• 제목/요약/키워드: Clinical Outcomes

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근거 중심 치의학 1. 기초개념, 질문하기, 그리고 근거검색 (Evidence-Based Dentistry - 1. Basic Concepts, Question, and Searching)

  • 홍순민
    • 대한치과의사협회지
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    • 제45권2호통권453호
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    • pp.89-102
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    • 2007
  • Evidence-based dentistry is a new, worldwide trend in the field of clinical dentistry. Despite this fact, it has been neglected in Korean dental community. Thus, its basic concepts and the 5-step procedures are introduced and described in this 2-part series report. Evidence-based dentistry is a method of clinical practice where the clinicians use the best available research evidence for their own clinical decision making. By using this method, the clinical outcomes can be improved and the clinicians themselves can have the ability to keep watch over their daily practices. To clinically apply the principles of evidence-based dentistry, dental practitioners have to formulate a clear question, find the best available research evidence efficiently, critically appraise the evidence systematically, apply the results of the evidence to their practice, and evaluate the clinical outcomes comprehensively. In building a clinical question, it is essential to categorize questions according to their types followed by their organization using the key elements. Then, literature search must be done. There are many web sites for searching evidence, but PubMed is considered to be the leading site. To efficiently search the literature, search term must be selected appropriately and the search results should be limited.

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이미지 상상훈련을 적용한 핵심기본간호술 실습교육이 간호대학생의 임상수행능력, 자율실습시간에 미치는 효과 (The Effects of Imagery Training on Outcomes of Clinical Competence, Voluntary Practice Time and Nursing Skills)

  • 김수연
    • 한국간호교육학회지
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    • 제23권1호
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    • pp.76-85
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    • 2017
  • Purpose: The aim of this study was to explore the effects of imagery training on outcomes of clinical competence, voluntary practice time and basic nursing skills performance during a core basic nursing skills course. Methods: The design was a pre-post test design with two groups consisting of 88 nursing 3rd-year students. Clinical competence was assessed with a pre-post test, and basic nursing skills' performance and voluntary practice time were assessed at the post-test point. Data were collected from March, 2016 to June, 2016. Results: The pre-post differences of all subcategories of clinical competence were significantly improved in the experimental group (p<.05). but the control group did not show significant differences in the teaching/coordinating and professional development areas (p>.05). The experimental group practiced 1.33 hours more than the control group in voluntary practice. The two groups showed no significant difference in basic nursing skills' performance (p>.05). Conclusion: Imagery training during a core basic nursing skills course showed positive effects on nursing students' clinical competence improvement and increase of voluntary practice time.

하악 제1대구치 치근본체의 길이가 조직유도재생술의 임상결과에 미치는 영향 (Effects of root trunk length after GTR on clinical outcomes)

  • 피성희;신형식
    • Journal of Periodontal and Implant Science
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    • 제36권2호
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    • pp.427-434
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    • 2006
  • The form of furcation influence both the pathogenesis of periodontal destruction and therapeutic results. The present study was performed to evaluate the effect of root trunk length on clinical outcomes of guided tissue regeneration. Total 30 mandibular first molars were evaluated in this study. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were measured at baseline and 6 month after GTR. Correlation coefficients between root trunk length and other clinical measurement were analyzed. The results of this study were as follows 1. The mean root trunk length in lower 1st molar was 2.15 mm. 2. Probing pocket depth, clinical attachment level, vertical defect depth and horizontal defect depth were significantly reduced at 6 month postoperatively compared to values of baseline 3. Correlation coefficient between root trunk length and vertical defect depth at baseline was 0.406 showing the positive correlation 4. Correlation coefficient between root trunk length and horizontal defect depth at baseline was -0.463 showing the negative correlation. 5. Correlation coefficient between root trunk length and decrease of horizontal defect depth after GTR was 0.654 showing the positive correlation. In conclusion, the root trunk length maybe effector for clinical outcome after guided tissue regeneration.

이중 다발 전방십자인대 재건술의 임상적 결과 (Clinical Review in Double-Bundle Anterior Cruciate Ligament Reconstruction)

  • 이주홍
    • 대한관절경학회지
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    • 제13권2호
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    • pp.111-114
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    • 2009
  • 단일 다발 십자인대 재건술의 임상적 결과를 보다 향상하고자 제안된 이중 다발 전방십자인대 재건술은 해부학적, 생역학적, 생물학적, 운동역학적으로 많은 이론적 장점이 있고 이에 따른 임상적 측면에서의 결과 향상이 기대되지만 이를 입증할 만한 충분한 관찰 기간을 가진 임상적 연구들이 매우 부족한 실정이다. 따라서 저자는 이중 다발 전방십자인대 재건술에 관련되어 최근까지 발표된 문헌을 통해 임상적 결과를 분석하고 이에 제기된 문제점을 살펴보고자 한다.

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급성 허혈성 뇌졸중에서 항혈전제 치료의 최신 가이드라인 개정과 근거에 대한 고찰 (Review of Updated Guidelines and Evidence for Antithrombotic Therapy in Acute Ischemic Stroke)

  • 백수희
    • 한국임상약학회지
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    • 제34권2호
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    • pp.79-99
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    • 2024
  • Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

의과대학 문제중심학습에서 튜터의 전문분야와 교수경험이 학습결과에 미치는 영향 (The Impact of Tutors' Domain and Teaching Expertise on Medical Students' Learning Outcomes in a PBL Environment)

  • 강명희;이수지;김민정;김민지
    • 의학교육논단
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    • 제13권2호
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    • pp.9-23
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    • 2011
  • This study aimed to investigate the effects of tutors' domain and teaching expertise on learning outcomes in a problem based learning (PBL) environment. Four tutors and 25 first-year medical students participated in this study. Tutors' domain expertise was classified by clinical or non-clinical which is basic medicine and teaching expertise by previous tutoring experiences or not. The results showed a statistically significant difference in achievement depending on the tutors' domain expertise. Students grouped with an experienced clinical tutor attained higher achievement scores than those with an experienced non-clinical tutor, while those with an inexperienced non-clinical tutor attained higher scores than those with both inexperienced clinical tutors and experienced non-clinical tutors. Students with clinical medicine tutors also showed higher satisfaction scores than those with non-clinical medicine tutors. In particular, students grouped with an experienced clinical tutor gained higher satisfaction scores than those with inexperienced non-clinical tutors, and among the inexperienced tutors, students tutored by a clinical tutor showed higher scores than those with a non-clinical tutor. Different intervention styles were also found depending on tutors' domain and teaching expertise. Experienced tutors gradually reduced the tutoring intervention, whereas the novice provided more as the semester proceeded. Moreover, experts with a clinical medicine degree preferred direct teaching, whereas, non-clinical tutors preferred facilitating. Also, experienced tutors in the clinical medicine facilitated critical awareness than the other tutors. These results show the importance of developing a program for novice tutors to improve PBL in medical education.

Long-Term Follow-Up Results of Anterior Cervical Inter-Body Fusion with Stand-Alone Cages

  • Kim, Woong-Beom;Hyun, Seung-Jae;Choi, Hoyong;Kim, Ki-Jeong;Jahng, Tae-Ahn;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • 제59권4호
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    • pp.385-391
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    • 2016
  • Objective : The purpose of this study was to evaluate long-term follow-up radiologic/clinical outcomes of patients who underwent anterior cervical discectomy and inter-body fusion (ACDF) with stand-alone cages (SAC) in a single academic institution. Methods : Total 99 patients who underwent ACDF with SAC between February 2004 and December 2012 were evaluated retrospectively. A total of 131 segments were enrolled in this study. Basic demographic information, radiographic [segmental subsidence rate, fusion rate, C2-7 global angle, and segmental angle changes)/clinical outcomes (by Odom's criteria and visual analog score (VAS)] and complications were evaluated to determine the long-term outcomes. Results : The majority were males (55 vs. 44) with average age of 53.2. Mean follow-up period was 62.9 months. The segmental subsidence rate was 53.4% and fusion rate was 73.3%. In the subsidence group, anterior intervertebral height (AIH) had more tendency of subsiding than middle or posterior intervertebral height (p=0.01). The segmental angle led kyphotic change related to the subsidence of the AIH. Adjacent segmental disease was occurred in 18 (18.2%) patients. Total 6 (6%) reoperations were performed at the index level. There was no statistical significance between clinical and radiological outcomes. But, overall long-term clinical outcome by Odom's criteria was unsatisfactory (64.64%). The neck and arm VAS score were increased by over time. Conclusion : Long-term outcomes of ACDF with SAC group were acceptable but not satisfactory. For optimal decision making, more additional comparative long-term outcome data is needed between ACDF with SAC and ACDF with plating.

Early Clinical Outcomes of Tricuspid Valve Repair with a Tri-Ad Annuloplasty Ring in Comparison with the Outcomes Using an MC3 Ring

  • Jung, Woohyun;Choi, Jae Woong;Hwang, Ho Young;Kim, Kyung Hwan
    • Journal of Chest Surgery
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    • 제51권2호
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    • pp.92-99
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    • 2018
  • Background: We evaluated the early clinical outcomes of tricuspid valve annuloplasty (TAP) with the Tri-Ad annuloplasty ring for functional tricuspid regurgitation (TR). Methods: From January 2015 to March 2017, 36 patients underwent TAP with a Tri-Ad ring for functional TR. To evaluate the early clinical outcomes of TAP with the Tri-Ad ring, we conducted a propensity score-matched analysis comparing the Tri-Ad and $MC^3$ tricuspid annuloplasty rings (n=34 in each group). The follow-up duration was $11.0{\pm}7.07$ months. Results: There was 1 case of operative mortality (2.8%) and no cases of late mortality. Postoperative complications occurred in 15 patients (41%), including acute kidney injury in 6 patients (16%), bleeding requiring reoperation in 4 patients (11%), and low cardiac output syndrome in 4 patients (11%). There were no ring-related complications, such as atrioventricular block or ring dehiscence. The TR grade decreased significantly (from $2.03{\pm}1.06$ to $1.18{\pm}0.92$, p<0.01), as did the systolic pulmonary artery pressure (from $43.53{\pm}13.84$ to $38.00{\pm}9.72mm\;Hg$, p=0.03). There were no cases of severe residual TR, but moderate TR was observed in 3 patients, all of whom had severe TR preoperatively. Severe preoperative TR was also associated with moderate in the univariate analysis (p<0.01). In the propensity score-matched analysis comparing the Tri-Ad and $MC^3$ rings, there was no significant difference in early clinical outcomes. Conclusion: TAP with the Tri-Ad ring corrected functional TR effectively and provided good early clinical and echocardiographic results without ring-related complications. However, severe preoperative TR was associated with moderate or severe residual TR in the immediate postoperative period. A follow-up study is necessary to confirm the stability of this procedure.

기본의학교육 학습성과 개발과 활용 (Specification and Application of Learning Outcomes in Basic Medical Education)

  • 이병두
    • 의학교육논단
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    • 제18권3호
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    • pp.119-124
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    • 2016
  • The Korea Association of Medical Colleges (KAMC) has been developing learning outcomes for basic medical education (BME) since 2012. This initiative is designed to help medical schools implement competency-based medical education. KAMC divided the BME competencies into three domains (clinical practice, scientific concepts and principles, and human beings and society) with learning outcomes for each domain. KAMC plans to revise the learning outcomes to reflect feedback from medical schools, changes in social health needs, and changes in the healthcare environment and healthcare system in the near future. KAMC also plans to specify learning outcomes that integrate the three domains.

Growth patterns of preterm infants in Korea

  • Lim, Joohee;Yoon, So Jin;Lee, Soon Min
    • Clinical and Experimental Pediatrics
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    • 제65권1호
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    • pp.1-9
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    • 2022
  • With advancements in neonatal care and nutrition, the postnatal growth of preterm infants has improved; however, it remains an issue. Accurate assessments of growth using a standardized reference are needed to interpret the intrauterine and postnatal growth patterns of preterm infants. Growth in the earlier periods of life can contribute to later outcomes, and the refinement of postnatal growth failure is needed to optimize outcomes. Catch-up growth occurs mainly before discharge and until 24 months of age, and very low birth weight infants in Korea achieve retarded growth later in life. Knowing an infant's perinatal history, reducing morbidity rates during admission, and performing regular monitoring after discharge are required. Preterm infants with a lower birth weight or who were small for gestational age are at increased risk of poor neurodevelopmental outcomes. Furthermore, poor postnatal growth is predictive of adverse neurodevelopmental outcomes. Careful monitoring and early intervention will contribute to better development outcomes and national public health improvements.