• Title/Summary/Keyword: Clinical decision support

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Review of Economic Evaluation Studies for Drug Reimbursement Decision (의약품 보험급여 결정을 위한 경제성평가 연구의 평가)

  • Choi Sang-Eun;Sullivan Sean D.
    • Health Policy and Management
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    • v.15 no.4
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    • pp.1-25
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    • 2005
  • Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

Relationship Between Major Satisfaction, Career Decision Autonomy, and Career Search Behavior of Nursing College Students in Clinical Practice Experience (임상실습경험 간호대학생의 전공 만족도, 진로결정자율성 및 진로탐색행동의 관계)

  • Lee, Yu Jin;Kim, Yun Su
    • The Journal of Korean Academic Society of Nursing Education
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    • v.23 no.4
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    • pp.474-485
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    • 2017
  • Purpose: The purpose of this study was to identify a causal relationship among major satisfaction, career decision autonomy, and career search behavior of nursing college students in clinical practice experience. Methods: Data were collected using a self-reported questionnaires from 197 nursing students in S city from December 1 to 23, 2016. These were then analyzed by descriptive statistics, ANOVA, t-test, Pearson correlation coefficient, and multiple regression using SPSS/PC+ program. Results: The results suggest that major satisfaction was correlated with career decision autonomy; likewise, major satisfaction was correlated with career search behavior. The factors influencing career search behavior were grades and major satisfaction. Conclusion: It is necessary to develop a learning method considering interest and aptitude to increase the satisfaction of the major and to apply the various programs to understand the self and the work environment so as to determine how desirable the course will be.

Proposal of East-west Integrative Medicine Manual for Rehabilitation after Lumbar Spine Surgery (요추 수술 후 재활 치료에서의 한양방협진 매뉴얼 제안)

  • Song, Min-Yeong;Jo, Hee-Geun;Sul, Jae-Uk;Leem, Jungtae
    • Journal of Korean Medicine Rehabilitation
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    • v.28 no.4
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    • pp.59-69
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    • 2018
  • Objectives This is one of the manuals of East-west integrative medicine which was created by the Committee on integrative medicine of Chung-Yeon Korean Medicine Hospital. The purpose of this manual is to support clinical decision making and communication during the rehabilitation of patients after lumbar spine surgery. Methods The drafting was done by two rehabilitation specialists in Korean Medicine. After a rehabilitation specialist in western medicine reviewed the draft and exchanged their ideas, a revised version that reflects the goal of consultation was made. Then the Committee agreed to adopt the manuals through the process of review and feedback in addition to face-to-face discussions. Results This manual describes clinical decision making for rehabilitation after lumbar microdiskectomy, interbody fusion, and kyphoplasty. Therefore it contains the schedule of rehabilitation treatment through the surgical technique, general goal of the rehabilitation by phase, scales for outcome measure and postoperative infection management. Conclusions The proposal of this manual has a significance for it provides information about decision making process and contents of treatment in one medical institution for East-west integrative rehabilitation treatment after lumbar spine surgery.

A Study about the Human Communication between Clinical Nurse and Patient (임상간호사-환자 관계의 인간커뮤니케이션 이해)

  • 전명희
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.841-854
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    • 1999
  • This study tried to the answer to the question : “How does the human communication happen between clinical nurse and patient\ulcorner” To answer that, a micro-ethnographic research method was used and I performed field work at the orthopedic ward in one Korean metropolitan city. After analysis of interview data, observational data and field notes, I could understand that clinical nurse-patient communication performed for clinical decision making, providing patient education and emotional support. Prepared nurse communicate with patient more effectively, eventually can establish more trust relationship with patient. Conclusively I discussed about the way of nurse's skill acquisition, need of collaborative conference with doctor and nurse, and curriculum development to promote nurses's understanding of human.

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Emerging Machine Learning in Wearable Healthcare Sensors

  • Gandha Satria Adi;Inkyu Park
    • Journal of Sensor Science and Technology
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    • v.32 no.6
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    • pp.378-385
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    • 2023
  • Human biosignals provide essential information for diagnosing diseases such as dementia and Parkinson's disease. Owing to the shortcomings of current clinical assessments, noninvasive solutions are required. Machine learning (ML) on wearable sensor data is a promising method for the real-time monitoring and early detection of abnormalities. ML facilitates disease identification, severity measurement, and remote rehabilitation by providing continuous feedback. In the context of wearable sensor technology, ML involves training on observed data for tasks such as classification and regression with applications in clinical metrics. Although supervised ML presents challenges in clinical settings, unsupervised learning, which focuses on tasks such as cluster identification and anomaly detection, has emerged as a useful alternative. This review examines and discusses a variety of ML algorithms such as Support Vector Machines (SVM), Random Forests (RF), Decision Trees (DT), Neural Networks (NN), and Deep Learning for the analysis of complex clinical data.

Data-Linking Infrastructure for the Health Technology Assessment (의료기술평가 기반으로서의 데이터 연계)

  • Park, Chong Yon
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.81-87
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    • 2018
  • With the recent change of healthcare environment including rapid technological development, evidences are more and more important and necessary to support relevant policies in health technology assessment to provide safe and effective health services, utilizing medical resources efficiently. Despite of the emphasis on the importance of real world data and real world evidence in health care research, current infrastructure supporting clinical research is considerably weak due to absence of legal and institutional basis. However, in accordance with the Article 26 of the Health and Medical Technology Promotion Act, there is a limited legal apparatus that can be used only in public data with other dataset for the purpose of healthcare technology assessment at the National Evidence-based Collaborating Agency. Although the use of linked data from various sources was often required in the field of clinical research, it was not yet working well due to insufficient environmental conditions. In order to support the decision-making of medical practice and health care policies, data-linking platform for clinical research is needed. If the legal system that can link up to the data of the private institutions without violating the significant value such as the protection of private informations is established, it will be a decisive foundation reinforcing the researches and policy making processes for the improvement of the national health care system.

U-health Service Model for Managing Health of Chronic Patients in Multi-platform Environment (멀티플랫폼 환경의 만성 질환자 건강관리를 위한 유헬스 서비스 모델)

  • Park, Dong-Kyun;Kim, Jong-Hun;Kim, Jae-Kwon;Jung, Eun-Young;Lee, Young-Ho
    • The Journal of the Korea Contents Association
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    • v.11 no.8
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    • pp.23-32
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    • 2011
  • U-health services have been progressed as treatment and management for specific diseases and prevention services for providing the behavior management to customers according to the increase in chronic patients. The conventional U-health services provide required services and bio-information monitoring only through remote diagnoses and counsels and that represent limitations in preventing and managing metabolic syndrome patients like chronic patients. Thus, in this study a multi platform based U-health service model for managing the health of chronic patients is proposed. The multi-platform based U-health service model can provide continuous health information, diet, and exercise services regardless of the location of customers through PCs and smart phones. In addition, it is able to provide prescription services to doctors and nurses using a CDS (Clinical Decision Support) module based on clinical information. Doctors can identify the life pattern of patients through a behavior modification program and provide customized services to patients. The U-health service model provides effective services in multi-platform environments to customers and that will improve the health of chronic patients.

Web based System for Supporting Medical Treatment in Korean Medicine based on Korean Medicine Ontology (온톨로지를 활용한 웹 기반 한의 진료 지원 시스템)

  • Seo, Jin Soon;Kim, Sang Kyun;Oh, Yong Taek;Kim, An Na;Jang, Hyun Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.1
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    • pp.113-121
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    • 2014
  • With the development of information technology, knowledge information-oriented and information systems are being rapidly paced. In addition, doctor's needs of the system that assist decision making is gradually increasing. Because the complex process of decision-making should be a lot. We propose a web based system for supporting medical treatment based on Korean medicine ontology. There are three kinds of processes. First, a pattern is decided for patient' symptoms, a formula for the pattern is selected and medicinal materials constituting the formula is added or removed. Second, a formula is decided for patient' symptoms, medicinal materials constituting the formula is added or removed. Third, a Treat method is decided for patient' symptoms, medicinal materials constituting the formula is added or removed. We have designed and implemented the clinical decision support system that supports flexible processes and necessary information and functions. The system shows the appropriate form of ontology knowledge as interrelated and provide analysis and processing, does not show simply search. The system is one of the systems utilizing ontology and a web based system that can be used in anywhere. Therefore, This system Will be useful as for doctors to make decision.

The effective approaches of clinical nursing education (임상교육의 효과적인 대안에 관한 연구)

  • Sin, Gyeong-Rim
    • The Korean Nurse
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    • v.32 no.5
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    • pp.93-105
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    • 1994
  • Nursing is indeed a practice discipline with experiential learning in clinical practice areas comprising an overwhelming portion of a Nursing Student's education. The statement is used to provide a basis for discussion of some issues involved in relation to clinical nursing education. However the lack of substantial research in the area of clinical nursing education would suggest that this 'heart' of the nursing student's professional education has olng been ignored. The purpose of this study is to critically review and analysis then suggest effective approaches of clinical nursing education. First. the curriculum can be developed by faculty consistently. Curriculum design begins with the writing of philosophy and the selection of objectives for the program. The philosophy must include a statement of beliefs and intrinc values about human being. nursing and teaching learning process. Second. faculty practice can be narrowed practice-theory gaps. Third. clinical teaching strategies can be used many different methods in order to facilitate development of clinical judgement and decision making. Fourth, clinical teacher's rols can influence student's learning attitude and intrinsic value; relating to students as mature individuals; creating an atomosphere where in the student felt comfortable approaching the instructor; providing support crisis situations. Fifth. clinical nursing evaluation can be developed the integrated models.

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

  • Yun, Young-Hee;Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.25 no.2
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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.