• 제목/요약/키워드: Clinical Guideline

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아토피피부염의 한의학 진료 지침 개발을 위한 사전 연구 (A study on the Development of Traditional Korean Medicine Clinical Practice Guideline for Atopic Dermatitis)

  • 윤영희;최인화
    • 한방안이비인후피부과학회지
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    • 제25권2호
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    • pp.38-48
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    • 2012
  • Background : The atopic dermatitis patient and their families are looking for safer herb-medicine treatments that possess therapeutic effects, but without the recurrence of symptoms and long-term harmful consequences that can result from other treatment. However, for many reasons, including methodological difficulties and lack of high quality study like randomized clinical study and systematic review, there are no consistent clinical guide line for atopic dermatitis in Traditional Korean Medicine. Objectives : Evidence-based clinical practice guidelines support clinical decision-making by making recommendations to guide clinical practice. The purpose of this study was to develop Traditional Korean Medicine clinical practice guideline for atopic dermatitis Result : The future guide should be based on scientific evidence and include the followings: (1) diagnosis of atopic dermatitis (2) the pattern identification of atopic dermatitis (3) classification of Sasang Constitution (4) efficacy assessment (5) treatment guideline (6) education for patients and care givers Conclusion : The development of Traditional Korean Medicine clinical practice guideline for atopic dermatitis is needed.

한국의 다지역 임상시험 가이드라인 적용에 대한 인식: 다중 이해관계자 설문조사 (Perspectives on Adopting the Guideline for Multi-regional Clinical Trials in Korea: A Multi-stakeholder Survey)

  • 손민지;송윤경;전아영;오정미;김인화
    • 한국임상약학회지
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    • 제29권4호
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    • pp.267-277
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    • 2019
  • Backgrounds: With the globalization of drug development, multi-regional clinical trials (MRCTs) have emerged to facilitate rapid availability of medicines to patients worldwide. The present study aimed to has explored attitudes and perceptions towards adopting the Korean MRCT guideline. Methods: An online survey, consisting of 16 questions, classified into two subjects, was administered to stakeholders in Korea. Most quantitative components were measured using the Likert scales. A content analysis of the qualitative components was carried out to identify the keywords in open-ended responses. Results: A total of 94 survey responses were analyzed: 51 participants from pharmaceutical companies, 11 from clinical research organizations, and 21 from clinical trial centers. The content of the guideline was rated as appropriate for clarity, acceptability, and applicability (96.8, 96.8, and 93.6%, respectively). The local environmental impact of the systemic/political, academic/technical, and industrial/economical aspects of the guideline was rated as appropriate at 95.7, 97.9, and 91.5%, respectively. The suggested adoption period was 1~2 years (40, 42.6%). The concept and individuals' domestic circumstances were the key problems affecting the clarity, applicability, and local environmental impact of the guideline. Conclusion: The Korean MRCT guideline was well-developed. Their overall impact on the local environmental impact of MRCTs in Korea was expected to be beneficial, but methods are needed to minimize the negative impacts. The findings of this study can inform the priorities for the future adoption of the guideline in Korea.

수용개작을 통한 뇌실외배액 간호 실무지침 개발 (Development of Nursing Practice Guideline for External Ventricular Drainage by Adaptation Process)

  • 정원경;이영희
    • 임상간호연구
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    • 제22권3호
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    • pp.294-304
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    • 2016
  • Purpose: This study was done to develop an evidence-based external ventricular drainage (EVD) nursing practice guideline in order to provide standardized nursing and prevent EVD related complications. Methods: We used the standardized methodology for nursing practice guideline adaptation developed by Korean Hospital Nurses Association for the guideline adaptation process in this study. Results: The newly developed EVD nursing practice guideline was adapted to the American Association of Neuroscience Nurses (AANN)'s clinical practice guideline which is 'Care of the patient undergoing intra-cranial pressure monitoring/external ventricular drainage of lumbar drainage.' There were 61 recommendations documented in the preliminary guideline all evaluated by 9 experts based on acceptability and applicability. The final practice guideline was composed of 3 domains with 57 recommendations. The three domains of nursing were the insertion, maintenance, and removal of the EVD. The number of recommendations in each domain was 8 in EVD insertions, 39 in EVD maintenance, and 10 in EVD removals. Of the 57 recommendations 3.5% were level 1, 31.5% were level 2, and 65% were level 3. Conclusion: The standardized practice guideline can improve nurses' performance and accuracy. It can also be used as the foundation for effective communication between all medical staff.

한의 표준임상진료지침 및 한의 표준임상경로에 대한 한의사의 인식 (Korean Medicine Doctor's Perception in Korean Medicine Clinical Practice Guideline and Korean Medicine Cliniical Pathways)

  • 김동수;안해인;권수현;안은지;김남권
    • 대한예방한의학회지
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    • 제26권2호
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    • pp.55-67
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    • 2022
  • Objectives : This study is aimed to survey Korean Medicine Doctors's perceptions in Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways for its spread(to increase utilization in clinical sites). Methods : The research population was set at 14,831 Korean medical institutions registered with the Health Insurance Review and Assessment Service for sampling representative of Korean Medicine Doctors, and the final 2,007 subjects were selected in consideration of the research period and budget. This survey was conducted based on a telephone survey, and in some cases, a fax or e-mail survey was also conducted together. Six questions were asked about the perception of 'Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways', and three questions about the characteristics of the respondent. Results : The rate of recognizing Korean Medicine Clinical Practice Guideline was 36.1%. Those who worked at Korean medicine hospitals, were under 39 years of age, and had less than 11-20 years of experience as an Korean medical doctor were more likely to be aware of it. Regarding the experience of using Korean Medicine Clinical Practice Guideline, the rate of 'not used in the past and not used now' was very high at 82.9%, but the intention to use it in the future was high at 60.7%. About the Korean Medicine Clinical Pathways, 79.9% of respondents answered that they did not know. 80.6% of respondents recognized the need for the development of clinical manuals such as Korean Medicine Clinical Practice Guideline and Standard Korean Medicine Clinical Pathways. Conclusion : Their low awareness of Korean Medicine Clinical Practice Guideline seems to affect its low utilization. Therefore, active education and public relations are required in the future.

근막통증증후군의 한의표준임상진료지침 개발 프로토콜 (Development Protocol of Korean Medicine Clinical Practice Guideline for Myofascial Pain Syndrome)

  • 전병현;우현준;하원배;김청수;이정한
    • 한방재활의학과학회지
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    • 제33권4호
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    • pp.203-213
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    • 2023
  • Objectives This study aimed to develop a Korean medicine (KM) clinical practice guideline for myofascial pain syndrome (MPS) via the collaboration of clinical and methodological experts. Methods The study will include an initial survey to establish a common understanding of MPS. To develop the clinical guideline, a multidisciplinary development group was formed. The group will finalize the clinical questions based on a preliminary draft. The GRADE methodology is going to be applied to determine the level of evidence and grading of the recommendations. Finally, approval from the relevant medical societies will be obtained. Results A protocol for developing a KM clinical guideline for MPS was presented. Before finalizing the clinical key questions, a literature search was conducted according to the protocol, and a draft of 19 clinical key questions was established. Conclusions An evidence-based KM clinical guideline for MPS is expected to contribute to the management of MPS. This may also serve as a reference for the development of other KM clinical practice guidelines in the future.

뜸 임상시험 가이드라인 개발 연구 (Development of the General Guideline for Clinical Trial of Moxibustion)

  • 김혜수;김소연;유정은;이은정;김영일;정인철
    • 동의생리병리학회지
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    • 제31권4호
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    • pp.233-237
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    • 2017
  • In this study, we report on the procedure of developing a guideline for clinical research protocol using moxibustion. Systematic review of the literature about moxibustion was conducted as a preliminary study to make basic content. Review and consulting by experts from each field was conducted to improve the quality. And we made checklist by arranging keypoint of this guideline. This guideline, Moxibustion Randomized Controlled Clinical Trial Guideline(MOXRATE), aims to be a guide for future researchers in planning clinical study using moxibustion as an intervention. MOXRATE also reports on an ethical issues.

사상의학 임상증례 보고를 위한 가이드라인 개발연구 (Development of guideline for reporting CAse REport for Sasang medicine (CARES))

  • 이슬;김소형;한상윤;이용재;이정윤;배나영;채한
    • 사상체질의학회지
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    • 제30권3호
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    • pp.74-94
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    • 2018
  • Introduction The case report provides pivotal basis for clinical research and education, however systematically organized guideline for reporting case report was not properly applied and it tackled the development of traditional medicine in Korea. The purpose of this study was to implement guideline for reporting CAse REport(CARE guideline) incorporating unique characteristics of Sasang medicine with the help of examples and explanations. Methods and Results The guideline for reporting CAse REport for Sasang medicine(CARES guideline) including diagnosis of traditional medicine and treatment with acupuncture and medical herbs was suggested, and practical examples explaining details of each CARES items were provided. Discussion and Conclusion This study would provide foundation for consensus-based and common CARE guideline for traditional Korean medicine. And, the CARES guideline would provide clinical platform for developing refined Sasang type differentiation technique using reported biopsychosocial and clinical type-specific features and realistic cases for Problem Based Learning courses as evidence-based education.

낙상위험요인 평가 및 낙상예방활동 임상진료지침 (Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People)

  • 천자혜;김현아;곽미정;김효선;박선경;김문숙;최애리;황지인;김윤숙
    • 한국의료질향상학회지
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    • 제24권2호
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    • pp.41-61
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    • 2018
  • Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석 (The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication)

  • 김동숙;박춘선;장선미
    • 한국임상약학회지
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    • 제18권2호
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가 (Evaluation of the Effect of Clinical Practice Guideline using Systematic Review)

  • 이선희;하귀염;김주혜;서주현;김현미
    • 한국병원경영학회지
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    • 제14권1호
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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