• 제목/요약/키워드: Clinical evidence

검색결과 2,680건 처리시간 0.029초

Clinical reliability of zirconium abutment in implant restorations in the English and Korean literature

  • Yu, Su-Been;Song, Bong-Gyu;Cheon, Kyeong-Jun;Kim, Ju-Won;Kim, Young-Hee;Yang, Byoung-Eun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제40권
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    • pp.26.1-26.10
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    • 2018
  • Background: This study aimed to evaluate the mechanical, biological, and esthetic stability of a zirconium abutment according to evidence-based dentistry. Main text: An electronic search was performed. Domestic studies were found using the keywords "zirconia abutments" and "zirconium abutment" in KMbase, KoreaMed, and the National Assembly Library, and international studies were found using the same keywords in PubMed. All identified studies were divided by evidence level from the viewpoint of the research type utilizing the evidence-based review manual. A total of 102 domestic studies (with Korean language) were found, and 9 of these studies were selected. In these nine studies, 3 had evidence level 3 and 6 had evidence level 4. A total of 97 international studies (with English language) were found, and 19 were selected. Among these 19 studies, 5 had evidence level 2 and 7 had evidence level 3, whereas the remainder had evidence level 4. According to the studies, zirconium abutments are mechanically, biologically, and esthetically stable, but the evidence level of these studies is low, and the follow-up duration is no longer than 5 years. Conclusions: All examined studies verified the mechanical stability of zirconium abutments for a period no longer than 5 years. Therefore, a long-term clinical observation is needed. Zirconium abutments are thought to be biologically stable, but they are not superior to titanium abutments. As the esthetic stability of such abutments had a low evidence level in the studies that examined here, a much higher evidence level is needed.

국내 근거기반 임상간호실무지침의 주제 선정 (Topics for Evidence-Based Clinical Nursing Practice Guidelines in Korea)

  • 구미옥;조명숙;조용애;정재심;정인숙;박정숙;김혜정;은영
    • 임상간호연구
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    • 제17권3호
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    • pp.307-318
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    • 2011
  • Purpose: This study was to identify topics for evidence-based clinical nursing practice guidelines in Korea. Methods: Data were collected from 330 staff nurses from 10 general hospitals and 53 nurses in charge of nursing education in 110 hospitals with over 500 beds. Using open questions, the nurses identified activities which could not be verified, which lacked consistency among nurses, clinical units and/or hospitals, which were not based on the up-to-date knowledge and which needed reform. The data were analysed by content analysis using a qualitative methodology. Results: Collected data consisted of 1882 clinical topics, which were classified into 50 topics, 207 mid-categories, and 456 sub-categories. The most frequent topics in order of frequency were medications, central line management, intravenous injections, urinary catheterization, perioperative nursing care, skin tests, pressure ulcer care, blood transfusions, laboratory examination-culture, respiratory care which were performed routinely in clinical setting by staff nurses. Conclusion: The research findings indicate the urgent need to develop evidence-based clinical nursing practice guidelines related to these research findings. Further research is needed to identify topics related to health promotion, and symptom/management of health problem.

근거중심의학에 기반한 한의치료기술 및 한방진단기기 개발을 위한 임상수요조사 (Clinical Demands for Evidence-based Medical Interventions and Diagnostic Technology in Oriental Medicine)

  • 김경철;박상욱;송경훈;박주연;홍상민;이해웅
    • 대한예방한의학회지
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    • 제14권2호
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    • pp.121-133
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    • 2010
  • Objects : To establish directions to evidence-based medical interventions and diagnosis technology in oriental medicine, we did survey research among oriental medical doctors. Methods : Systematically-organized questionnaires were provided for survey. 105 Oriental medical doctors nationwide participated in the survey. We investigated diseases of their patients, differential diagnosis methods, frequently used medical interventions, needs for diagnosis devices, evidence-based clinical manuals, etc. Results : In oriental medical clinics, the most frequent patient class was patients with musculo-skeletal diseases. Oriental medical doctors assumed that the preparation of care solution for chronic life-style diseases was the most urgent. Dong-Eui-Bo-gam(東醫寶鑑) was the most frequently used reference for their herbal medication prescription. Fixed document for diagnosis and treatment were thought to be the most important in the developing evidence-based clinical manuals. Conclusions : Validity and reliability should be considered as very important in developing oriental diagnosis devices. Evidence-based clinical manuals are needed to build standardized document for diagnosis and treatment and to verify efficacy and safety of oriental medical diagnosis and treatment.

요양병원 입원 노인을 위한 신체 억제대 프로토콜의 수용개작 (Evidence-based Clinical Practice Protocol of Physical Restraints by Adaptation Process for Patients in a Geriatric Hospital)

  • 박미화;송경애
    • 재활간호학회지
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    • 제19권2호
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    • pp.118-127
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    • 2016
  • Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

Applying Theory Informed Global Trends in a Collaborative Model for Organizational Evidence-based Healthcare

  • Lockwood, Craig
    • 간호행정학회지
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    • 제23권2호
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    • pp.111-117
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    • 2017
  • Getting evidence in to practice tends to focus on strategies, theories and studies that aim to close the gap between research knowledge and clinical practice. The evidence to practice gap is more about systems than individual clinician decision making. The absence of evidence for administration and management in the organization of healthcare is persistent. Teaching nurses and providing evidence as the solution to evidence-based healthcare is no longer axiomatic. Previous studies have concluded that unit level strategies integrate multi-professional teams with organizational needs and priorities. This 'best fit' approach that characterizes how healthcare is structured and delivered. The published literature shows that increased readiness for change is aligned with integrated approaches informed by conceptual models. The Joanna Briggs Collaboration is the largest global collaboration to integrate evidence within a theory informed model that brings together academic centres, hospitals and health systems for evidence synthesis, transfer and implementation. The best approaches to implementation are tailored to local culture and context, benchmark against international evidence, combine a theory informed model and stakeholder perspectives to improve the structure and processes of health care policy and practice.

임상 간호사들의 연구 관련 활동 실태 및 연구결과 활용의 장애 요인 (Nurses′ Research Activities and Barriers of Research Utilization)

  • 오의금;오현주;이윤정
    • 대한간호학회지
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    • 제34권5호
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    • pp.838-848
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    • 2004
  • Purpose: This study was to describe nurses' research activities, perceptions and performances of evidence-based practice and barriers to the use of research evidence in nursing practice in Korea. Method: A cross-sectional survey design was used. A questionnaire, except for Barriers Scale, was developed for the study. Data was collected from a convenient sample of 437 registered nurses working at research and education oriented university hospitals. Result: Nurses' research-related activities were relatively low compared to previous studies. Also perceptions and performances of evidence based nursing practice were low. Preferred informational resources for clinical decision making were identified as ward manuals/clinical guidelines, manager/senior nurses, and literature/research. The major barriers to research utilization were a lack of implication for practice along with inadequate facilitation to implement research evidence and difficulty understanding research written in English. Priorities of barriers factor were Administrator, Communication, Adopter, and Research. Conclusion: The findings provide directions for future training, education, and managerial policy to achieve successful evidence based nursing practice.

근골격계 통증성 질환에 대한 온침의 임상 연구 고찰 -계통적 고찰- (Review of Clinical Trials on Warming Acupuncture for Musculoskeletal Pain Diseases -A Systematic Review-)

  • 정지윤;최도영;우현수;강성길
    • Journal of Acupuncture Research
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    • 제26권4호
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    • pp.11-18
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    • 2009
  • Objectives : The objective of this review was to evaluate clinical trials of warming acupuncture for musculoskeletal pain diseases, to assess the methodologic quality of the trials and determine whether low-quality trials are associated with positive outcomes, to document adverse effects and to identify the effectiveness of the warming acupuncture. Methods : Seven databases and the Journal ZHONGGUO ZHENJIU(中國鍼灸) published between 2004-2008 were searched. Korean and Chinese randomized trials were evaluated for methodologic quality using the modified Jadad scale. Outcome measurements were pain, function and global improvement. The best-evidence synthesis was performed to determine the strength of evidence by control group. Results : Six clinical trials representing 564 patients with musculoskeletal pain diseases were identified. For pain and function, there was moderate evidence that warming acupuncture is more effective than manual acupuncture. For patient global assesment, there was limited evidence that warming acupuncture is more effective than manual acupuncture. However, for function, there was inconclusive evidence that warming acupuncture is more effective than acupuncture with TDP or western medicine or acupoint-injection treatment. Conclusions : The evidence suggests that warming acupuncture is more effective for musculoskeletal pain diseases than manual acupuncture, acupuncture with TDP, western medicine and acupoint-injection treatment. But the evidence is moderate to inclusive due to the low methodologic quality of the trials. Further clinical trials with high methodologic quality is required to investigate the effectiveness of warming acupuncture.

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치위생 과정 기반의 임상 치위생 교육과 실무 (Clinical Dental Hygiene Education and Practice based on Dental Hygiene Process)

  • 조영식
    • 치위생과학회지
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    • 제11권3호
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    • pp.135-154
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    • 2011
  • Dental hygiene was originated from dentistry and dental hygiene knowledge was a component of dental knowledge body. Since the late 1980s dental hygiene theory was began to develop. Nursing theories such as metaparadigm, nursing process and human need theory affected theory development as dental hygiene process. Dental hygiene process provides a framework for high quality dental hygiene care. Dental hygiene process include five phases; assessment, dental hygiene diagnosis, dental hygiene planning, implementation, evaluation. Dental hygiene process of care is recognized as standard for dental hygiene education and clinical dental hygiene practice. Dental hygiene practice has moved from auxiliary model to professional model. Critical thinking skill and disposition are necessary to provide evidence-based dental hygiene care using dental hygiene process as clinical process and critical thinking process. Critical thinking, problem solving and evidence-based practice must be integrated into dental hygiene process for quality dental hygiene care.

Evidence-based herbal medicine in efficacy and safety assessments

  • Park, Jin-Han
    • Advances in Traditional Medicine
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    • 제8권2호
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    • pp.103-110
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    • 2008
  • Herbal medicine is the use of medicinal plants for prevention and treatment of diseases: it ranges from traditional and popular medicines of every country to the use of standardized and tritated herbal extracts. Generally cultural rootedness enduring and widespread use in a traditional medical system may indicate safety, but also efficacy of treatments, especially in herbal medicine where tradition is almost completely based on remedies containing active principles at very low and ultra low concentrations or relying on magical-energetic principles. The efficacy and safety assessments of medicines, whether modern or herbal, invariably encounter challenges or problems during the course of pre-clinical and clinical research. Some of the challenges in evidence-based herbal medicinal research are unique, and the researcher must be cognizant of them in order to safeguard the quality of the data obtained. Key challenges are: the quality of raw materials; appropriateness of biological/pharmacological activity assessment methodology, and data interpretation; standardization methodology; pharmacokinetics and bioavailability of active constituents and metabolites; clinical dosage formulation/production; and clinical study designs and outcome measures.

Developmental procedures for the clinical practice guidelines for conscious sedation in dentistry for the Korean Academy of Dental Sciences

  • An, So-Youn;Seo, Kwang-Suk;Kim, Seungoh;Kim, Jongbin;Lee, Deok-Won;Hwang, Kyung-Gyun;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제16권4호
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    • pp.253-261
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    • 2016
  • Background: Evidence-based clinical practice guidelines (CPGs) are defined as "statements that are scientifically reviewed about evidence and systematically developed to assist in the doctors' and patients' decision making in certain clinical situations." This recommendation aims to promote good clinical practice for the provision of safe and effective practices of conscious sedation in dentistry. Method: The development of this clinical practice guideline was conducted by performing a systematic search of the literature for evidence-based CPGs. Existing guidelines, relevant systematic reviews, policy documents, legislation, or other recommendations were reviewed and appraised. To supplement this information, key questions were formulated by the Guideline Development Group and used as the basis for designing systematic literature search strategies to identify literature that may address these questions. Guideline documents were evaluated through a review of domestic and international databases for the development of a renewing of existing conscious sedation guidelines for dentistry. Clinical practice guidelines were critically appraised for their methodologies using Appraisal of guidelines for research and evaluation (AGREE) II. Results: A total of 12 existing CPGs were included and 13 recommendations were made in a range of general, adult, and pediatric areas. Conclusion: The clinical practice guidelines for conscious sedation will be reviewed in 5 years' time for further updates to reflect significant changes in the field.