• IE interfaces
• /
• v.20 no.4
• /
• pp.488-497
• /
• 2007

In order to provide appropriate decision supports in medical domain, it is required that clinical knowledge should be implemented in a computable form and integrated with hospital information systems. Healthcare organizations are increasingly adopting tools that provide decision support functions to improve patient outcomes and reduce medical errors. This paper proposes a process centric clinical decision support system based on medical knowledge. The proposed system consists of three major parts - CPG (Clinical Practice Guideline) repository, service pool, and decision support module. The decision support module interprets knowledge base generated by the CPG and service part and then generates a personalized and patient centered clinical process satisfying specific requirements of an individual patient during the entire treatment in hospitals. The proposed system helps health professionals to select appropriate clinical procedures according to the circumstances of each patient resulting in improving the quality of care and reducing medical errors.

• Korean Circulation Journal
• /
• v.53 no.5
• /
• pp.294-312
• /
• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.

• Journal of the Korea Society of Computer and Information
• /
• v.26 no.4
• /
• pp.169-179
• /
• 2021

The purpose of this study is to examine types and characteristics of self-regulation which explain how individual diabetic patients determine their behavior in terms of diabetes management. Based on the results, we proposed the management method of the diabetic patients. As a method of analyzing the subjectivity of each item, a Q method study was used. There were 38 subjects who were treated with oral drugs or insulin injections, but not currently hospitalized. And 40 statements in Q samples were classified in the form of a normal distribution using a 9-point scale. Research results regarding self-regulation in diabetic patients, type 1 is evidence-based compliance, type 2 is crisis responding denial reaction, type 3 is information-based orientation to relationship, type 4 is independent practice, and type 5 is willingness deficit impulse reaction. Therefore, for effective management of diabetic patients, it is necessary to understand the characteristics of each type of self-regulation and develop a program that reflects motivation for diabetes management, improvement of confidence, and countermeasures for negative emotions related to disease.

• The Journal of Health Technology Assessment
• /
• v.6 no.2
• /
• pp.81-87
• /
• 2018

With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

• Journal of Society of Preventive Korean Medicine
• /
• v.21 no.2
• /
• pp.45-53
• /
• 2017

Background and Aim : Lately the age of competition has come among the medical service area. At the same time disputes over the medical practice related to the medical person's territory tend to increase. In part it is due to the increased medical persons but in part it is because the medical practice is not defined clearly in the Medical Service Act for the practice of each medical person. So the legal definition of medical practice will be discussed here. Materials and Method : The cases from the court have been confirmed the difference between the two medical persons regarding the actual events. Legal aspects of medical practice in Korean medicine and the related cases will be reviewed and analysed. Results : The form of medical practice consists of administrating Korean medicine treatment and providing guidance for health based on Korean medicine. For medical doctors the practice includes medical treatment and guidance for health. Circular definition in the Medical Service Act over the medical practice, medical person and medical instruments makes it difficult to understand the whole idea. Therefore, the court has a tendency to decide the medical practice of medical doctor of Korean medicine from the some reliable points which is: 1) it is based on the principle of traditional Korean Medicine, 2) it is practiced by the medical doctor of Korean Medicine, 3) it can do harm to the patient without proper involvement of the medical doctor of Korean Medicine. Now the Act on the promotion of Korean Medicine and Pharmaceuticals makes it include the concept of "scientifically applied and developed" medical practice of Korean Medicine. Conclusions : With the essential change in the Act on the promotion of Korean Medicine and Pharmaceuticals, it is expected that even slight change can be seen in the court cases. However, still the concept of medical practice in the Medical Service Act remains the same. Modernisation of Korean Medicine, enhancement of textbooks and clinical practice training and the effort to amend the law to clearly define the medical practice of Korean Medicine will contribute to the clinical and academic environment. Evidence based Korean Medicine and even the unification of east-west medicine could be considered for the situation.

• Korean Journal of Radiology
• /
• v.23 no.5
• /
• pp.517-528
• /
• 2022

Due to its excellent diagnostic performance, CT is the mainstay of diagnostic test in adults with suspected acute appendicitis in many countries. Although debatable, extensive epidemiological studies have suggested that CT radiation is carcinogenic, at least in children and adolescents. Setting aside the debate over the carcinogenic risk of CT radiation, the value of judicious use of CT radiation cannot be overstated for the diagnosis of appendicitis, considering that appendicitis is a very common disease, and that the vast majority of patients with suspected acute appendicitis are adolescents and young adults with average life expectancies. Given the accumulated evidence justifying the use of low-dose CT (LDCT) of only 2 mSv, there is no reasonable basis to insist on using radiation dose of multi-purpose abdominal CT for the diagnosis of appendicitis, particularly in adolescents and young adults. Published data strongly suggest that LDCT is comparable to conventional dose CT in terms of clinical outcomes and diagnostic performance. In this narrative review, we will discuss such evidence for reducing CT radiation in adolescents and young adults with suspected appendicitis.

• Journal of Korean Clinical Nursing Research
• /
• v.17 no.2
• /
• pp.176-191
• /
• 2011

Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.2
• /
• pp.131-140
• /
• 2021

Purpose : The purpose of this study was to systematically review the studies on the effects of social story intervention on the individuals with autism spectrum disorders(ASD) to provide the basis for evidence-based practice. Methods : In order to find out the studies on the effect of social story intervention on individuals with ASD, studies published from 2011 to December 2020 were searched on Google Academic Search. The keywords used were "autism spectrum disorder AND social story". A total of 16,900 studies were searched, and from these, 12 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 10 single subject design studies and 2 randomized controlled trials design studies. The included studies were analyzed in accordance to population, intervention, outcome measures and results. Results : As a result of analysing the subjects of the included studies, we found out that pre-school children and adolescents were the most common groups of individuals diagnozsed with ASD. In addition to ASD, the diagnosis of the subjects included intellectual disability, Asperger, and Prader-willi. We found out that there were more interventions that were mixed with other interventions, than just the pure social story interventions. In particular, video modeling was found to be the most frequent intervention. This was followed by photo-based social stories. For outcome measure, autism social skills profile was found to be the most often used standardized assessment. For a non-standardized assessment, social desired behavior was found to be the most frequently evaluated behavior, followed by personal problem behavior. Of all the dependent variables, the dependent variable reported as "effective" was the most, followed by "some effective". Conclusion : This study is organized to help the individuals with ASD, families, researchers, and therapists understand the effects of social story intervention on the individuals with ASD in an easy fashion. Further, therapists can use this study as the basic data for evidence-based practice.

• Journal of Korean society of Dental Hygiene
• /
• v.14 no.4
• /
• pp.463-470
• /
• 2014

Objectives : The purpose of this study was to investigate the association factors of infection control practice based on health belief model in the dental hygienists in dental clinics. Methods : A self-reported questionnaire was filled out by 278 dental hygienists in 160 dental clinics in Gwangju by a proportional stratified sampling method from September 13 to October 7, 2013. Data were analyzed by t-test, ANOVA, correlation analysis, and multiple regression analysis using SPSS version 12.0. Results : In multiple regression analysis, practice scores were significantly higher in aged dental hygienists and those who took infectious disease history from the patients before treatment. With regard to health belief model, perceived barrier was negatively associated with the practice(${\beta}$=-.16, p<.001), importance of infection control in hand hygiene(${\beta}$=.14, p=.026), and use of personal protective equipment(${\beta}$=.17, p=.043). The intention of action was positively associated with the practice(${\beta}$=.13, p=.002). Conclusions : This study will provide the basic evidence for the quality improvement of infection control and prevention. So the dental hygienists will be able to put into practice in infection control management.

• Journal of Korean Elementary Science Education
• /
• v.35 no.2
• /
• pp.181-193
• /
• 2016

We examined the inquiry activities in the material domain of the elementary science textbooks and experimental workbooks based on 2009 revised curriculum. The analysis framework was SEP (Science and Engineering Practices) - 'Asking questions and defining problems', 'developing and using models', 'planning and carrying out investigations', 'analyzing and interpreting data', 'using mathematics and computational thinking', 'constructing explanations and designing solutions', 'engaging in argument from evidence', and 'obtaining, evaluating, and communicating information'. Sub-SEP of each grade band were also used. The results showed that the $3^{rd}{\sim}5^{th}$ grade science textbooks and workbooks mainly emphasized 'make observations and/or measurements', 'represent data in tables and/or various graphical displays', or 'use evidence to construct or support an explanation or design a solution to a problem' among around 40 sub-SEP. In the case of the inquiry activities for $6^{th}$ grade, majority of sub-SEP included were also only 'collect data to produce data to serve as the basis for evidence to answer scientific questions or test design solutions', 'analyze and interpret data to provide evidence for phenomena' or 'construct a scientific explanation based on valid and reliable evidence obtained from sources'. The type of 'asking questions and defining problems', 'using mathematics and computational thinking' or 'obtaining, evaluating, and communicating information' were little found out of 8 SEP. Educational implications were discussed.