• 제목/요약/키워드: Clinical Outcome

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뇌졸중으로 인한 운동 관련 후유증의 한의 치료 연구에서 뇌졸중 시기 및 평가 척도에 대한 국내 문헌 고찰 (A Review of the Stroke Stage and Outcome Measures in Stroke Motor Sequelae Clinical Studies in Korea)

  • 이지은;천세은;전민결;신용진;임정태;신선호
    • 대한한방내과학회지
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    • 제43권4호
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    • pp.656-679
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    • 2022
  • Objectives: The aims of this study were to evaluate the fidelity of stroke stage reporting, the timeliness of the outcome measures, and the use of the core outcome set. Methods: We searched the literature using 6 domestic databases. We selected studies that used Korean medicine interventions and targeted stroke patients with motor sequelae. We examined whether the included studies reported the stroke stage and whether they used the outcome measures in the appropriate period based on the recommendations of the "Stroke Evidence Database to Guide Effectiveness". We also confirmed the use of the essential assessment tools suggested by the core outcome set. Results: Overall, 77 studies were finally selected, with 16 (21%), 55 (71%), and 6 (8%) published on the acute, subacute, and chronic phases, respectively. Only 11 of the studies directly mentioned the stroke stage. The most commonly used assessments were the National Institutes of Health Stroke Scale, Modified Barthel Index, and Manual Muscle Testing. Only 5 studies failed to apply the stage-related outcome measures at the recommended period. The outcome variables used inadequately were the National Institutes of Health Stroke Scale, Functional Ambulation Categories, 36-Item Short Form Health Survey, and Mini-Mental State Examination. Among the core outcome set items, some studies used liver and renal function tests, but no herbal medicine safety reporting was conducted. Conclusions: In future studies, we propose to ensure accurate reporting of the stroke stage with reliable outcome measures to deliver better clinical and research outcomes. Furthermore, in future clinical studies on stroke, a standard protocol that reflects the core outcome set should be developed.

경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향 (Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition)

  • 라미용;김은미;조영연;서정민;최혜미
    • 대한지역사회영양학회지
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    • 제11권1호
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Treatment for Patients with Acute Ischemic Stroke Presenting beyond Six Hours of Ischemic Symptom Onset : Effectiveness of Intravenous Direct Thrombin Inhibitor, Argatroban

  • Park, Jung-Soo;Park, Seung-Soo;Koh, Eun-Jeong;Eun, Jong-Pil;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • 제47권4호
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    • pp.258-264
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    • 2010
  • Objective : The objectives of this study were to analyze the outcome and hemorrhagic risk of intravenous (IV) argatroban in patients with acute ischemic stroke presenting beyond six hours of ischemic symptom onset. Methods : Eighty patients with acute ischemic stroke who were admitted to the hospital beyond six hours from ischemic symptom onset were retrospectively analyzed. We could not perform IV thrombolysis or intra-arterial thrombolysis because of limited time window. So, IV argatroban was performed to prevent recurrent thrombosis and progression of infarcted area. The outcome was assessed by the National Institute of Health Stroke Scale (NIHSS) score and related hemorrhagic risk was analyzed. Also, each outcome was analyzed according to the initial stroke severity, subtype, and location. Results : The median NIHSS was 8.0 at admission, 4.1 upon discharge, and 3.3 after three months. A good outcome was achieved in 81% of patients upon discharge and 88% after three months. Symptomatic hemorrhage occurred in only two patients (3%). IV argatroban was effective regardless of initial stroke severity, subtype, and location. Conclusion : IV argatroban may be an effective and safe treatment modality for acute ischemic stroke presenting beyond six hours of ischemic symptom onset.

비특이적 목 통증에 사용된 침구치료에 대한 체계적 문헌고찰 (A Systematic Review of Acupuncture-Moxibustion Treatments for Nonspecific Chronic Neck Pain)

  • 양창섭;김익태;김영은;김보영;서복남;박지은
    • Korean Journal of Acupuncture
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    • 제34권4호
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    • pp.209-230
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    • 2017
  • Objectives : The aim of this study was to describe the details and to assess the clinical evidence of acupuncture and moxibustion for non-specific chronic neck pain. Methods : We searched seven databases including Korean, English, and Chinese databases through July 2016. Studies using acupuncture, moxibustion, pharmacopuncture, electroacupuncture, auricular-acupuncture, acupressure for non-specific chronic neck pain were included. Only controlled clinical trials or randomized clinical trials were assessed. Study design, number of subject, inclusion criteria, intervention, and results were extracted. In addition, details of intervention including needle type, retention time, acupoints were analyzed. Results : Total 64 studies(39 acupuncture, 9 laser, 6 pharmaco-acupuncture, 3 electro-acupuncture, 3 auricular-acupuncture, 3 moxibustion, 1 acupressure) were included. Among 39 acupuncture studies, 35 used acupuncture as sole intervention. Sham treatment was the most common intervention for control group, followed by no intervention. Various outcome including pain, disability, quality of life, range of motion was used as outcome measurement. The effect of acupuncture and moxibustion was different depending on the type of control and outcome measurement. The most commonly used method in acupuncture for neck pain was GB21, SI3, GB20, LI4, BL11 acupoints, 10~30 mm insertion depth, 20~30 retention time, and 1~2 times per week. Conclusions : Analyzing the details of acupuncture and moxibustion treatment could be helpful for researches and clinics. Further studies should consider the characteristics of study design, intervention, and outcome to assess the effect of TKM.

Outcome of endodontic treatments performed by Brazilian undergraduate students: 3- to 8-year follow up

  • Jessica Gabriele da Rocha;Isabella Marian Lena;Jessica Lopes Trindade;Gabriela Salatino Liedke;Renata Dornelles Morgental;Carlos Alexandre Souza Bier
    • Restorative Dentistry and Endodontics
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    • 제47권3호
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    • pp.34.1-34.12
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    • 2022
  • Objectives: This study aimed to evaluate the success rate of endodontic treatments performed by undergraduate students and the factors associated with the outcome. Materials and Methods: A follow-up of 3 to 8 years after root canal filling was carried out in 91 patients. At the follow-up visits, medical and dental history questionnaires were applied along with clinical and radiographic examinations. Data collected in the clinical exam included: the presence of pain, swelling, sinus tract, mobility, tenderness to palpation and percussion, periodontal probing profile, and type/quality of coronal restoration. Postoperative and follow-up radiographs were digitalized and analyzed by 2 trained and calibrated examiners to assess periapical healing. The treatment outcome was based on strict clinical and radiographic criteria and classified as success (absence of any clinical and radiographic sign of apical periodontitis) or failure (other combination). Logistic regression was used to investigate the impact of clinical and radiographic variables on endodontic treatment outcomes at a 5% significance level. Results: The success rate of endodontic treatments was 60.7%. The only risk factor significantly associated with failure was the presence of a periapical lesion on the postoperative radiograph (odds ratio, 3.35; 95% confidence interval, 1.17-9.54). Conclusions: The success rate of endodontic treatments performed by undergraduate students was low and was jeopardized by the presence of a periapical lesion on the postoperative radiograph.

Kernel Methods를 이용한 Human Breast Cancer의 subtype의 분류 및 Feature space에서 Clinical Outcome의 pattern 분석 (Subtype classification of Human Breast Cancer via Kernel methods and Pattern Analysis of Clinical Outcome over the feature space)

  • Kim, Hey-Jin;Park, Seungjin;Bang, Sung-Uang
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2003년도 봄 학술발표논문집 Vol.30 No.1 (B)
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    • pp.175-177
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    • 2003
  • This paper addresses a problem of classifying human breast cancer into its subtypes. A main ingredient in our approach is kernel machines such as support vector machine (SVM). kernel principal component analysis (KPCA). and kernel partial least squares (KPLS). In the task of breast cancer classification, we employ both SVM and KPLS and compare their results. In addition to this classification. we also analyze the patterns of clinical outcomes in the feature space. In order to visualize the clinical outcomes in low-dimensional space, both KPCA and KPLS are used. It turns out that these methods are useful to identify correlations between clinical outcomes and the nonlinearly protected expression profiles in low-dimensional feature space.

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집중치료실에서 치료한 중첩성 경련 환자의 신경생리학적 결과 분석 (The Analysis of Neuro-Physiological Outcome of Patients with Status Epilepticus in an Intensive Care Unit)

  • 김대식;김천식
    • 대한임상검사과학회지
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    • 제37권2호
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    • pp.96-101
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    • 2005
  • Status epilepticus is a medical emergency, so that rapid and vigorous treatment is required to prevent neuronal damage and systemic complication. Status epilepticus is generally defined as a continuous or intermittent seizure or an unconscious condition after the onset of seizure, lasting for 30 minutes or more. We report here the outcome of status epilepticus. We retrospectively reviewed medical record of 15 patients who were diagnosed with status epilepticus at the Asan Medical Center from January 2003 to February 2004. This outcome was evaluated considering various factors such as age of patients, history of seizures, neurologic impairment, etiology, mortality, return to baseline and initial electroencephalogram (EEG) findings. The range of age was between 1 to 79 years old and the longest duration of treatment was 118 days. Most patients were treated by using pentobarbital, midazolam, phenobarbital and other antiepileptic drugs. The overall mortality was 5 (33%) out of 15 patients. The mortality was related to etiology, underlying other medical conditions and initial EEG findings. 5 (55%) out of the 9 patients with acute etiology, 5 (71%) out of the 7 patients with a multifocal or burst-suppression EEG activity, and 3 (60%) out of the 5 patients with other medical disease were related to mortality. This data demonstrate high mortality due to status epilepticus. Mortality is related to etiology, other medical conditions and abnormalities on the initial EEG.

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중환자전문간호사들의 실무경험: 포커스 그룹 연구 (Korean Critical Care Advanced Practice Nurses' Work Experience: A Focus Group Study)

  • 김금순;김복자;이영희;강지연
    • 중환자간호학회지
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    • 제4권2호
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    • pp.1-14
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    • 2011
  • Purpose: This study was aimed to understand and describe the Korean critical care advanced practice nurses' work experience. Methods: Data was collected through 2 focus group interviews that were held in two different university hospitals in Seoul, Korea. All interviews were recorded and transcribed, and data were analysed using modified qualitative content analysis. Results: Ten themes were drawn from data analysis. They are "Various and complex tasks", "Excellency of advanced nursing practice", "Pressure and responsibility accompanied with pride", "Role identity confusion", "Role conflict", "Leaping and evolving role", "Gap between role and outcome evaluation", "Underestimated outcomes", "Where are my outcomes?" "Searching for outcomes: publicize the role". Conclusion: The results of this study help to understand the role of Korean critical care advanced practice nurses and to guide to outcome evaluation of their role effectiveness. Developing qualitative outcome indicators, cost-effectiveness ananlysis of Korean critical care advanced practice nurses' role, and accumulation of evidences through researches on outcome evaluation will be needed to successfully settle down advanced practice nursing in Korea.

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소아 청소년 만성기침 환자를 대상으로 한 중재 임상시험 등록 현황 분석 - WHO ICTRP를 중심으로 - (The Analysis of Registration Status of Interventional Clinical Trials for Children and Adolescents with Chronic Cough - Focused on WHO ICTRP -)

  • 정윤경;최서연;방미란;이준환;이보람;장규태
    • 대한한방소아과학회지
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    • 제37권3호
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    • pp.75-93
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    • 2023
  • Objectives We aimed to analyze the registration status of interventional clinical trials in children and adolescents with chronic cough. Methods All interventional clinical trials registered up to 3 July, 2023 on the international clinical trial registry platform (ICTRP) of the World Health Organization (WHO) were analyzed. Information was extracted including study design, interventions, inclusion and exclusion criteria, and outcome indicators. Results A total of 18 interventional clinical trials were analyzed. For study design, multicentre trials, randomized allocation, parallel group design and phase 4 trials were the most frequently reported. Blinding was used in 44.4% and informed consents were obtained from 61.1%. For intervention, drugs were used in 61.1%, using placebo control group in 27.8%. Quality of life questionnaires were most frequently reported in 50% as the primary outcome, and adverse events were the most as the secondary outcome. In most cases, the assessment timepoints were after two weeks. Conclusions Based on the characteristics of clinical trial design analyzed in this study, it is necessary to design traditional Korean medicine clinical trials with improved quality and accuracy of information.

알레르기성 비염의 변증과 평가방법에 대한 고찰 (Research of Pattern Identification and Outcome Measurement in Allergic Rhinitis)

  • 김지은;백정한
    • 대한한방소아과학회지
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    • 제30권1호
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    • pp.32-39
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    • 2016
  • Objectives To evaluate the effectiveness of allergic rhinitis treatment, and to set the ground in clinical studies, adequate outcome measures must be established. Thus, this study was designed to develop useful criteria based on those that have been suggested, and those that we are using today. Methods To assess outcome measures used in allergic rhinitis in Korean medicine, related articles found in Korea Traditional Knowledge Portal from 2000-2015 were evaluated. Then pattern identification and outcome measures were reviewed in each study. Results Among 27 studies, we have found 24 studies used subjective symptoms as outcome measures, 9 studies used quality of life, and most of allergic rhinitis were caused by Spleen-Gi deficiency. Conclusions It is necessary to develop outcome measures that directly reflect pattern identifications in Korean medicine, and those measures need to be further evaluated for their applicability, validity and sensitivity.