• Title/Summary/Keyword: Clinical Effectiveness

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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.

Chuna Manual Therapy for Primary Insomnia; A Review of Clinical Study (일차성 불면증의 추나 치료에 대한 문헌 연구 보고)

  • Hwang, Man-Suk
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.79-84
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    • 2016
  • Objectives To evaluate the evidence supporting the effectiveness of Chuna manual therapy for primary insomnia. Methods The researcher conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for primary insomnia. Results Four RCTs met inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy in terms of the PSQI when compared to medication treatments alone. Positive results were also obtained, in terms of the PSQI, when comparing Chuna manual therapy combined with acupuncture therapy to acupuncture therapy alone, but was not statistically significant. Conclusions The review found encouraging but limited evidence of Chuna manual therapy for primary insomnia. We recommend clinical trials which compare the effectiveness of Chuna manual therapy with usual care to obtain stronger evidence without the demerits of trial design.

Recruitment and enrollment in a randomized clinical trial of mandibular two-implant overdenture

  • Lee, Jeong-Yol;Kim, Min-Soo;Kim, Ha-Young;Shin, Sang-Wan
    • The Journal of Advanced Prosthodontics
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    • v.5 no.2
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    • pp.204-208
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    • 2013
  • PURPOSE. The purpose of this study was to evaluate the effectiveness of a promotion campaign for subject recruitment and selection, and reasons of withdrawal from a prospective clinical trial of mandibular two-implant supported overdenture. MATERIALS AND METHODS. The subjects of this study were participants in a randomized controlled clinical trial for investigating prognosis of implants and overdentures with attachments. Recruited subjects were classified by gender, age, and participation motives. Withdrawal rate of the participants before and after enrollment were evaluated. RESULTS. 177 patients were recruited and 51 patients were enrolled for the trial. Among them, 40 participants eventually took part in the trial. 116 subjects (65.5%) were recruited by advertisement and 61 (34.5%) were referred by patients of the hospital or local clinics. Regarding recruitment effectiveness, newspaper recruited the largest number of participants. With respect to referral patients, the proportion of our hospital patients was higher (37/61). Subjects in their 70s comprised the largest proportion (22/51). The male to female ratio was similar (25:26). Final withdrawal rate of all subjects were 74.0%. Among the reasons for withdrawal from enrollment (n=126) presence of remaining teeth and lack of motivation were the most common reasons. CONCLUSION. To facilitate recruitment of clinical trial subjects and improve enrollment rate, it is important to obtain a sufficient number of researchers, perform promotion activity with diverse strategies, cooperate with local dentists, increase the research funding, and alleviate subjects' fear against clinical trials by thorough consultation.

Pragmatic Clinical Studies: An Emerging Clinical Research Discipline for Improving Evidence-Based Practice of Cardiovascular Diseases in Asia

  • Dong Zhao;Chen Yao
    • Korean Circulation Journal
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    • v.52 no.6
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    • pp.401-413
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    • 2022
  • Pragmatic clinical studies, an emerging clinical research discipline, include a wide range of studies that are largely embedded with routine clinical practice and aim to evaluate the comparative effectiveness and safety of different clinical intervention strategies. Increased availability and quality of electronic medical/health records drives the development of pragmatic clinical studies. In this review, we describe evolution of the conceptual framework of pragmatic clinical studies and share perspectives on the importance of pragmatic clinical studies in evidence-based practice for cardiovascular diseases, as a complement to conventional randomized controlled trials. We also highlight specific needs of pragmatic clinical studies in improving evidence-based practice for cardiovascular disease in Asian countries. The main challenges of pragmatic clinical studies are discussed briefly in this review.

The effect of clinical nurse's personality on job stress and organizational effectiveness (임상간호사의 성격특성이 직무스트레스와 조직유효성에 미치는 영향)

  • Yoon, Sook-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.4
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    • pp.595-603
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    • 2002
  • Purpose : The purpose of this study was to identify the effect of clinical nurse's locus of control of personality on job stress and job satisfaction and organizational commitment out of organizational effectiveness. Methods : The subjects were 463 staff nurses, who were employed in four university hospitals located in Seoul, Pusan and Kyungki-do. Data was collected from October 4th to October 14th in 2000 by a self-report questionnaire. Data was analyzed by the SAS for the general characteristics of the subjects, descriptive statistics, test for reliability and correlations. The effect of variables were tested using the Lisrel 8.12(a) program. Results : With the findings from this study, the internal-external locus of control affects job stress directly. Also it affects job satisfaction directly and via job stress indirectly. But it affects organizational commitment only via job stress and job satisfaction indirectly. Direct effect of locus of control to organizational commitment is not significant. Job stress affects job satisfaction and organizational commitment out of organizational effectiveness directly. Finally, job satisfaction was direct predictor of organizational commitment. Conclusion : Therefore, nursing managers ought to develop social learning programs to change the perception of individual personality and job stress management programs in order to improve organizational effectiveness.

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Clinical Test on Application of ShiHo-GuizhiTang (시호계지탕(柴胡桂枝湯)의 임상치험(臨床治驗)에 관(關)한 소고(小考))

  • Lee, Min-seop;Kim, Dong-hee;Shin, Soon-shik
    • Journal of Haehwa Medicine
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    • v.9 no.1
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    • pp.201-214
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    • 2000
  • Precise and detailed clinical research and evaluation based on objective standards are imperative factors in securing reliability of a clinical test. Built on this principle, this clinical test has been conducted during the period between March 1999 and March 2000 dealing with 31 outpatients treated with ShiHo-GuizhiTang or ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions at the Sung-bo ORIENTAL MEDICAL CLINIC. A variety of information relating to those patients has been collected and analyzed under such criteria as precise diagnoses and their clinical effectiveness. The analysis was duly based on "The theory of cold syndrome". Then, the 31 patients' individual clinical information was compared one another by breaking down the results into sub-categories including gender, age, disease, main symptom, blood pressure, pulse beats, syndrome of abdomen, treatment period, modify and mixed prescription, and evaluation. The result of this clinical test can be summarized as follows: First, ShiHo-GuizhiTang appears to be more frequently prescribed in the case of female patients than in the case of male patients despite the fact that it does not necessarily need to be applied only to female. In addition, the numbers of prescriptions of ShiHo-GuizhiTang in the two age groups consisting of elementary school children and economically active adults respectively were the highest among other age groups. Second, ShiHo-GuizhiTang proved to be most effective in treatment for respiratory ailments and arthritis. Third, ShiHo-GuizhiTang brought down blood pressure of hypertension patients and at the same time benefited patients with normal or lower-than-normal blood pressure who were vulnerable to diseases due to low disease-resistance. Fourth, ShiHo-GuizhiTang was effective in the case of frequent pulse(rapid pulse) and thereby indicating the fact it carries Taiyang superficies syndrome. 지맥 arises from suppressed immune responses owing to adrenocortical hormones. ShiHo-GuizhiTang controls and revitalizes those suppressed immune systems which stem from slow pulse and, as a consequence of that process, helps them return to normal condition of pulse. Fifth, from the standpoint of syndrome of abdomen, feeling of obstruction in the epigastrium serves as an important standard in the process of diagnosing diseases and evaluating effectiveness of treatments. Sixth, according to the results of the clinical test with the 31 patients, a total of 81 percent of test subjects benefited from the treatment. The figure is the sum of 52 percent of I-class (both main symptom and accompanying symptoms had been eliminated) and 29 percent of II-class (part of main symptom and accompanying symptoms had been eliminated) respectively. All told it is safe to say that ShiHo-GuizhiTang can elect to be a viable clinical treatment. In conclusion, it is estimated that this clinical study has drawn up guidelines for objective diagnostic standards and evaluation on specific treatments' effectiveness. This will lead to more general application of ShiHo-GuizhiTang. On top of that, this study could also provide an opportunity to stress the significance of ShiHo-GuizhiTang and ShiHo-GuizhiTang modify and ShiHo-GuizhiTang mixed prescriptions as an alternative treatment for collagen disease which comes from environmental degradation and pollution.

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Effectiveness of Shortwave Therapy in Management of Knee Osteoarthritis : A Systematic Review and Meta-analysis of Randomized Controlled Trials (무릎 뼈관절염의 단파치료 효과 : 무작위임상시험의 메타분석과 체계적 고찰)

  • Lee, Jae-Hyoung;Cho, Hyuk-Shin;Song, In-Yong
    • The Journal of Korean Physical Therapy
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    • v.26 no.5
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    • pp.331-343
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    • 2014
  • Purpose: The purpose of this study is to assess the effectiveness of short-wave therapy (SWT) for treatment of knee osteoarthritis (OA) as compared to placebo and control, and to assess the question of whether the effects are related to the mode, dosage, and application method. Methods: We searched randomized, placebo-controlled trials using electronic databases. We also manually reviewed sources in order to identify additional relevant studies. Results: Eight studies (597 participants) with OA were included in the meta-analysis. Pulse SWT had a significant effect on pain relief compared with control treatment, while did not favour compared with the placebo group. Pulse SWT had a significant effect on functional improvement compared with control and placebo treatment. Continuous SWT had no effect on pain relief and functional improvement. Capacitive SWT a significant effect on pain relief, functional improvement, and muscle strength. Continuous and capacitive SWT had increased muscle strength significantly. We found no clinical significance of all outcomes except pain and functional improvement in pulsed SWT with low dose. There was no difference in adverse events. None of the participants experienced any serious adverse events. Conclusion: Low dose pulsed SWT provided a short-term clinical benefit for pain relief and functional improvement. Pulsed SWD with low and high dose had effects on pain and function. There seems to be a placebo effect. We found significant effects on pain and function in capacitive SWT. Despite some positive findings, this analysis lacked data on how effectiveness is affected by mode, dosage, and application method of SWT. Further well-designed clinical studies are required in order to confirm the effectiveness of SWT.

Relationship between Knowledge Management Process and Organizational Effectiveness in Clinical Nurses (간호사의 지식관리활동과 조직유효성과의 관계)

  • Jeong, Seok-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.415-427
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    • 2003
  • Purpose: The purpose of this study was to investigate the degree and pattern of knowledge management process, and to identify the relationship between knowledge management process and organizational effectiveness in clinical nurses. Method: Participants were 665 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Four structured instruments were used to collect the data: Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), cCommitment Questionnaire(Mowday, Steers, & Porter, 1979), General Satisfaction Scale(CooK, Hepworth, Wall, & Warr, 1981), and one for general characteristics. The data were analyzed using factor analysis, reliability analysis, descriptive analysis, cluster analysis, one-way ANOVA, Scheffe test, correlation analysis with the SPSS for Windows 10.0 program. Result: 1) The average score for knowledge management process in nurses was $3.08{\pm}.54$ on a 5-point Likert scale. In order from highest mean score, the elements of knowledge management process, were Knowledge $Utilization(3.35{\pm}.57)$, Knowledge $Sharing(3.07{\pm}.58)$, Knowledge $Creation(2.99{\pm}.63)$, and Knowledge $Storage(2.91{\pm}.82)$. 2) Four knowledge management patterns for nurses, which were derived from cluster analysis, were inactivate pattern, delayed pattern, activate pattern, and high-activate pattern of knowledge management. 3) The degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization, were significantly correlated with nurses' organizational commitment and job satisfaction(p=.000). 4) The nurses' organizational commitment and job satisfaction showed significant differences according to the knowledge management patterns derived from cluster analysis of high-activate pattern, activate pattern, delayed pattern, inactivate pattern(p=.000). Conclusion: These results suggest that there are four knowledge management patterns for nurses, and knowledge management process positively affects the nurses' organizational commitment and job satisfaction. From the above findings, knowledge management process is empirically verified as a useful and effective method to increase organizational effectiveness, and develop the organization.

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A Systematic Review of the Effectiveness of Eastern-Western Integrative Medicine for Musculoskeletal Disorders (근골격계 질환의 한·양방협진치료 효과 연구에 대한 체계적 문헌 고찰)

  • Lee, Seung-Jin;Shin, Byung-Cheul;Song, Geun-Sung;Hwang, Eui-Hyoung;Yun, Young-Ju;Cho, Hyun-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.21 no.4
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    • pp.87-96
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    • 2011
  • Objectives: This study aims to systematically evaluate the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western Medicine. Methods: Systematic sea-mes of 9 major Korean databases were conducted for articles published up to July 2011. Searching keyword was "Integrative Medicine". Prospective studies dealt with musculoskeletal disorders by Eastern-Western integrative medicine were included. Quality assessment of included studies was evaluated by Cochrane risk of bias tool. Results: 470 studies in total were seamed, Amalg them 7 studies met our inclusion criteria(3 randomized controlled clinical trials, 2 non-randomized controlled trials and 2 uncontrolled clinical trials). Included studies dealt with lumbar pan(3), shoulder pain(2), pain after traffic injury(1), spinal compression fracture(1). Eastern-Western integrative medicine showed better or equal effect for the treatment of various muscloskeletal disorders compared with Eastern or Western medicine alone. Conclusions: There is very weak evidence for the effectiveness of Eastern-Western integrative medicine for musculoskeletal disorders compared with Eastern or Western medicine alone. Well designed randomized controlled trials with rigorous methodology are needed to evaluate the effectiveness of Eastern-Western integrative medicine objectively in the future.

Analysis for Randomized Controlled Clinical Trials of Korean Medicine External Treatment on Bacterial Vaginosis (세균성 질증의 한방외치요법에 대한 무작위 대조군 비교 임상시험 중심의 고찰)

  • Hwang, Young-Sik;Lee, Jin-Wook;Kim, Gyu-Tae;Park, Seung-Hyeok;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.50-70
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    • 2019
  • Objectives: The purpose of this study was to show effectiveness of Korean medicine external treatment on bacterial vaginosis by analyzing randomized controlled clinical trials. Methods: We searched randomized controlled clinical trials related with Korean external treatment on bacterial vaginosis through national and overseas database and analyzed them in detail. Results: 15 articles were included according to our selection criteria and 2,176 women were involved. 1. All treatment groups were treated with intervention including Korean medicine external treatment and their results were statistically more effective than control groups. 2. External washing was the most frequently used method followed by vaginal tablet, fumigation and powder. 3. The most frequently used herbal medicine was Sophorae Radix followed by Phellodendri Cortex, Cindi Fructus, Dictamni Radicix Cortex and Kochiae Fructusa. 4. There were 4 studies reporting side effects of treatment and no significant side effects were observed. Conclusions: There was significant difference in the effectiveness of the intervention including Korean external therapy. Based on the analysis, it could be an effective way for the treatment of bacterial vaginosis in clinical practice.