• Title/Summary/Keyword: Clinical evidence

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Guideline for Prevention of Constipation in Korean Elderly - Local Adaptation of the $NGC^{TM}$ Guideline for Prevention of Constipation in the Old Adult Population - (한국 노인의 변비예방 지침 - $NGC^{TM}$ 노인의 변이예방 가이드라인을 변용한 -)

  • Park, Tae-Nam
    • Research in Community and Public Health Nursing
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    • v.17 no.3
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    • pp.315-325
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    • 2006
  • Purpose: The Purpose of this study was to build up guidelines for preventing constipation in the Korean elderly based on the National Guideline $Clearinghouse^{TM}$ Guideline. Method: The process is composed of four steps: first. the composition of an expert group; second, the evaluation by the expert group about the appropriateness and applicability of each recommendation in the guideline; third, systematic literature review for evidence searching; and fourth. the formation of guidelines for Preventing constipation in the Korean elderly according to experts' opinions and literature review. Result: The appropriateness and applicability of each recommendation showed high scores, but the score of applicability was lower than that of appropriateness. The reasons for lower score of applicability were lack of cognition on the importance of constipation management and lack of recent information and evidence-based knowledge on constipation. There were some inadequate recommendations in Korean clinical setting. So the modified and replaced recommendations were added to the guidelines for preventing constipation in the old adult population to improve the applicability in Korea. Conclusion: The results of this study can be used as fundamental baseline data for future study to develope guidelines for management of constipation in the elderly and will be adapted locally for Korean clinical setting.

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Can carbamide peroxide be as effective as hydrogen peroxide for in-office tooth bleaching and cause less sensitivity? A systematic review

  • Patrick Wesley Marques de Boa;Kaiza de Sousa Santos;Francisca Jennifer Duarte de Oliveira;Boniek Castillo Dutra Borges
    • Restorative Dentistry and Endodontics
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    • v.49 no.2
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    • pp.14.1-14.13
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    • 2024
  • This study aimed to answer the question through a systematic review: Can carbamide peroxide be as effective as hydrogen peroxide and cause less in-office bleaching sensitivity? A literature survey was performed in PubMed/MEDLINE, Embase, Scopus, ISI Web of Science, and gray literature. Primary clinical trials that compared the efficacy or the in-office bleaching sensitivity between carbamide and hydrogen peroxides were included. The risk of bias was evaluated using the RoB2. The certainty of the evidence was assessed using the GRADE approach. DPI training significantly improved the mean scores of the dental undergraduates from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. The limited evidence suggests that the 37% carbamide peroxide may be similarly effective to the 35% hydrogen peroxide for bleaching teeth in-office and causes less bleaching sensitivity. However, more well-designed split-mouth clinical trials are necessary to strengthen the evidence.

Development of process-centric clinical decision support system (프로세스 중심의 진료의사결정 지원 시스템 구축)

  • Min, Yeong-Bin;Kim, Dong-Soo;Kang, Suk-Ho
    • IE interfaces
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    • v.20 no.4
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    • pp.488-497
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    • 2007
  • In order to provide appropriate decision supports in medical domain, it is required that clinical knowledge should be implemented in a computable form and integrated with hospital information systems. Healthcare organizations are increasingly adopting tools that provide decision support functions to improve patient outcomes and reduce medical errors. This paper proposes a process centric clinical decision support system based on medical knowledge. The proposed system consists of three major parts - CPG (Clinical Practice Guideline) repository, service pool, and decision support module. The decision support module interprets knowledge base generated by the CPG and service part and then generates a personalized and patient centered clinical process satisfying specific requirements of an individual patient during the entire treatment in hospitals. The proposed system helps health professionals to select appropriate clinical procedures according to the circumstances of each patient resulting in improving the quality of care and reducing medical errors.

A systemic review of literature in clinical practice research for nursing students

  • Kim, Jungae
    • International Journal of Advanced Culture Technology
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    • v.10 no.3
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    • pp.39-46
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    • 2022
  • This study is an attempted content analysis study to analyze recent studies on clinical practice of nursing college students to identify problems with clinical practice and provide evidence for desirable clinical practice. For data collection, a total of 14 papers published in academic journals between 2017 and 2021 were selected. The analysis method was performed according to the systematic review reporting guidelines presented by Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) group. As a result of the analysis, two themes, Four sub-themes, and seventeen concepts were derived, and the clinical practice study of nursing college students showed the necessity of standardized clinical practice protocol regulations for nursing college students and respect for patient human rights. Based on the above research results, it is proposed to prepare a nursing and clinical practice protocol that can clearly present the role of nursing college students during clinical practice.

Diagnosis and Management of Acute Otitis Media and Otitis Media With Effusion (급성 중이염과 삼출성 중이염의 진단과 치료)

  • Jang, Seong Hee
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1283-1294
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    • 2005
  • The American Academy of Pediatrics and American Academy of Family Physicians developed the clinical practice guideline on the management of acute otitis media. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery developed the clinical practice guideline on the diagnosis and management of otitis media with effusion. These two guidelines provide evidence-based recommendations.

Clinical Applications of Light Therapy for Sleep Disorders (수면장애에서 광치료의 이용)

  • Sohn, Chang-Ho
    • Sleep Medicine and Psychophysiology
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    • v.15 no.1
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    • pp.12-16
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    • 2008
  • Light therapy (also called light treatment or phototherapy) involves scheduled exposure to bright artificial light. Evidence-based treatments for sleep disorders especially for circadian rhythm sleep disorders include light therapy and pharmacotherapy. In clinical practice, many of patients with sleep problems tend to impair circadian rhythmicity. Considering that light is the most potent entraining agent of circadian rhythm, careful use of light therapy can be recommended for patients with several kinds of sleep disorders. I briefly review the possible therapeutic mechanisms and clinical applications of light therapy, focusing on circadian sleep disorders.

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Health Level 7 Version 3 based Generating Clinical Document Architecture for Medication Administration System (HL7 버전 3 기반의 투약관리시스템을 위한 임상문서구조의 생성)

  • Kim, Genun-Hee;Cho, Su-Mi;Lee, Eun-Joo;Kim, Hwa-Sun;Cho, Hune
    • Journal of Korea Multimedia Society
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    • v.11 no.3
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    • pp.386-397
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    • 2008
  • This study proposes the actualization of a standard data model for activities through the development of clinical document architecture for medication administration using the health level 7 development frameworks(HDF) process based on object oriented analysis and development method of health level 7 V 3. Medication administration is the most common activity performed by clinical professionals at healthcare settings. A standardized information model and structured hospital information system are necessary to achieve evidence-based clinical activities. We had used HDF and various tools(Rose tree, RMIM designer, V3 generator) to create the clinical document architecture(CDA). This allowed us to illustrate each step of the HDF in the administration of medication. This study generated a information model of the medication administration process, which is one clinical activity. It should become a fundamental conceptual model for understanding international standard methodology by information technology(IT) developers with the objective of modeling healthcare information systems.

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Current Perspectives on Emerging CAR-Treg Cell Therapy: Based on Treg Cell Therapy in Clinical Trials and the Recent Approval of CAR-T Cell Therapy (장기이식 거부반응과 자가면역질환 치료제로서의 CAR Treg 세포치료제의 가능성: Treg 세포치료제 임상시험 현황과 CAR T 세포치료제 허가 정보를 바탕으로)

  • Kang, Koeun;Chung, Junho;Yang, Jaeseok;Kim, Hyori
    • Korean Journal of Transplantation
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    • v.31 no.4
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    • pp.157-169
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    • 2017
  • Regulatory T cells (Treg) naturally rein in immune attacks, and they can inhibit rejection of transplanted organs and even reverse the progression of autoimmune diseases in mice. The initial safety trials of Treg against graft-versus-host disease (GVHD) provided evidence that the adoptive transfer of Treg is safe and capable of limiting disease progression. Supported by such evidence, numerous clinical trials have been actively investigating the efficacy of Treg targeting autoimmune diseases, type I diabetes, and organ transplant rejection, including kidney and liver. The limited quantity of Treg cells harvested from peripheral blood and subsequent in vitro culture have posed a great challenge to large-scale clinical application of Treg; nevertheless, the concept of CAR (chimeric antigen receptor)-Treg has emerged as a potential resolution to the problem. Recently, two CAR-T therapies, tisagenlecleucel and axicabtagene ciloleucel, were approved by the US FDA for the treatment of refractory or recurrent acute lymhoblastic leukemia. This approval could serve as a guideline for the production protocols for other genetically engineered T cells for clinical use as well. The phase I and II clinical trials of these agents has demonstrated that genetically engineered and antigen-targeting T cells are safe and efficacious in humans. In conclusion, both the promising results of Treg cell therapy from the clinical studies and the recent FDA approval of CAR-T therapies are paving the way for CAR-Treg therapy in clinical use.

The Characteristics of KM Clinical Trials - Focusing on the Clinical Research Information Service (CRIS) (한약 임상시험의 특성 : 질병관리본부 임상연구정보서비스(CRIS)를 중심으로)

  • Jeung, Chang-woon;Jeon, Sun-woo;Jo, Hee-Geun
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.959-966
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    • 2020
  • Objectives: To examine the fundamental characteristics of interventional clinical trials registered in the CRIS (Clinical Research Information Service) database. Methods: We systematically analyzed the status of Korean medical interventions using the search function of the CRIS database. Results: From 2010 to January 2020, 267 Korean medicine-related clinical trials were registered with CRIS. The studies, which included many randomized trials (80.14%), focused primarily on demonstrating the effectiveness and safety of acupuncture and Korean herbal remedies. Most of these studies were government-sponsored and researcher-led clinical trials, but a few were company-sponsored trials. All trials were small and need improvement. Conclusion: This study reviews the current status of clinical trials in the field of Korean medicine and the basic data that can be used to create evidence-based Korean medicine.