• 제목/요약/키워드: Clinical Practice Guidelines

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Radiomics and Deep Learning from Research to Clinical Workflow: Neuro-Oncologic Imaging

  • Ji Eun Park;Philipp Kickingereder;Ho Sung Kim
    • Korean Journal of Radiology
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    • 제21권10호
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    • pp.1126-1137
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    • 2020
  • Imaging plays a key role in the management of brain tumors, including the diagnosis, prognosis, and treatment response assessment. Radiomics and deep learning approaches, along with various advanced physiologic imaging parameters, hold great potential for aiding radiological assessments in neuro-oncology. The ongoing development of new technology needs to be validated in clinical trials and incorporated into the clinical workflow. However, none of the potential neuro-oncological applications for radiomics and deep learning has yet been realized in clinical practice. In this review, we summarize the current applications of radiomics and deep learning in neuro-oncology and discuss challenges in relation to evidence-based medicine and reporting guidelines, as well as potential applications in clinical workflows and routine clinical practice.

Effect of Evidence-based Clinical Practice Guidelines for Promotion of Postoperative Nausea and Vomiting of Patients with Laparoscopic Hysterectomy (복강경 수술 환자의 수술 후 오심과 구토 관리를 위한 근거중심 실무 가이드라인 적용 효과)

  • Lee, Sung-Hee;Hong, Sung-Jung;Kim, Hwa Sun;Jeon, Younghoon
    • Korean Journal of Adult Nursing
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    • 제27권5호
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    • pp.481-492
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of the evidence-based clinical practice guidelines on Postoperative Nausea and Vomiting (PONV). Methods: The research design was a non-equivalent control group with a non-synchronized design. The participants were the patients undergoing gynecologic laparoscopy. Data were collected from July, 2014 through January, 2015. The participants in the experimental group (n=35) received an assessment of risk factors of PONV, aroma therapy, and P6 acupressure method as recommended in the guidelines. Those in the control group (n=35) received usual nursing care. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test using SPSS/WIN 19.0 program. Results: The occurrence of nausea and vomiting, the level of nausea and vomiting, and the need for antiemetic medicine in the experimental group were significantly less than those in the control group after surgery. The levels of postoperative pain and the amounts of time for nursing activities in the experimental group were significantly reduced than those in the control group after surgery. The levels of satisfaction were significantly higher in the experiment group than that of the control group. Conclusion: The evidence-based guidelines is recommended for nursing practice as a guidance for managing PONV and helping the recovery of patients after laparoscopic surgery.

Integrative Oncology Practice Guidelines (통합 종양학 시술 지침)

  • Liu, Yuan-Sheng;Lee, Jong-Hoon;Lee, Yeon-Weol;Cho, Chong-Kwan;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • 제12권1호
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    • pp.37-65
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    • 2007
  • The Society for Integrative Oncology (SIO) is an international organization established to encourage scientific evaluation, dissemination of evidence-based information, and appropriate clinical integration of complementary therapies (http://www.Integrativeonc.org.). Practice Guidelines were developed by the authors listed below and by the Executive Committee of the Society for Integrative Oncology, which approved this document. Guidelines are a work in progress; they will be updated as needed and are available on the SIO Web site as well: www.IntegrativeOnc.org.

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Updates of Nursing Practice Guideline for Intravenous Infusion (정맥주입요법 간호실무지침 개정)

  • Gu, Mee Ock;Cho, Yong Ae;Eun, Young;Jung, Ihn Sook;Kim, Hyun Lim;Yoon, Hee Sook;Kim, Eun Hyun;Yoon, Ji Hyun;Chang, Hee Kyung
    • Journal of Korean Clinical Nursing Research
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    • 제23권3호
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    • pp.361-375
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    • 2017
  • Purpose: This study was conducted to update the existing nursing practice guideline for intravenous infusion guidelines according to the evidence-based practice guideline in South Korea. Methods: Guideline update process was performed using 22 steps according to the manuals developed by NICE and SIGN. Results: Updated nursing practice guidelines for the intravenous infusion were consisted of 23 domains and 322 recommendations. The number of recommendations in each domain were 4 for general instruction, 12 for vascular access device selection, 20 for site selection, 9 for insertion, 54 for stabilization, 21 for maintaining patency, 4 for blood sampling, 33 for exchange and removal, 28 for add-on device selection, 28, 72 for infusion related complications, 56 for infusion therapies, 7 for education, and 2 for documentation and report. There were 15.9% of A, 30.2% of B, 53.9% of C in terms of grade recommendations. A total of 178 (51.6%) recommendations were newly developed and 24 previous recommendations have been deleted. Conclusion: Updated nursing practice guideline for intravenous infusion was expected to be an evidence-based practice guideline for intravenous infusion in South Korea. This guideline is suggested to be disseminated to clinical nursing settings nationwide to improve the efficiency of intravenous infusion practice.

Middle East Respiratory Syndrome Outbreak and Responsiveness of the Pharmacy Programs on the Pharmacy Practice Education (중동호흡기증후군(MERS) 발생관련 전국 약학대학의 실무실습교육 대응현황)

  • Choi, Kyung Hee;Choi, Kyung Suk;Lee, Young Sook;Kim, Jaeyoun;Jeong, Kyeong Hye;Oh, Jung Mi;Choi, Kyung Eob;Ra, Hyeon Oh;Lee, Euni
    • Korean Journal of Clinical Pharmacy
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    • 제27권1호
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    • pp.9-14
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    • 2017
  • Background: Pharmacy curriculum change was made from a 4-year program to a 2+4 year program in year 2009 in Korea. The change has resulted in more educational exposures on patient-centered practice environments for about 1,400 hours in the last year of the professional pharmacy program. When the Middle East Respiratory Syndrome (MERS) outbreak hit Seoul and suburban areas and propagated to other provinces in Korea, emergency response to avoid student infection in the pharmacy practice sites became an urgent issue. While other health professional programs such as medicine and nursing had activated emergency preparedness manuals, timely and clear guidelines were not disseminated to all pharmacy programs and protective measures largely relied on individual pharmacy program. Methods: A survey was developed by the Committee on Pharmacy Practice Experience Programs in the Korean College of Clinical Pharmacy to document the status of pharmacy programs during the Korea MERS outbreak in 2015. The 10-question survey was distributed to the pharmacy practice experience coordinators to 34 out of 35 pharmacy schools in Korea by emails. Results: Our findings showed that 82.4% of the program coordinators (28/34) responded to the survey, 96.4% of the programs did not have emergency preparedness manuals, administrative meetings were held in 89.3% of the pharmacy programs, the rotation schedules were modified or withheld in 53.6% of schools, and the changes were mostly observed from the programs classified as MERS outbreak regions. Conclusion: Further needs in establishing the emergency preparedness manual should be explored for pharmacy education stakeholders.

Effects of Evidence Based Practice Integrated Critical Care Clinical Practicum (근거중심실무 연계 중환자간호 실습교육의 적용 및 효과)

  • Park, Myong-Hwa
    • The Journal of Korean Academic Society of Nursing Education
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    • 제17권3호
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    • pp.346-354
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    • 2011
  • Purpose: This study examines the effects of integrating Evidence Based Practice (EBP) into a critical care clinical practicum on nursing students' access and use of information resources and EBP competency. Methods: A one-group pretest-posttest design was used. Fifty senior nursing school students from a university participated. A critical care clinical practicum combined with EBP consisted of six full days of clinical practicum in intensive care units with EBP education. Group and individual training in EBP skills, lectures, small group discussion and conferences were provided. Data were analyzed using paired t tests for 50 participants. Results: The scores of evidence based practice competency increased significantly (p<.001) showing significant improvement in searching and classifying the evidence. Nursing students' access and use of research evidence improved (p=.004). Conclusion: This study showed that the integration of EBP into a clinical practicum was effective in improving accessibility and usefulness in research evidence such as guidelines and research articles, and increasing EBP competency in undergraduate students.

Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy (조영제 유발 신장병증 예방을 위한 수액요법에 관한 근거기반 임상실무지침 개발)

  • Lee, Kyung Hae;Shin, Kyung Min;Lee, Hyeon Jeong;Kim, So Young;Chae, Jung Won;Kim, Mi Ra;Han, Min Young;Ahn, Mi Sook;Park, Jin Kyung;Chung, Mi Ae;Chu, Sang Hui;Hwang, Jung Hwa
    • Journal of Korean Clinical Nursing Research
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    • 제23권1호
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    • pp.83-90
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    • 2017
  • Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

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

  • Chun, Ja-Hae;Kim, Hyun-Ah;Kwak, Mi-Jeong;Kim, Hyuo-Sun;Park, Sun-Kyung;Kim, Moon-Sook;Choi, Ae-Lee;Hwang, Jee-In;Kim, Yoon-Sook
    • Quality Improvement in Health Care
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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.

A Survey on Korean Medicine Treatment of Autonomic Dysfunction: Preliminary Research for Clinical Practice Guidelines (자율신경실조증 한의표준임상진료지침 개발을 위한 한의임상 실태조사)

  • Hui-Yeong Park;Geum-Ju Song;Hyun Woo Lee;Chan Park;Seok-In Yoon;Jung Hwan Park;Sun-Yong Chung;Jong Woo Kim
    • Journal of Oriental Neuropsychiatry
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    • 제34권4호
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    • pp.335-347
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    • 2023
  • Objectives: The study aimed to understand the current treatment patterns in Korean medicine to develop clinical practice guidelines for autonomic dysfunction in Korean medicine. Methods: This study sent an online survey vai text message to 25,900 Korean medicine doctors whose contact information was registered with the Association of Korean Medicine. A total of 1,410 Korean medical doctors completed the online survey. Results: When autonomic treating dysfunction clinically, 77% of the cases included only a description without entering a diagnosis code. The most commonly used information to diagnose o autonomic dysfunction was history-taking and symptoms (79%), and the main symptoms of autonomic dysfunction were palpitations, dizziness, sleeping difficulties, anxiety/nervousness, and depression/lethargy. The most frequently mentioned cause of autonomic dysfunction was mental problems (54%). The most commonly used Korean medicine treatment method for autonomic dysfunction was herbal medicine (70%), and Soyo-san/Gamisoyo-san is the most frequently used herbal medicine preparation. Liver qi depression used to indicate the most often mentioned Korean medicine pattern identification used to indicate autonomic dysfunction (31%). When asked whether cardiac neurosis in Chinese medicine can be considered autonomic dysfunction, opinions for and against it are determined almost equally. Conclusions: Our results serve are a foundation for developing clinical practice guidelines for autonomic dysfunction in Korean medicine and are expected to catalyst promoting future clinical research on autonomic dysfunction.

Practice method and performance according to clinical practice contents of dental hygiene student (치위생과 학생의 임상실습내용에 따른 실습방법 및 수행 정도)

  • Shin, Myong-Suk;Kim, Chang-Hee;Ahn, Eun-Suk;Hwang, Ji-Min
    • The Journal of the Convergence on Culture Technology
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    • 제5권2호
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    • pp.123-138
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    • 2019
  • The clinical institution of some dental hygiene students and the degree of practice and performance according to the practice contents are identified, so as to develop clinical practice guidelines and to improve the education of universities and practical institutions. From November 2016 to March 2017, the questionnaire was prepared by self-inclusion after explaining the purpose of research and how to prepare questionnaire to some dental hygiene students. This material has been analyzed using PASW Statistics 18.0. As for the clinical practice content items of basic care and infection control, the frequency of "execution" among practice methods was high, and the distribution rate was high in oral evil face radiation, preventive dentistry, prosthesis, periodontology, orthodontics, and oral internal medicine. The conservation department has conducted various practical methods such as "executing," "observing" and "preparing." Oral surgery showed similar distribution rates, such as "observation," "preparation," and "execution" in the "preparation and cooperation of the feet." In pediatric dentistry, "observation" was the most common practice, and among them, "observation," "preparation," and "execution" were performed in "preparation and cooperation for infantile development." In addition, students with more experience in clinical practice showed statistically significant differences in basic care, oral hygiene, preventative dentistry, conservation, dental dentistry, oral surgery, orthodontics, and oral internal medicine(p<0.05). Most clinical practice shows that it is more observable than performed.It is expected that the goal of clear clinical practice content should be set by grade or number of clinical practice experiences, as well as the practice method that can be performed by the trainees.