• Clinics in Shoulder and Elbow
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• v.26 no.3
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• pp.312-322
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• 2023

Background: Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints. Methods: A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases. Results: Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates. Conclusions: Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.

• CELLMED
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• v.6 no.3
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• pp.15.1-15.4
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• 2016

Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

• Korean Journal of Radiology
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• v.21 no.12
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• pp.1345-1354
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• 2020

Objective: To evaluate radiomics analysis in studies on mild cognitive impairment (MCI) and Alzheimer's disease (AD) using a radiomics quality score (RQS) system to establish a roadmap for further improvement in clinical use. Materials and Methods: PubMed MEDLINE and EMBASE were searched using the terms 'cognitive impairment' or 'Alzheimer' or 'dementia' and 'radiomic' or 'texture' or 'radiogenomic' for articles published until March 2020. From 258 articles, 26 relevant original research articles were selected. Two neuroradiologists assessed the quality of the methodology according to the RQS. Adherence rates for the following six key domains were evaluated: image protocol and reproducibility, feature reduction and validation, biologic/clinical utility, performance index, high level of evidence, and open science. Results: The hippocampus was the most frequently analyzed (46.2%) anatomical structure. Of the 26 studies, 16 (61.5%) used an open source database (14 from Alzheimer's Disease Neuroimaging Initiative and 2 from Open Access Series of Imaging Studies). The mean RQS was 3.6 out of 36 (9.9%), and the basic adherence rate was 27.6%. Only one study (3.8%) performed external validation. The adherence rate was relatively high for reporting the imaging protocol (96.2%), multiple segmentation (76.9%), discrimination statistics (69.2%), and open science and data (65.4%) but low for conducting test-retest analysis (7.7%) and biologic correlation (3.8%). None of the studies stated potential clinical utility, conducted a phantom study, performed cut-off analysis or calibration statistics, was a prospective study, or conducted cost-effectiveness analysis, resulting in a low level of evidence. Conclusion: The quality of radiomics reporting in MCI and AD studies is suboptimal. Validation is necessary using external dataset, and improvements need to be made to feature reproducibility, feature selection, clinical utility, model performance index, and pursuits of a higher level of evidence.

• The Journal of Korean Obstetrics and Gynecology
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• v.24 no.2
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• pp.97-103
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• 2011

Objectives: Recently, high attention has been drawn towards evidence based medicine(EBM). However, there is little follow study after Park's analysis research (2002) in the journal of oriental gynecology. Therefore, there is a need to conduct analyzed research on the topic, due to the increasing interest about EBM. Methods: To analyze the treatises of the journal of oriental gynecology, we examined 56 journals published from 1987 to 2010. we followed the way of Park, classifying treatises into bibliographic, experimental and clinical categories. Results: Analytic research, as a part of clinical treatises, increased rapidly from 2001. As a result, it took 53.3% of whole study in general after 2002 and it reached up to 70.0% in 2004. Most part of clinical treatises until 2002 was about case report of patients, but the amount of clinical trial started to increase since 2003. Case report and case series showed dramatic increase after 2001, and clinical trial started to increase after 2003. As a result, 43.8% of the analyzed research was due to clinical trial by 2009. Conclusions: On the base of this research, quality evaluation of clinical treatises using guality assessment tool is needed for EBM in the part of oriental obstetrics & gynecology.

• Journal of Physiology & Pathology in Korean Medicine
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• v.31 no.5
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• pp.284-293
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• 2017

Thread embedding therapy is used increasingly for various disease including neck pain. However, the evidence of thread embedding therapy on neck pain and the assessment of their methodology are still limited. This study aimed to investigate the clinical research methodology using thread embedding therapy on neck pain. Thread embedding therapy is used increasingly for various disease including neck pain. However, the evidence of thread embedding therapy on neck pain and the assessment of their methodology are still limited. This study aimed to investigate the clinical research methodology using thread embedding therapy on neck pain. Total 31 studies were included in analysis. Thread embedding therapy usually was used once a week(32.3%), once per 10days(29.0%), once per two weeks (25.8%). The most common concurrent treatment used with thread embedding therapy was Chinese medicine. Among acupuncture points, EX-B2 (61.3%) was most commonly used, followed by GV14(45.2%), GB20(29.0%), GB21(22.6%). For control group, acupuncture were most commonly used(58.1%). All studies reported that the effect of thread embedding therapy was more effective compared to control group. and 11 studies reported side effects. Only 13 studies(41.9%) reported the appropriate randomization method, and the mean Jadad score of included studies was 1.52. Previous clinical trials included in this study showed the effect of thread embedding therapy for neck pain. However, the quality of the studies was not high. Further rigorous clinical trials are need to assess the effect of thread embedding therapy.

• Journal of Korean Foot and Ankle Society
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• v.22 no.4
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• pp.135-144
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• 2018

Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

• Therapeutic Science for Rehabilitation
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• v.1 no.2
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• pp.41-53
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• 2012

Objective : The purpose of the research is to investigate Korean occupational therapists' awareness of Evidence-Based Practice(EBP), basis of clinical decision making, barrier factors of EBP execution. Methods : Form December 2009 to March 2010, 500 questionnaires were sent out to clinical occupational therapists and 160 questionnaire which are returned by the therapists were analyzed through descriptive statistics. Results : There are more female respondents than male. More than 90% of them had less than 5 years experience. Most of respondents hadn't experienced education concerning EBP(76%), and the education is not periodically conducted(55%). Moreover, treatment was being tailored based on subjective judgement. On the other hand, the degree of recognition showed that the professionalism of occupational therapists can be improved through EBP(96%), and be helpful to make clinical decision(88%). Most of the therapists answered that guaranteeing enough time to search the basis of treatment(90%) and participating in the education course(92%) is needed to make EBP applicable. This result shows that while the application rate of EBP is low, the recognition rate of EBP is high, which means it is necessary to revitalize EBP education program. Conclusions : In order to provide quality service, education course and instructor training program is needed. We should also make a great effort to offer evidence-based education to occupational therapy students. Furthermore, EBP has to be carried out to improve the professionalism of occupational therapists, and the research about education program and its effect has to be executed.

• Child Health Nursing Research
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• v.22 no.2
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• pp.126-136
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• 2016

Purpose: The purposes of this review were to address misconceptions of childhood fever and fever management practice among parents and health care providers, and to identify the scientific evidences against such misconceptions and practices. Methods: Journal databases and clinical guidelines from 2000 to 2015 were searched. The search terms were fever, fever management, misconception, myth, fiction, fact, fever phobia, child, antipyretics, tepid bath, alternating use/combined use of antipyretics, and physical cooling method. Results: There are significant gaps between current concepts and practices, and the scientific evidence. Misconceptions and unrealistic concerns about childhood fever still exist among parents and even health care providers, worldwide. The evidences suggest that antipyretics should be given carefully with the aim of relieving discomfort or pain rather than decreasing the temperature itself. Alternating use of antipyretics should be discouraged due to the risk of confusion and error. Antipyretics do not prevent febrile convulsions. Moreover, the scientific evidence does not support tepid sponge massage. Conclusion: Evidence-based childhood fever management interventions should be targeted toward parents and health care providers. By adopting an evidence-based approach to nursing interventions, pediatric nurses can ensure children receive appropriate and safe fever management.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.947-950
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• 2013

Background: We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. Methods: The Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database were searched and all randomized controlled trials of axillary dissection in old women (at least 60 years old) were considered. Meta-analyses were completed using RevMan5.1. Results: Three eligible randomized controlled trials (RCTs) including 5,337 patients were considered. There was weak evidence in favour of axillary dissection (AD) in old women. The meta-analysis showed that the overall survival (OS) after 1, 3, 5 and 7 years and the disease free survival (DFS) after 1, 3 and 5 year were not statistically significantly different between AD and no AD groups. However, there was a difference in the 7 year DFS. Conclusions: Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Therefore, axillary dissection is not well-indicated in old women with breast cancer.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.2
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• pp.112-122
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• 2014

Purpose: The purpose of this study was to examine the effects on body temperature, shivering, and perceived thermal comfort of web-based evidence-based practice guideline for patients undergoing gastrectomy. Methods: Eighty patients scheduled for gastrectomy were recruited and assigned to the control or experimental group by sequential order. Before collecting data from the experimental group, a systematic educational program on evidence-based guidelines was provided to the nurses as well anesthesiologists. Data were analyzed using t-test and repeated measured ANOVA. Results: The experimental group showed higher body temperature from the induction of anesthesia until four hours after surgery compared to the control group. In addition, the levels of thermal comfort as well as satisfaction with thermal management were significantly higher in the experiment group. Conclusion: Use of evidence-based guidelines was effective in maintaining body temperature, lowering sensitivity to shivering, and promoting perceived thermal comfort. Therefore, adoption of evidence-based interventions in nursing practice is recommended.