• Title/Summary/Keyword: Clinical Practice Guidelines

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Expert Opinions and Recommendations for the Clinical Use of Quantitative Analysis Software for MRI-Based Brain Volumetry (뇌 자기공명영상 뇌용적 분석 소프트웨어의 임상적 적용에 대한 전문가 의견과 권고안)

  • Ji Young Lee;Ji Eun Park;Mi Sun Chung;Se Won Oh;Won-Jin Moon;Aging and Neurodegeneration Imaging (ANDI) Study Group, Korean Society of Neuroradiology (KSNR)
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1124-1139
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    • 2021
  • The objective assessment of atrophy and the measurement of brain volume is important in the early diagnosis of dementia and neurodegenerative diseases. Recently, several MR-based volumetry software have been developed. For their clinical application, several issues arise, including the standardization of image acquisition and their validation of software. Additionally, it is important to highlight the diagnostic performance of the volumetry software based on expert opinions. We instituted a task force within the Korean Society of Neuroradiology to develop guidelines for the clinical use of MR-based brain volumetry software. In this review, we introduce the commercially available software and compare their diagnostic performances. We suggest the need for a standard protocol for image acquisition, the validation of the software, and evaluations of the limitations of the software related to clinical practice. We present recommendations for the clinical applications of commercially available software for volumetry based on the expert opinions of the Korean Society of Neuroradiology.

Structured Assessment to Evaluate a Family Medicine Clerkship Program (가정의학 임상실습과정에 대한 구조화된 평가)

  • Park, Eun Ju;Lee, Sang Yeoup;Im, Sun Ju;Yune, So Jung;Kam, Beesung;Baek, Sun Yong;Kim, Yun-Jin;Woo, Jae Seok;Lee, Jeong-Gyu;Jeong, Dong-Wook;Cho, Young-Hye;Yi, Yu-Hyeon;Tak, Young Jin
    • Korean Medical Education Review
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    • v.19 no.1
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    • pp.47-55
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    • 2017
  • This study was conducted to analyze the strengths and weaknesses of a 3-week family medicine clerkship program based on the results of an online survey taken by the students (N=127) and a structured interview with a focus group (n=10), aimed to improve the quality of the clerkship program. The online survey contained questions pertaining to goals, schedule, contents, arrangement, atmosphere, environment, evaluation, and satisfaction regarding the clerkship. The focus group interview addressed the schedule and achievements of the program. Scores were reported on a 5-point Likert scale. Most students were highly satisfied with the overall quality of the clerkship. The structured interview results showed that 97.6% of the clerkship program was executed according to the schedule. The focus group reported a perfect score of 5 points on several measures including: accomplishment of the educational goals of the family medicine clerkship, providing many chances to obtain medical histories and perform physical examinations on real patients, experience with various symptoms and diseases, positive attitudes of faculty members when teaching, notification of the guidelines for evaluation beforehand, well-constructed and effective clerkship schedule, and reflection of student feedback. However, the focus group gave low scores on: support for health accidents of students, access to patient information, enough opportunities to practice clinical skills, appropriate rest facilities for students, and fairness of clerkship evaluation process. In conclusion, the structured evaluation performed after the 3-week clerkship program motivated students and helped them ensure an efficient clerkship. This structured evaluation also suggested basic data to make the professor who is subject of the assessment. This study shows that structured assessment is an effective method which can be used to improve the quality of clerkships.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment - (주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 -)

  • Lee, Moon-Soo;Park, Su-Bin;Kim, Gyung-Mee;Kim, Hyun-Jin;Park, Sangwon;Kim, Yunsin;Lee, Young Sik;Kweon, Yong-sil;Shin, Dongwon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey (다기관 설문조사를 통한 국내 소아 음성질환 환자의 검사 및 치료 유형 연구)

  • Lee, Jong-Geun;Bang, Seung-Hwan;Jeon, Jae-Min;Lee, Jung-Kyu;Kim, Angela Yun;Woo, Jeong-Soo;Cho, Jae-Gu
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.39-47
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    • 2019
  • Background and Objectives : Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method : An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results : Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion : Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

An Overview of the Herbal Remedies and other Non-conventional Therapies for 2009 Novel Influenza A(H1N1) (2009년 유행 신종인플루엔자 A(H1N1)의 한약 및 기타 비전형적 치료에 대한 고찰)

  • Sun, Seung-Ho;Jang, In-Soo;Baik, You-Sang;Bae, Sun-Jae;Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.30 no.3
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    • pp.558-570
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    • 2009
  • Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.

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The frontal characteristics of esthetic lips and lips after anterior segmental osteotomy in Korean females (정면에서 평가한 한국인 여성 입술의 심미성과 전방 분절 골절단술 후 입술의 평가)

  • Lee, Beom-Suk;Kang, Yoon-Goo;Yoon, Tae-Ho;Kook, Yoon-Ah
    • The korean journal of orthodontics
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    • v.37 no.5
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    • pp.331-340
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    • 2007
  • The aim of this study was to determine firstly the characteristics of esthetic lips in Korean females and secondly to measure the changes of the lips before and after anterior segmental osteotomy in bimaxillary protruded patients. Methods: Samples consisted of 30 models and 26 nonmodels, and 10 patients who had received anterior segmental osteotomy. Twelve linear measurements, 5 angular measurements, and the lip perimeter and area were measured. These results were compared for each group using unpaired and paired t-tests. Results: Full face width, nose to chin, upper vermilion height and angle, lateral heights at the point of the tips of Cupid's bow, central bow angle, and the lower lip to chin lengths were significantly greater in nonmodels than in models. However, overall lip width, lower vermilion height and angle, tip-to-tip of Cupid's bow lip perimeter, and lower vermilion area were greater in models than in nonmodels. Comparison of before and after anterior segmental osteotomy revealed that the values for the upper vermilion and lateral heights, the angle to Cupid's bow tip lengths, and upper vermilion area of post-operative patients had become similar to those of Korean female models. Our findings demonstrated that Korean female models have a fuller lower vermilion & thinner upper vermilion compared with nonmodel controls, as determined by the vermilion heights, angles, and areas. Conclusions: It will be helpful for clinicians to use these measurements as guidelines for improving patients' facial esthetics.

Factors Affecting on the Clinical Nurse's Safety Nursing Activity (임상간호사의 안전간호활동 영향요인)

  • Song, Eun-Jeong;Park, Yeon-Suk;Ji, Hyun-Soon;Lee, Hye-Kyung
    • Journal of Digital Convergence
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    • v.14 no.11
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    • pp.469-479
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    • 2016
  • This research is a descriptive investigation research in order to understand the influences on the perception of the patient safety culture and safey nursing activity with the clinical nurses of the university hospitals as the subjects. The data collected were analyzed using the SPSS 23.0 program. As a result, the perception of patient safety culture of the subjects was 3.30 of the full score of 5points, and safety nursing activity 3.89. It appeared that, also, in the safety nursing activity, the total career experience, the position, immediately superior/manager, the communication procedures, and the frequency of accident reports receive the influences. As a result, in order to enhance the safety nursing activity, the developments of the practice guidelines that can appropriately manage the experienced people, that can communicate smoothly between the organizations, and that can make the case reports and the developments of the educational programs are needed.

Treatment Strategies for Psychotic Depression (정신병적 우울증의 치료 전략)

  • Lee, Soyoung Irene;Jung, Han-Yong
    • Korean Journal of Biological Psychiatry
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    • v.13 no.4
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    • pp.234-243
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    • 2006
  • Objectives : Several factors, such as biological markers, clinical correlates, and course of the depressive disorders with psychotic symptoms differ from those without psychotic symptoms. Therefore, specification of a treatment algorithm for depressive disorder with psychotic symptoms is legitimated. This article provides a systematic review of somatic treatments for depressive disorder with psychotic symptoms. Methods : According to the search strategy of the Clinical Research Center for Depression of Korean Health 21 R & D Project, first, PubMed and EMBASE were searched using terms with regard to the treatment of depressive disorders with psychotic symptoms(until July 2006). Reference lists of related reviews and studies were searched. In addition, relevant practice guidelines were searched using PubMed. All identified clinical literatures were reviewed and summarized in a narrative manner. Results : Treatment options, such as a combination of an antidepressant and an antipsychotic versus an antidepressant or an antipsychotic alone are summarized. In addition, issues regarding the electroconvulsive therapy( ECT), combination therapy, and maintenance treatment are discussed. Conclusion : In former times, the combination of an antidepressant and an antipsychotic or ECT were recommended as the first line treatment for depressive disorder with psychotic symptoms. Recently, however, there was a suggestion that there was no conclusive evidence that the combination of an antidepressant and an antipsychotic drug is more effective than an antidepressant alone. More evidence regarding the pharmacological treatment for depressive disorder with psychotic symptoms is needed.

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Review Study of Headache Measurement Tools - Mainly on Reliability and Validity - (두통 평가 척도에 관한 고찰 - 신뢰도와 타당도를 중심으로 -)

  • Kim, Eun-Jung;Jung, Chan-Yung;Jang, Min-Gee;Yoon, Eun-Hye;Nam, Dong-Woo;Kang, Jung-Won;Lee, Jae-Dong;Lee, Seung-Deok;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.27 no.1
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    • pp.51-64
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    • 2010
  • Objectives : To introduce and compare various headache measurement tools, in order to provide fundamental information for future clinical trials and development of oriental medicine measurement tools. Methods : Eight headache assessment scales, Migraine-Specific Quality of Life Questionnaire(MQoLQ), Migraine-Specific Quality of Life(MSQOL), Migraine-Specific Quality of Life Questionnaire(MSQ), The Headache Impact Questionnaire(HImQ), Headcahe Needs Assessment Survey(HANA), Henry Ford Headache disability Inventory(HDI), Migraine Disablity Assessment Scale(MIDAS) and Headache Impact Test(HIT-6), were searched through Pubmed. General character, the process of development, verification of reliability, internal consistency, responsiveness to patient's change and validity were reviewed. Results : In assessing the quality of life of migraine patients, MQoLQ can be used to measure the change within 24 hours, MSQ and MSQOL can be used to measure the change during a relatively longer period of time. The frequency and bothersomeness of headache can be easily measured by HANA. HImQ can be used to measure the intensity of headache and the influence on normal daily activities. HDI can measure the emotional difficulties of headache patients. HIT-6 and MIDAS makes measurements possible in a short period of time, and the reliability and validity have been verified numerously. HIT-6 and MIDAS are the most frequently used measurement tools because they are simple and easy for both the assessor and the patient to understand and use. Conclusions : In this study, various headache assessment tools have been reviewed. The assessed tools were widely used after being verified for their reliability and validity. We hope this study provides fundamental information in establishing future clinical trial and clinical practice guidelines. We also hope this study to contribute to the development of an oriental medicine assessment tool for headache.

Methodological and Reporting Quality of Systematic Reviews Published in Journal of Society of Preventive Korean Medicine (대한예방한의학회지에 게재된 체계적 문헌고찰의 방법론 및 보고 질에 대한 평가)

  • Song, Eunhye;Jun, Jihee;Lee, Myeong Soo;Ang, Lin;Kim, Kyeong Han;Park, Sunju
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.67-76
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    • 2019
  • Objectives : The publication of systematic reviews (SRs) has increased significantly over the years, and systematic reviews are considered to have the strongest evidence as they are at the top of the hierarchy of evidence pyramid. In this study, a thorough assessment of all SRs published in Journal of Society of Preventive Korean Medicine (JSPKM) was performed to evaluate their reporting quality and methodological quality to better improve the quality of SRs in JSPKM. Methods : JSPKM website was searched to include all SRs published in JSPKM from 1997 to 2018. Two independent researchers assessed the SRs using A MeaSurement Tool to Assess systematic Reviews (AMSTAR, formerly known as Assessment of Multiple Systematic Reviews) tool checklist for methodological quality assessment, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline checklist for reporting quality assessment. Results : Out of 618 published articles published in JSPKM from 1997 to 2018, only 3 SRs were identified as SRs. For AMSTAR methodological quality scoring, the average score of 3 SRs was 3.0 out of 11 which is low quality level. For PRISMA reporting quality items, the 3 SRs reported 17.3 items on average out of 27 items. The 3 identified SRs did not provide information on protocol or registration which is included in both AMSTAR assessment tool and PRISMA guideline. Conclusions : Improvements on reporting quality and methodological quality of SRs using relevant tools or guidelines are needed to assure the quality of SRs published in JSPKM so that their conclusions will be more transparent and reliable for decision-making in healthcare and the best clinical practice.