• 한국치위생학회지
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• 제20권5호
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• pp.717-731
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• 2020

Objectives: The purpose of this study was to develop applicable standards for clinical dental hygiene practice in Korea and to evaluate their validity. Methods: Based on the standards for clinical dental hygiene practice developed in the United States and Canada, the standards were adapted to be applicable in Korea. The validity of the standards was evaluated by a self-writing questionnaire among 14 professors and 10 clinicians using a developed tool for evaluating the standards. A focus group interview was additionally conducted for clinicians to increase the validity of the standards. Descriptive statistics and Mann-Whitney test were performed using SPSS 25.0. To analyze the content of the focus group interviews, content analysis was conducted. Results: The standards for clinical dental hygiene practice consisted of five elements of professionalism for dental hygienists and a total of 28 items to perform the five stages of dental hygiene process of care (assessment, diagnosis, planning, implementation, and evaluation) and included conceptual meaning, clinical significance, and application methods with examples for each item. Conclusions: The standards for clinical dental hygiene practice developed in this study could contribute to standardizing dental clinical practices provided by dental hygienists. It is necessary to consistently improve the standards that are highly practical, to prevent oral diseases and maintain oral health of the public, based on the results of this validity evaluation.

• 대한영양사협회학술지
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• 제21권1호
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• pp.37-56
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• 2015

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

• 간호행정학회지
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• 제16권3호
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• pp.326-335
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• 2010

Purpose: This study was conducted to develop nursing standards for medical patients with Coronary Artery Disease (CAD) patients. Methods: This study was a methodological study. The content of nursing standards for medical patients with CAD developed in this study was validated. The nursing standards of cardiovascular nursing developed by the American Nurses Association (2008), the nursing standards developed by the Korea Nurses Association (2003) and a clinical manual of patients with CAD developed by K teaching hospital were reviewed. Literature regarding CAD nursing standards was also reviewed. The basic contents of nursing standards for medical patients with CAD were selected by an expert group including two nursing faculties, a cardiovascular unit manager, and two cardiologists. A pilot study was conducted then in real clinical settings, in which includes cardiovascular outpatient clinic, cardiovascular inpatient units, and cardiac intensive care units to evaluate clinical suitability of the nursing standards. Results: The final version of the nursing standards for medical patients with CAD included 12 standards, 24 criteria, 38 indicators and 92 nursing activities. Conclusion: The nursing standards developed in this study can be used in evaluating quality of nursing service and in educating nurses who are involved in patients with CAD.

• 대한영양사협회학술지
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• 제21권2호
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• pp.91-109
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• 2015

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

• Annals of Clinical Microbiology
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• 제21권4호
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• pp.69-74
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• 2018

진단검사의학은 신속하고 정확한 체외검사 결과를 제공함으로써 임상의사가 환자를 진료하는 데 도움을 주는 전문 분야이다. 정확한 검사 결과를 제공하기 위해서는 검사에 관련된 모든 요소의 표준화가 필요하다. Clinical and Laboratory Standards Institute (CLSI)는 1968년에 표준화를 하는 데에 모두가 동의할 수 있는 공식적인 절차를 마련하기 위해 만들어졌고, 현재까지 임상검사실, 연구용 검사실을 포함한 많은 종류의 검사실 전 분야에 대해서 표준과 지침을 출판하여, 전 세계의 많은 검사실들이 표준화를 위해 이를 이용하고 있다. CLSI의 항생제 감수성 검사 소위원회(AST SC)는 6개의 상설 부서와 필요에 따라 만들어지는 많은 특설 부서로 구성되어 있다. AST SC의 구성원들은 소위원회에 제안된 내용을 검토하여 연 2차례 열리는 회의에서 제안 내용을 반영할지 여부를 결정함으로써 문서의 개정이 이루어진다. 이 회의는 등록한 사람은 누구나 참여할 수 있으므로, 우리 학회원들도 회의에 참여하여 표준 혹은 지침 문서의 생산에 능동적인 역할을 하기를 기대한다.

• Korean Journal of Radiology
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• 제24권2호
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• pp.155-165
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• 2023

Objective: Little is known about the effects of using different expert-determined reference standards when evaluating the performance of deep learning-based automatic detection (DLAD) models and their added value to radiologists. We assessed the concordance of expert-determined standards with a clinical gold standard (herein, pathological confirmation) and the effects of different expert-determined reference standards on the estimates of radiologists' diagnostic performance to detect malignant pulmonary nodules on chest radiographs with and without the assistance of a DLAD model. Materials and Methods: This study included chest radiographs from 50 patients with pathologically proven lung cancer and 50 controls. Five expert-determined standards were constructed using the interpretations of 10 experts: individual judgment by the most experienced expert, majority vote, consensus judgments of two and three experts, and a latent class analysis (LCA) model. In separate reader tests, additional 10 radiologists independently interpreted the radiographs and then assisted with the DLAD model. Their diagnostic performance was estimated using the clinical gold standard and various expert-determined standards as the reference standard, and the results were compared using the t test with Bonferroni correction. Results: The LCA model (sensitivity, 72.6%; specificity, 100%) was most similar to the clinical gold standard. When expert-determined standards were used, the sensitivities of radiologists and DLAD model alone were overestimated, and their specificities were underestimated (all p-values < 0.05). DLAD assistance diminished the overestimation of sensitivity but exaggerated the underestimation of specificity (all p-values < 0.001). The DLAD model improved sensitivity and specificity to a greater extent when using the clinical gold standard than when using the expert-determined standards (all p-values < 0.001), except for sensitivity with the LCA model (p = 0.094). Conclusion: The LCA model was most similar to the clinical gold standard for malignant pulmonary nodule detection on chest radiographs. Expert-determined standards caused bias in measuring the diagnostic performance of the artificial intelligence model.

• 한국의료질향상학회지
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• 제2권1호
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• pp.86-109
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• 1995

Clinical trials of drugs on humans is the final and most important stage in evaluating the safety and efficacy of the drugs. Good Clinical Practice(GCP) standards were announced in 1987 to protect testees' rights as well as to ensure validity of the clinical trial results, but its implementation has been delayed until now. The purpose of this study is to evaluate the preparedness of the designated institutions to abide by GCP standards during clinical trials, and thereby to determine GCP implementability at the institutions. Survey on the status of clinical trials was conducted for the designated 83 clinical trial hospitals. Response rate was 95.2%. Donabedian's quality assessment model was applied as the basic framework for the study. And the relative - weights for the evaluation items were determined by expert's evaluation. Among the designated 83 hospitals, 39 conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Only 19 institutions are found to be able to meet the requirements of KGCP. Structure variables - manpower, organization, and facility -, which are the basic elements for GCP, are evaluated as unsatisfied in many hospitals. Institutions which established IRB accounted for 41 or 51.9%, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12 and 21 institutions, respectively. Also, the institutions providing educational programs on conducting clinical trials are few - 20. The study results indicates that the level of conducting KGCP is unsatisfactory. However, more institutions are expected to be able to meet the standards soon because GCP standards does not require so much regulation on facilities, but stress importance on research methodology and human right. At present as the institutions for clinical trials are primarily training hospitals with residency programs, such efforts as education will accelerate the implementability of GCP in Korea. Institutions must build the appropriate infrastructure and government must prepare to strongly enforce KGCP before it can successfully take place.

• 한국임상약학회지
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• 제24권4호
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• pp.272-281
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• 2014

Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.

• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8595-8598
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• 2016

Background: Decision making modalities for screening for many cancer conditions and different stages have become increasingly complex. Computer-based risk assessment systems facilitate scheduling and decision making and support the delivery of cancer screening services. The aim of this article was to survey electronic risk assessment system as an appropriate tool for the prevention of cancer. Materials and Methods: A qualitative design was used involving 21 face-to-face interviews. Interviewing involved asking questions and getting answers from exclusive managers of cancer screening. Of the participants 6 were female and 15 were male, and ages ranged from 32 to 78 years. The study was based on a grounded theory approach and the tool was a semi-structured interview. Results: Researchers studied 5 dimensions, comprising electronic guideline standards of colorectal cancer screening, work flow of clinical and genetic activities, pathways of colorectal cancer screening and functionality of computer based guidelines and barriers. Electronic guideline standards of colorectal cancer screening were described in the s3 categories of content standard, telecommunications and technical standards and nomenclature and classification standards. According to the participations' views, workflow and genetic pathways of colorectal cancer screening were identified. Conclusions: The study demonstrated an effective role of computer-guided consultation for screening management. Electronic based systems facilitate real-time decision making during a clinical interaction. Electronic pathways have been applied for clinical and genetic decision support, workflow management, update recommendation and resource estimates. A suitable technical and clinical infrastructure is an integral part of clinical practice guidline of screening. As a conclusion, it is recommended to consider the necessity of architecture assessment and also integration standards.

• Annals of Clinical Neurophysiology
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• 제20권1호
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• pp.18-25
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• 2018

Evoked potentials (EPs) measures the electrophysiologic responses of the nervous system to variety of stimuli. In clinical practice, only a few are used on a routine basis. Because of the small amplitude of EPs recorded by noninvasive methods, computer summation or averaging generally is necessary to resolve them from background noise. Therefore, waveform acquisition under good condition according to standard method is important. We aimed to provide the standards for clinical EP equipment, technical consideration and minimal requirements for obtaining good clinical EP waveforms, and general criteria for writing EP reports in practice as Korean guidelines.