simulation experiment reveal that the proposed algorithm can exert favorable effect on the fusion of unknown complex radar signals, with higher efficiency and less time, maintaining stable processing even of considerable samples.

• The Korean Journal of Pain
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• v.28 no.2
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• pp.75-87
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• 2015

Background: Lumbar discogenic pain without pain mediated by a disc herniation, facet joints, or the sacroiliac joints, is common and often results in chronic, persistent pain and disability. After conservative treatment failure, injection therapy, such as an epidural injection, is frequently the next step considered in managing discogenic pain. The objective of this systematic review is to determine the efficacy of lumbar epidural injections in managing discogenic pain without radiculopathy, and compare this approach to lumbar fusion or disc arthroplasty surgery. Methods: A systematic review of randomized trials published from 1966 through October 2014 of all types of epidural injections and lumbar fusion or disc arthroplasty in managing lumbar discogenic pain was performed with methodological quality assessment and grading of evidence. The level of evidence was based on the grading of evidence criteria which, was conducted using 5 levels of evidence ranging from levels I to V. Results: Based on a qualitative assessment of the evidence for both approaches, there is Level II evidence for epidural injections, either caudal or lumbar interlaminar. Conclusions: The available evidence suggests fluoroscopically directed epidural injections provide long-term improvement in back and lower extremity pain for patients with lumbar discogenic pain. There is also limited evidence showing the potential effectiveness of surgical interventions compared to nonsurgical treatments.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.2
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• pp.1-12
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• 2014

Purpose : The purpose of this study was to investigate the effect that the academic achievement of the students about the evidence based learning investigates the learning utility value about and the request. Method : The agreement of college students explaining the purpose of research for 12 weeks against 17 students and investigate through a questionnaire. The level of academic achievement according to the sex and claim showed a characteristic with a percentage. An utility investigate the descriptive epidemiologic characteristic about the class of the evidence based learning. Result : The most of college students the level of academic achievement and requests the expected grade of the students about the evidence based learning wanted the 'high' grade of 9 persons, 'middle' grade of 8 persons in the part and the expectation for the class taken so much was high(p<.05). There was the significant different in the utility aspect in the need of the evidence based learning, homework solution, learning synergy effect improvement, and reference search ability improvement(p<.05). Conclusion : These finding revealed that the evidence based learning the satisfaction with class raises the improvement and utility value, and provided the need and the has to develop the educational model which the college students contentment raises an improvement after this opportunity for the new recognition.