• Title/Summary/Keyword: Clinical evidence

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Systemic Review of Clinical Studies about Oriental Medical Treatment of Cancer in Korea (국내에 보고된 한국 한의학의 암치료 임상연구에 대한 계통적 고찰)

  • Park, Bong-Ky;Lee, Jong-Hoon;Cho, Chong-Kwan;Shin, Hyun-Kyu;Eom, Seok-Ki;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.29 no.4
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    • pp.1061-1074
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    • 2008
  • Objectives : Recently, the number of cancer patients who use complementary and alternative medicine (CAM), including oriental medicine, are increasing. Also, evidence for efficacy and safety of cancer CAM is reported continuously. This study was designed to evaluate the quality of the published papers for clinical studies about oriental medical cancer treatment in Korea. Methods : We searched for clinical research papers on the websites of the Korean oriental medical society and subsidiary academies, Korean traditional knowledge portal. Koreanstudies information service system (KISS), etc. We used the reference words 'cancer', 'malignant tumor', 'leukemia', 'lymphoma', 'multiple myeloma', 'melanoma', etc, We then chose studies that had been presented between 1991 and 2008 and analyzed them by publication year, design, cancer type, intervention, subject and journal. Results : There were 86 clinical research papers that were published between 1991 and 2008. The number of clinical studies has increased in a time-dependent manner. Case reports and case series studies account for 78% of total clinical research. Studies of lung cancer account for 17%. Studies of cancer-related symptoms of cancer patients account for 38%. Studies of Hang-Am-Dan account for 33%. Studies published in the journal of the Korean Society of Oriental Internal Medicine account for 35%. Conclusion : The clinical research papers about oriental medicine are increasing over time, but most of the studies are retrospective case reports or case series. Well-designed and prospective clinical trials would be recommended to provide more reliable evidence.

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Evaluation of Pharmacy Students' Perception on Clinical Pharmacy Practice Experience in the Tertiary and Secondary Hospital settings (상급종합병원과 종합병원 필수실무실습에 관한 학생들의 인식 평가)

  • Chun, Pusoon;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.1
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    • pp.30-39
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    • 2018
  • Background: Clinical Pharmacy Practice Experience (CPPE) is an important curriculum that offers students patient-centered disease prevention and treatment with evidence-based optimal pharmacotherapy for better clinical outcomes. However, few studies have evaluated the perception of pharmacy students regarding CPPE in tertiary and secondary hospitals. This study aimed to evaluate the perception of pharmacy students regarding the learning program of CPPE. Methods: The survey questionnaire consisted of 15 self-administered questions regarding pharmacy practices, barriers, and improvement of practical training. Fourteen institutional pharmacies located in seven regions responded to a survey questionnaire from March 1 to June 30, 2017. The participants were pharmacy students doing clerkship in a hospital setting. Results: The response rate was 73.6%. Thirty-five participants (22.4%) had used a hospital library, but 121 (77.6%) had never used the library for drug information resources. Eighty-one (50.0%) responded that clinical knowledge and drug information was the most beneficial practice. Thirty-seven (31.1%) respondents in the tertiary hospitals and 19 (46.3%) in the secondary hospitals answered that they were filling prescriptions during the daily break. On the other hand, 72 respondents (60.5%) in the tertiary hospitals and 17 (41.5%) in the secondary hospitals did literature research to prepare for presentation. Conclusion: More students in secondary hospitals continue to fill prescriptions during the daily break, as compared to those in tertiary hospitals. Therefore, the authors suggest self-directed learning to improve clinical performance and each institution considers offering onsite or online library service to improve evidence-based CPPE for pharmacy school students.

The Study of an Improvement of Clinical Competency through Evidence Based Learning (근거 중심의 학습을 통한 학생들의 임상 실무 능력 개선에 관한 연구)

  • Lee, Dongyup
    • Journal of The Korean Society of Integrative Medicine
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    • v.2 no.2
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    • pp.1-12
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    • 2014
  • Purpose : The purpose of this study was to investigate the effect that the academic achievement of the students about the evidence based learning investigates the learning utility value about and the request. Method : The agreement of college students explaining the purpose of research for 12 weeks against 17 students and investigate through a questionnaire. The level of academic achievement according to the sex and claim showed a characteristic with a percentage. An utility investigate the descriptive epidemiologic characteristic about the class of the evidence based learning. Result : The most of college students the level of academic achievement and requests the expected grade of the students about the evidence based learning wanted the 'high' grade of 9 persons, 'middle' grade of 8 persons in the part and the expectation for the class taken so much was high(p<.05). There was the significant different in the utility aspect in the need of the evidence based learning, homework solution, learning synergy effect improvement, and reference search ability improvement(p<.05). Conclusion : These finding revealed that the evidence based learning the satisfaction with class raises the improvement and utility value, and provided the need and the has to develop the educational model which the college students contentment raises an improvement after this opportunity for the new recognition.

Nurses' Awareness and Performance about Evidence-based Pain Management in Older Adults (병원 간호사의 근거중심 노인통증관리 지침에 대한 인지도와 수행도)

  • Kim, Eun-Kyoung;Park, Myong-Hwa
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.20-30
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    • 2012
  • Purpose: This study was to explore the gap between awareness and performance toward evidence-based pain management in older adults for the purpose of establishing baseline data for evidence-based pain management protocol development and dissemination. Methods: The subjects were 290 staff nurses from three general hospitals. Self administered questionnaires were used to collect the data and the results of the study were analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation. Results: There were statistically significant differences between awareness and performance in pain assessment (t=17.31, $p$ <.001), patient and family education (t=17.33, $p$ <.001), pharmacologic management (t=12.99, $p$ <.001), non pharmacological management (t=16.28, p<.001), and evaluation of effectiveness (t=11.70, $p$ <.001). There were also statistically significant differences in awareness and performance according to the workplace, knowledge, and usual performance. Conclusion: The study showed that the hospital nurses' performance about evidence-based pain management in older adults was lower than their awareness level thus indicating significant gaps between evidence and actual practice. To ensure effective pain care, the factors contributing to these gaps need to be analyzed to identify the barriers. In addition, the evidence-based pain management guideline suitable for various clinical settings needs to be developed and disseminated.

Surgical Perspective of T1799A BRAF Mutation Diagnostic Value in Papillary Thyroid Carcinoma

  • Brahma, Bayu;Yulian, Erwin Danil;Ramli, Muchlis;Setianingsih, Iswari;Gautama, Walta;Brahma, Putri;Sastroasmoro, Sudigdo;Harimurti, Kuntjoro
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.1
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    • pp.31-37
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    • 2013
  • Background: Throughout Indonesia, thyroid cancer is one of the ten commonest malignancies, with papillary thyroid carcinoma (PTC) in our hospital accounting for about 60% of all thyroid nodules. Although fine needle aspiration biopsy (FNAB) is the most reliable diagnostic tool, some nodules are diagnosed as indeterminate and second surgery is common for PTC. The aim of this study was to establish the diagnostic value and feasibility of testing the BRAF T1799A mutation on FNA specimens for improving PTC diagnosis. Materials and Methods: This prospective study enrolled 95 patients with thyroid nodules and future surgery planned. Results of mutational status were compared with surgical pathology diagnosis. Results: Of the 70 cases included in the final analysis, 62.8% were PTC and the prevalence of BRAF mutation was 38.6%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for BRAF mutation analysis were 36%, 100%, 100% and 48%, respectively. With other data findings, nodules with "onset less than 5 year" and "hard consistency" were proven as diagnostic determinants for BRAF mutation with a probability of 62.5%. This mutation was also a significant risk factor for extra-capsular extension. Conclusions: Molecular analysis of the BRAF T1799A mutation in FNAB specimens has high specificity and positive predictive value for PTC. It could be used in the selective patients with clinical characteristics to facilitate PTC diagnosis and for guidance regarding extent of thyroidectomy.

Development of a Program to Facilitate Evidence-Based Practice Based on the Transtheoretical Model (범이론적 모형에 기반한 근거기반실무 활성화 프로그램의 개발)

  • Cho, Myung Sook;Cho, Yong Ae;Song, Mi Ra;Kim, Mi Kyung;Cha, Sun Kyung
    • Korean Journal of Adult Nursing
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    • v.25 no.2
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    • pp.136-147
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    • 2013
  • Purpose: This study developed a program to facilitate evidence-based practice (EBP) in one nursing organization, and identifies the effects of the program on the nurses' EBP facilitators. Methods: The program was based on the Transtheoretical Model of stages of organizational change, a literature review, the cases of hospitals overseas, and a prior study. To identify the effects of the program, a one-group pretest-posttest study was conducted with 45 nurses who participated in the EBP implementation. Results: The program consisted of EBP educational sessions, consultations with academic nursing faculty and clinical EBP mentors, and support from the administration and relevant departments. After the EBP program, there was a statistically significant difference in belief in the value of EBP between the pretest and the posttest (t=2.31, p=.026). However, no significant differences were found between the pretest and the posttest for organizational support to develop EBP (t=0.62, p=.537), skills in locating and evaluating research reports (s=-1.00, p=.987), knowledge of research language and skills (s=-1.00, p=.986), and time to devote to EBP (s=-23.00, p=.711). Conclusion: The findings provide important data that can be used to develop and implement strategies for enhancing EBP in clinical settings in Korea.

Nurses' Evidence-Based Practice Beliefs and Competencies, and Organizational Supports (일개 대학병원 임상간호사의 근거기반 간호실무 신념, 역량, 조직의 지원에 관한 조사)

  • Kim, Sun Kyung;Lee, Hyun Hee;Park, Gwang Hee;Kim, Hyun Jeong;Choi, Jong Hee;Park, Kyong Gjin;Lee, Min Ji;Lee, Eun Jeong
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.2
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    • pp.245-254
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    • 2018
  • Purpose: The aim of this study was to assess nurses' evidence-based practice (EBP) beliefs and competencies, and organizational supports to develop EBP. Methods: A descriptive study was conducted using a survey of clinical nurses at a tertiary hospital in South Korea. Results: The survey was distributed to a total of 1,413 nurses and was completed by 1,318 nurses. There were significant differences in the EBP beliefs and competencies, and the perception of organizational supports among nurses at different educational levels. The EBP beliefs, EBP competencies, and organizational supports had a positive correlation with each other. EBP competencies were the highest in nurses with less than 3-years of clinical experience, and the perception of organization supports were the highest in nurses with more than 10-years of clinical experience. Conclusion: The findings suggest that educational programs, training, and organizational supports are recommended for facilitating successful EBP among nurses.

Adaptation of the Evidence-Based Nursing Practice Guideline: Prevention and Management of Moisture Associated Skin Damage (근거 기반 간호 실무지침 수용개작: 습기 관련 피부 손상의 예방과 관리)

  • Baek, Kyu Won;Park, Joo Hee;Kim, Min Kyung;Kim, Kyung Sun;Jeon, Kyoung Ok;Park, Su Hyun;Yang, Weon Ji;Hwang, Ji Won
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.263-272
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    • 2018
  • Purpose: This study was done to develop an evidence-based nursing clinical practice guideline for Moisture associated skin damage (MASD) prevention and management for patients in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by the Korean Hospital Nurses Association. It consists of three main phases and 9 modules including a total of 24 steps. Results: The adapted MASD clinical practice guideline consisted of 4 sections, 8 domains and 28 recommendations. The number of recommendations in each section was: 7 on MASD assessment, 14 on MASD prevention and management, 4 on education, and 3 on organizational policy. Of the recommendations, 3.6% were marked as A grade, 28.6% as B grade, and 67.8% as C grade. Conclusion: This MASD clinical practice guideline is the first to be developed in Korea. The developed guideline will contribute to standardized and consistent MASD prevention and management. The guideline can be recommended for dissemination and utilization by nurses nationwide to improve the quality of MASD prevention and management. Regular revision is recommended.

International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy

  • Seung Joo Kang;Chung Hyun Tae;Chang Seok Bang;Cheol Min Shin;Young-Hoon Jeong;Miyoung Choi;Joo Ha Hwang;Yutaka Saito;Philip Wai Yan Chiu;Rungsun Rerknimitr;Christopher Khor;Vu Van Khien;Kee Don Choi;Ki-Nam Shim;Geun Am Song;Oh Young Lee
    • Clinical Endoscopy
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    • v.57 no.2
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    • pp.141-157
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    • 2024
  • Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

A Review of Recent Oriental Medicine Studies on Female Sexual Dysfunction (여성 성기능장애 관련 최근 국내외 한의학 연구 동향에 대한 고찰)

  • Choi, Min-Sun;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.3
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    • pp.171-189
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    • 2011
  • Objectives: Female Sexual Dysfuction(FSD) is a common gynecologic condition and its prevalence is more higher than men. Despite its high prevalence and clinical importance, research on FSD is not enough in both of oriental and western medicine. The purpose of this study is to review research tendency of recent oriental medicine studies on FSD and to suggest the following research on FSD. Methods: We searched oriental medicine papers related to FSD published in the last 10 years(2001-2011) through Korean Medicine Gynecology Society database, KISS, RISS, NDSL, CNKI(China National Knowledge Infrastructure), and Pubmed. Results: 26 papers were searched, then 18 papers of them were related to Traditional Chinese Medicine(TCM), 8 papers of them were related to Korean Medicine(KM). In classification according to paper type, 16 papers were clinical study, 1 paper was experimental study, 2 papers were bibliographic study, and 7 papers were the other study. Then 5 papers of clinical study was Randomized Controlled Trial(RCT). Conclusion: There was a lack of oriental medicine research on FSD. On the base of this study, so further research is needed. Especially, Clinical trials such as RCT have strong objective evidence power in the viewpoint of Evidence Based Medicine(EBM) are needed.