• Title/Summary/Keyword: Clinical Data

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The Korean Pharmacogenomic Database at NIFDS: 2008 Update

  • Kang, T.S.;Woo, S.W.;Park, H.J.;Han, S.Y.;Park, M.H.;Chung, M.W.
    • Genomics & Informatics
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    • v.7 no.3
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    • pp.163-167
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    • 2009
  • Since its first release in 2007, the National Institute of Food and Drug Safety Evaluation (NIFDS) has provided pharmacogenomic and comparative information specific to Koreans to allow regulatory reviewers and researchers to adapt their working practices to pharmacogenomics. The highlights of this year's additions include "Drug Information", "Gene Information" and "Pharmacogenomic information in the drug labels" sections. These new additions provide information on 737 genes, 719 drugs and pharmacogenomic data of the labels or relabels of 253 approved drugs as of November 2008. The latest version of the Korean Pharmacogenomic Database (KPD, release 2.0) has expanded significantly since its previous release. More SNP and haplotype information has been added to the database with the latest version of the KPD containing approximately four times as many SNPs and haplotypes than the previous version (719 vs. 152, and 30 vs. 7 respectively). Through the "SNP" and "Haplotype" sections, the KPD provides unique Korean SNP and haplotype information as well as comparative information of other populations (Japanese, Chinese, European, African) to offer a range of pharmacogenomic data that can help reviewers and the public understand pharmacogenomic information. The quality and quantity of information in the KPD has also been improved considerably. This data can be found at: http://www.nitr.go.kr/nitr/contents/m134700/view.do/.

The Teaching Efficiency of the Ordered Clinical Nursing Education by Preceptors (실습지도자(preceptor)를 활용한 주문식 실습교육의 교수효율성(teaching efficiency))

  • Kang, Ik-Wha
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.1
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    • pp.11-23
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    • 2004
  • Purpose: The objective of this study was to collect the basic data for improving the quality of nursing education by identifying the teaching efficiency of the ordered clinical nursing education by preceptor which was accepted by Gachongil College since 2001. Method: The data was collected from 30 Sept to 20 Oct 2002. The subjects of this study were 240 nursing students, junior 2nd term trained by the preceptors and 137 preceptors of 12 hospitals located in Inchon, Gyong Ki-do, and Seoul. The scale for measuring the teaching effectiveness, developed by Kim Miae et al.(1998), was employed as a tool for me study. The data was analysed by SPSS using mean value(SD), and ANOVA. Results: Mean value of teaching efficiency of preceptors evaluated by me nursing students scored 3.68(maximum 5). For 5 causal factors classified en the teaching efficiency, the factor of "teaching method and evaluation" showed the highest score, but "available as resource person" get the lowest. Items showing high score en teaching efficiency were "overall effectiveness of teacher", "was able to work with staff in cooperative manner", but the item of was unclear in instructions given to me showed the lowest. The psychiatric ward get the highest score, but cardiac catheterization room showed the lowest. The hospital 10 showed the highest score, but the hospital 8 get the lowest. Conclusion: As the findings from this study, the ordered clinical nursing education by preceptor showed higher teaching efficiency than the conventional education. Thus, cooperative relationship between nursing colleges and hospitals shall be suggested for improving the quality of clinical nursing education, and ordered clinical nursing education system.

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An Study on the Nature of Nursing as Perceived by Clinical Nurses (간호사가 인식하는 간호본질에 대한 탐색적 연구 - 환자중심 병원서비스 전략구축을 위한 기초단계)

  • Suh, Moon Ja;Kim, Hea Sook;Kim, Kuem Soon;Lim, Nan Young;Kim, Kwuy Bun;Sung, Ok Hee;Ju, Hee Joo
    • The Korean Nurse
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    • v.35 no.1
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    • pp.66-80
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    • 1996
  • Reacently one the main issues has been to develop useful strategies to improve hospital services for patients in the health care delivery system in our rapidly changing society. This study has focused on exploring the perceptions that the clinical nurses have concerning who they are and what they are going to become in the days ahead as medical care reaches a new stage of advancement centered around the patient and hospital services. This study in also based upon the premise that the role of the clinical nurse practitioner. is central to the progress of any patient centered nursing program. This study was carried out by the members of the academic committee of Seoul Branch of Korean Nurses Association from January 1995 to February 1995. The interview method was a semi-structured questionnaire used to collect data from 25 staff nurses who were working more than 3 years at 3 different university hospitals in Seoul. The 6 interviews were selected from each hospital and they were trained for the interviewing techniques. The data were analysed qualitatively and 10 elements of the nurse's responsibilities classified such as caring for the patients (which includes specific medical care as well as general); assessing; diagnosing; coordinating with other health personnel; careful listening; teaching and the patient guiding; administering the prescriptions; giving information and counseling the patient; ward management. Although the premise of this study was based on a wholistic concept, the overall behavioral aspects of hospital clinical nursing were the major thrust of the questionnaire. Broad philosophical questions regarding the nature of nursing need to be further explored. The data gathered for this questionnaire should be useful as a reenforcement tool in educating nursing students as well as in continuing education for clinical nurses. For the future, another study should be done to determine the nursing/patient relationship.

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A Investigative Study of Role Expectation on the Clinical Nurse Specialist (임상 전문간호사 역할 기대 조사;A 병원을 중심으로)

  • Lim, Kyung-Choon;Park, Kwang-Ok;Kim, Bog-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.65-82
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    • 1997
  • The purpose of this study was to investigate the role expectation of Clinical Nurse Specialist(CNS) in A tertiary-affiliated hospital in Seoul. Data were surveyed from Jul. 8, to Jul. 20, 1996. 74 medical doctors and 119 nurses participated in this survey. For data analysis, SPSS/PC+ program was used: ${\chi}2-test$, t-test, ANOVA. The difference was analyzed by the subjects' position and department. The results of this study were summarized as follows: 1. The perception about the CNS system : Most of the subjects of study perceived that the introduction of CNS system was needed. And the introduction time of CNS system was demanded as fast as possible, or after special preparation. 2. The comparison of the need for the subroles of the CNS in A tertiary-affiliated hospital : The need for the subroles(0=not known, 1=not needed to 4=absolutely essential) was significantly different between medical doctors and nurses. The total mean scores for degree of need for each subole were as follows: Education 3.37, Consultant 3.34, Researcher 3.29, Direct care provider 2.86. 3. The comparison of the percent of time spent in A tertiary-affiliated hospital : The percent of time spent was significantly different between medical doctors and nurses. The total mean percent of time spent in the five subroles was as follows: Direct care provider 34.9%, Educator 23.9%, Researcher 18.9%, Consultant 12.8%, and Management/Change agent 9.5% According to the study results, suggestions were made: 1. Further study for the need of the CNS role as direct care provider is needed, after correcting the items within the narrow scope in some clinical department. 2. Development of the detail roles for the extent of autonomy is needed, and validity should be tested. And then they will be used for the basic data of the role development of the CNS.

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Correlations between the Clinical Results and Radiologic Evaluation after Surgical Treatment of Calcaneal Fracture (종골 골절의 수술적 치료 후 방사선학적 평가와 임상적 결과의 상관 관계: 종골 골절의 술 후 방사선학적인 평가)

  • Park, Hyun-Woo;Kim, Yeon-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.157-160
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    • 2010
  • Purpose: The purpose of this study is to find out the correlation factors for prognosis of calcaneal fractures. Materials and Methods: 120 cases (feet) of calcaneal fractures, all of them followed up for more than 1 year after surgical procedures, consisted of 101 men (105 feet) and 13 women (15 feet) were reviewed retrospectively. The collected clinical data were as follows : injury mechanism, surgical procedures, time to procedure, time to work and the radiologic data: Bohler angle, heel width, displacement of posterior facet. AOFAS hindfoot score and VAS score were checked. With ANOVA test and multiple regression analysis, the data processed statistically. Results: According Sanders classification, type II was 37 cases (31%), type III 66 cases (55%), and type IV 17 cases (14%). On plane radiography, the Bohler angle improved to average 28.4 degree from 5.6 degree, and the displacement of posterior facet was corrected to average 1.2 mm. AOFAS hindfoot score was checked average 81.7 points postoperatively, and the meaningful difference existed between types of Sanders classification. The Bohler angle represented the outline of the calcaneus had the better correlation with the clinical outcome of calcaneal fractures rather than the anatomical reduction of the posterior facet did. And the width of calcaneus had good correlation with the clinical score. Conclusion: We should also concern about the outline of calcaneus, the width of calcaneus and the Bohler angle representing anatomical reduction, not only the acute reduction of the posterior facet.

Determination of Defined Daily Dose of Medicines using Nominal Group Technique and Analysis of Antibiotics Use in National Insurance Claim Data: Focused on Antibiotics without DDD of WHO (수정 델파이 기법을 이용한 의약품의 DDD(일일상용량) 결정과 항생제 사용량 분석: WHO 일일상용량이 없는 항생제를 중심으로)

  • Kim, Dong-Sook;Kim, Nam-Soon;Lee, Suk-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.17 no.1
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    • pp.19-32
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    • 2007
  • Objectives : It is necessary to monitor consumption of drugs in order to enhance promote appropriate use of drugs. Defined Daily Dose(DDD) of World Health Organization(WHO) has been used for evaluating the amount of medicine use. However, DDD of some drugs must be determined for drugs in Korea which are not listed by WHO. Our formulary follows ourself classification and DDD of some drugs must be determined since they exist only in Korea. This study was aimed to determine DDD value using RAND Appropriateness Methods and evaluate the amount of antibiotics use using DDD value. Methods : J01 antibiotics of WHO anatomical therapeutic chemical(ATC) classification were extracted from drug formulary. Antibiotics list without DDD was identified to determine their DDD with comprehensive review of references and recommendation of experts. defined. Review of reference was executed. of Expert panels were comprised of clinical pharmacist and clinical doctors. Modified Delphi Method was applied by survey and consensus meeting. Amount of antibiotic use was calculated by DDD/1000 inhabitants/day in the national level using health insurance claim data. Results : The result of 1 round, DDD values of 28 ingredients were determined from the first round of consensus meeting. With 2nd round meeting, 3 ingredients were deleted and DDD of 17 ingredients were decided. Analysis of antibiotic use in health insurance claim data showed 22.97 DDD/1000 inhabitants/day in 2003 year. Conclusion : This study can contribute to the establishment of DDD assignment and thus quantifying drug uses.

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Bayesian methods in clinical trials with applications to medical devices

  • Campbell, Gregory
    • Communications for Statistical Applications and Methods
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    • v.24 no.6
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    • pp.561-581
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    • 2017
  • Bayesian statistics can play a key role in the design and analysis of clinical trials and this has been demonstrated for medical device trials. By 1995 Bayesian statistics had been well developed and the revolution in computing powers and Markov chain Monte Carlo development made calculation of posterior distributions within computational reach. The Food and Drug Administration (FDA) initiative of Bayesian statistics in medical device clinical trials, which began almost 20 years ago, is reviewed in detail along with some of the key decisions that were made along the way. Both Bayesian hierarchical modeling using data from previous studies and Bayesian adaptive designs, usually with a non-informative prior, are discussed. The leveraging of prior study data has been accomplished through Bayesian hierarchical modeling. An enormous advantage of Bayesian adaptive designs is achieved when it is accompanied by modeling of the primary endpoint to produce the predictive posterior distribution. Simulations are crucial to providing the operating characteristics of the Bayesian design, especially for a complex adaptive design. The 2010 FDA Bayesian guidance for medical device trials addressed both approaches as well as exchangeability, Type I error, and sample size. Treatment response adaptive randomization using the famous extracorporeal membrane oxygenation example is discussed. An interesting real example of a Bayesian analysis using a failed trial with an interesting subgroup as prior information is presented. The implications of the likelihood principle are considered. A recent exciting area using Bayesian hierarchical modeling has been the pediatric extrapolation using adult data in clinical trials. Historical control information from previous trials is an underused area that lends itself easily to Bayesian methods. The future including recent trends, decision theoretic trials, Bayesian benefit-risk, virtual patients, and the appalling lack of penetration of Bayesian clinical trials in the medical literature are discussed.

Influence of gender role conflict, resilience, and nursing organizational culture on nursing work performance among clinical nurses (임상간호사의 성역할갈등, 회복탄력성, 간호조직문화가 간호업무성과에 미치는 영향)

  • Han, Ji Eon;Park, Nam Hee;Cho, Jeonghyun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.26 no.3
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    • pp.248-258
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    • 2020
  • Purpose: The purpose of this study was to identify the factors influencing nursing work performance among clinical nurses in the hospital. Methods: This descriptive correlational study collected data from 122 clinical nurses who were working in three tertiary referral hospitals in Busan. The data were collected, using self-reported questionnaires, from September 2 to October 14, 2019. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression using SPSS/WIN 25.0 program. Results: Nursing work performance was significantly associated with resilience, innovation oriented culture, relationship oriented culture, and hierarchy oriented culture. The factors significantly influencing nursing work performance of the participants included relationship oriented culture (β=.27, p=.015), hierarchy oriented culture (β=.25, p=.003), resilience (β=.19, p=.035), and total clinical career (β=.18, p=.030), which explained 27.3% of nursing work performance (F=8.59, p<.001). Conclusion: The results indicate that there is a need to improve communication skills among multidisciplinary team members and to harmonize hierarchical and relational cultures in order to enhance nursing work performance. In addition, this study suggests developing interventions for enhancing the resilience of clinical nurses.

A Survey on Korean Medicine Treatment for Traffic Injuries: A Second On-line In-depth Survey (교통사고 상해 증후군의 한의 임상진료 현황 조사: 2차 온라인 심층 설문 조사)

  • Lim, Kyeong-Tae;Hwang, Eui-Hyoung;Hwang, Man-Suk;Park, In-Hwa;Park, Sun-Young;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.89-101
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    • 2018
  • Objectives To understand current status of clinical practice patterns on Korean Medicine treatment practice of traffic injury patients by 2nd on-line survey for developing Korean Medicine treatment clinical pratice guideline (CPG) for traffic injuries. Methods A revised questionnaire about current practice patterns of Korean Medicine treatments for traffic injuries was distributed by e-mail survey to 19,385 respondents of Korean Medicine doctors from May 21th in 2018 to June 21th in 2018. All data were statistically analysed. Results The response rate was 3.5%. Most of the respondents felt necessity of the development of Korean Medicine CPG for traffic injuries. The results showed the detailed usage and trend of current Korean Medicine treatment such as acupuncture, pharmacopuncture, moxibustion, Chuna manual therapy, cupping, Korean Medicine physiotherpy for traffic injury patients. Conclusions This survey helps to determine current Korea Medicine treatments' clinical practice patterns for traffic injury patients. All data from the survey will provide basic data for future clinical studies and adaptation for the revision of Korean Medicine CPG for traffic injuries.

Clinical Benefit of Computerized Cognitive Therapy in Patients with Brain Disease : A Systematic Review and Meta-Analysis (뇌질환 환자에서 전산화 인지치료의 임상적 유용성 : 체계적 고찰 및 메타분석)

  • Song, Seungil;Park, Sowon
    • Journal of The Korean Society of Integrative Medicine
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    • v.8 no.4
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    • pp.277-289
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    • 2020
  • Purpose : This study aims to confirm the clinical usefulness of computerized cognitive therapy program for patients with brain diseases in Korea and to present basic data that can confirm the effectiveness of computerized cognitive therapy program to experts related to rehabilitation in the future. Methods : A systematic review and meta-analysis research method was used to confirm the clinical effectiveness of computerized cognitive therapy applied to patients with brain diseases in Korea. Based on the national institute of health and medical colleges association (NECA) systematic literature manual and preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines for conducting research through systematic review and meta-analysis methods. Systematic review was PICOST-SD was used to research and select papers. For meta-analysis, the data was input and analyzed separately by literature result using the revman manager 5.3 program and the results were presented visually through tables and forest, funnel plot figure. Results : As a result of comprehensive analysis of the contents of the finally selected literature, it as found that studies on stroke and dementia were mainly conducted. In addition, through the evaluation of the quality of the literature, most of the existing computerized cognitive therapy studies were identified as high-quality studies, but the results were insufficient for randomization and blinding. And through meta-analysis, the clinical effectiveness of computerized cognitive therapy on cognitive function, activities of daily living, and visual perception function of patients with brain disease was found. Conclusion : The research literature that applied computerized cognitive therapy to brain disease subjects was comprehensively analyzed and identified. It is thought that this could be used as basic data on the characteristics of cognitive therapy that should be applied to patients with brain diseases in the future and the usefulness of computerized cognitive therapy program in actual clinical practice.