• 제목/요약/키워드: Clinical trial Guideline

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인공발목관절의 임상시험 가이드라인 개발을 위한 문헌적 고찰 (Review of Literatures for Development of Clinical Trial Guideline for Total Ankle Arthroplasty)

  • 박진오;이모세;이진우;이수빈;한승환
    • 대한족부족관절학회지
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    • 제18권4호
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    • pp.195-201
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    • 2014
  • Purpose: The purpose of this study is to develop guidelines for clinical trial of the total ankle replacement system for premarket approval. Materials and Methods: We selected and analyzed nine peer-reviewed articles whose quality had been proven in a previous phase. Two investigators extracted parameters for guideline criteria, including number of cases, patient age, follow-up period, failure rate, radiographic osteolysis rate, residual pain rate, and percentage of satisfaction. In addition, the inclusion and exclusion criteria were analyzed and developed. Results: Eight level IV studies and one level II study were included. The average number of cases was 159 cases and the mean patient age was 63.5 years. The mean follow-up period was 4.2 years, ranging from two to nine. The average failure rate of total ankle replacement in mid- to long-term follow-up was approximately 13% (2%~32.3%). The rate of osteolysis was approximately 18%. Residual pain was common (21.4%~46%), but overall patient satisfaction was approximately 85.6% (67.5%~97%). Conclusion: The results could be used as criteria for designing the clinical studies, such as number of cases, patient age (over 60 years), and follow-up period (minimum two years). The clinical scoring system and 36-item short form health survey (SF-36) was the most commonly used method for clinical evaluation for total ankle arthroplasty. In addition, the overall results, including failure rate, osteolysis rate, and patient satisfaction, could be used as a parameter of guidelines for premarket approval.

위염치료제의 임상시험평가지침 연구 (Guideline for the Clinical Trials Evaluation for Gastritis)

  • 송윤경;진선경;한의식;안미령;정주연;이이다;조일영;김동섭;지은희;박효영;오정미;신원;이선희;김인규
    • 약학회지
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    • 제55권4호
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    • pp.345-351
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    • 2011
  • Gastritis is the most common disease among Korean. The demand for the development of gastritis drugs has been increasing. Currently, however, there is no guideline available for the clinical evaluation of gastritis drugs worldwide. As a consequence, domestic and international pharmaceutical companies make errors in the drug development processes, and it becomes difficult for them to establish the scientific validity and objectivity of newly developed drugs. The objective of this study was to develop the Guideline for Clinical Trials Evaluation of Gastritis which can be used in improving the quality and consistency of clinical trials. First, we collected and reviewed the clinical trials on gastritis drugs that were available from Japan Pharmaceuticals and Medical Devices Agency and Korea Food and Drug Administration (KFDA), and investigated the recent research trends on clinical trials of gastritis drugs. Reviewers from KFDA and National Institute of Food and Drug Safety Evaluation and scientific experts from the pharmaceutical industries developed the guidelines through regularly scheduled meetings. Opinions and consultation from academic fields and industry experts were also obtained. This project will provide the clinical trial practitioners, investigator and reviewers the scientific and rational guidelines for performance and evaluation of clinical trials for gastritis drugs. Furthermore, we hope this guideline contributes to establishing the national competitiveness, improving the quality of clinical trial, and encouraging researches on drug development for gastritis.

건선 한약제제 임상시험 가이드라인 개발을 위한 관련 국내외 가이드라인과 기존 건선치료 한약제제 연구와의 비교 (Comparison between domestic and foreign Clinical guidelines and previous researches on Korean medicine for psoriasis to develop the clinical trial guideline of psoriasis using Korean medicine)

  • 강세현;문영균;정우열;남혜정;김윤범;이준희;김규석
    • 한방안이비인후피부과학회지
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    • 제29권2호
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    • pp.12-32
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    • 2016
  • Objectives : The objective of this study is to develop the strategies of the psoriasis clinical trials guideline on Korean medicine by comparison between Clinical guidelines and domestic and foreign clinical trials papers of psoriasis on Korean medicine. Methods : This study is based on analysis of papers on Clinical trials guidelines, Clinical practice guideline and clinical trials about Korean medicine. The papers were searched from Pubmed, Medline, Oasis(Oriental Medicine Advanced Searching Integrated System), Korean Traditional Knowledge Portal and Google portal database. Results : A total 8 Clinical practice guidelines and 2 Clinical trials guidelines were found. Moreover, there were 15 foreign papers about clinical trials and 29 internal articles about case studies. They suggested the diagnostic strategy, classification, effective outcome measure, severity measure, precaution of combination therapy, precaution and treatment period of clinical trials, safety evaluation, patterns of Korean Medicine, clinical specific features on psoriasis.Conclusions : The criteria of every item to provide the clinical trials guideline using Korean medicine on psoriasis were developed by apply the results. If we accumulate the more clinical articles on Korean medicine, it will be great help to develop the reliable standard of that guideline.

다목적 안과용 레이저 시스템 안전성 성능평가 및 임상적 유효성평가 가이드라인 수립을 위한 연구 (A Study on Safety, Performance and Clinical effectiveness Test Guideline of Versatile Ophthalmic Laser System)

  • 김유림;유우진;박호준;장원석
    • 대한의용생체공학회:의공학회지
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    • 제40권6호
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    • pp.250-259
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    • 2019
  • Ophthalmic Laser System is widely used in Selective Laser Trabeculoplasty of Open Angle Glaucoma and Ocular Hypertension. Versatile ophthalmic laser system is a medical device with technology that checks the condition of the treatment area by irradiating a continuous laser pulse on the treatment area, and monitoring the microbubble reaction caused by the temperature increase of the melanosome through the ultrasonic signal and the optical signal sensor. It performs selective laser treatment without damaging the photoreceptor by controlling the wavelength of the laser when microbubbles are detected. This study aims to suggest a guideline for evaluating safety, performance and clinical effectiveness of Versatile Ophthalmic Laser System in accordance with the growing technology. International Standards, Regulations, and Clinical Trial Protocols were investigated and analyzed for this study. As a result of this study, the safety, performance and clinical effectiveness test guideline for Versatile Ophthalmic Laser System were proposed. This guideline will ensure the safety and efficacy of Medical device, and furthermore it is expected to be able to promote the development of technology development by supporting a clinical trial plan.

최근 일본의 의학계 연구규율의 특색 (The Characteristic of Research Regulation in Recent Japanese Medical World)

  • 송영민
    • 의료법학
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    • 제20권2호
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    • pp.173-206
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    • 2019
  • 본 연구는 최근 일본의 임상연구 관련 규율의 특색을 검토한 것이다. 첫째, 우리나라와 같이 일본에서도 그 동안 연구부정에 대해서는 엄벌주의를 취하여 왔지만, 최근 일본에서는 연구윤리정책을 제재가 아닌 교육연수에 의한 연구공정성 확보로 방향을 전환하였다는 점과 2018년 4월부터 시행된 임상연구법은 임상연구에 관한 자금제공 정보의 공표를 의무화하여 임상연구에 따른 자금제공의 투명성을 높인 점 및 의학계 연구의 윤리심사의 집약화 및 피험자를 집중시켜 증례나 우수한 연구자를 모집하여 임상연구·치험을 집약화한 점, 둘째, 그 동안 역학연구에 관한 윤리지침(이하, 「역학지침」이라 함)과 임상연구에 관한 윤리지침(이하, 「임상지침」이라 함)으로 이원화되어 있었던 윤리지침을 인간을 대상으로 하는 의학계 연구에 관한 윤리지침(이하, 「통합지침」이라 함)으로 통합 정비하여 임상연구와 역학연구에 필요한 윤리지침의 중복과 흠결을 보완했다는 점 이외에도 피험자보호를 위한 리스크 평가제도를 둔 점 이외에도 평가의 선결문제인 「침습」 개념을 명확히 했다는 점에서 긍정적인 평가를 받고 있다. 임상연구관련 국제규범상의 공통적인 내용인 「위험과 이익의 평가 문제」는 연구자의 연구가 적절히 고안되었는지를 검사하는 수단이다. 이는 연구윤리위원회가 피험자에게 가해질 위험이 정당화될 수 있는지 여부를 결정하는 방법이며, 장래의 피험자가 임상시험의 참여여부를 결정하는 중요한 기준이 되기도 한다. 그러므로 피험자의 리스크 평가의 선결문제인 「침습」 개념을 명확히 정의한 것은 의미 있는 것이다. 본 연구에서는 특히 최근 일본의 임상시험에서의 연구부정방지 대책에 대한 인식의 전환, 연구심사 및 피험자의 집약화를 통환 연구의 효율성 제고, 피험자 보호를 위한 리스크 평가의 전제가 되는 「침습」 개념의 명확화와 범위의 확장 등에 관한 논점을 중심으로 검토한 것이다.

국내 및 해외의 임상시험 데이터모니터링위원회 지침의 현황 (Independent Data Monitoring Committees: Review of Current Guidelines)

  • 이보람;이경은
    • 한국임상약학회지
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    • 제26권2호
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    • pp.181-186
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    • 2016
  • Background: There has been on increasing emphasis on the importance of monitoring the safety of participants in a clinical trial to protect patients and maintain the integrity of the trial. The independent data monitoring committee (IDMC) has become common component of randomized clinical trials in recent years. Methods: It is important to consider the implications of different approaches that are being used in various countries. IDMC guidelines in Korea, US, and Europe were reviewed and compared to provide the objective, composition and operation of IDMC in detail. Results: IDMC is a group of experts in related subject are as who perform interim data monitoring to make a recommendation to the sponsor or organizer regarding appropriateness of trial continuation and the need for modifications of the trial. Independence of IDMC is preferred in order to minimize influence of factors unrelated to scientific, medical and ethical considerations that should underlie decision-making. Conclusion: IDMC has become an increasingly important component of clinical trials in recent years. Practical operating procedures need to be developed considering the future regulatory status of data monitoring committees.

한국과 중국, 대만, 일본의 전통약 임상시험 현황에 대한 연구 (An Investigation about the Present States of Clinical Trial for Traditional Medicine in Korea, China, Taiwan and Japan)

  • 이경구;배순희;신현규
    • 한국한의학연구원논문집
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    • 제12권1호
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    • pp.13-22
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    • 2006
  • Background and Aims: Herbal drugs and traditional medicines have lately attracted considerable attention by global pharmaceutical corporations because the conventional chemical drugs didn't work well for many chronic diseases or intractable diseases. The government of Korea is also supporting to develop the new drug which is high value added product, and the natural medicine including herbal medicine(or Traditional Korean Medicine) have a significant presence in this field. non-clinical pharmacology/toxicology study and clinical trial are the two major criteria which estimate efficacy and safety for registration of new drugs. All of the pharmaceutical companies producing herbal medicine and the academic and the academic world of Tradition Korean Medicine have the will to develop new herbal drugs, but there are obstacles that they have neither experience nor guideline about clinical trial. Therefore for developing new herbal drugs, it is necessary to research the present conditions and comprehensive systems about clinical trial in Northeast Asian countries China, Taiwan and Japan because they have the common background with Korea in traditional medicine fields. Methods : The present state of clinical trial for herbal medicine in Korea was investigated. And then, those in China, Taiwan, Japan was also investigated. Results and conclusions : There are significant differences among 4 Southeast Asian countries Korea, China, Taiwan and Japan each in present condition, purpose, involved comprehensive system including legislation, and actual operation of clinical trial for traditional medicine.

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감기 임상시험 가이드라인 제정을 위한 최신 임상시험 연구 분석 (Analysis of Recent Clinical Studies to Establish Korean Herbal Medicine Clinical Trial Guidelines for the Common Cold)

  • 김관일;이호정;이범준;정희재;정승기;이준희
    • 대한한방내과학회지
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    • 제37권1호
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    • pp.109-134
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    • 2016
  • Objectives: The aim of this study was to help develop a guideline for the common cold. We searched recent clinical studies of the common cold in Western medicine and reviewed their objectives, inclusion and exclusion criteria, primary outcome, secondary outcome, and assessment tools to establish evidenced-based guideline.Methods: We searched electronic databases (Cochrane Library, MEDLINE, EMBASE) to identify eligible randomized controlled trials (RCTs) about the common cold for the last 10 years. We included 29 RCTs and showed their research summary via their objectives, participants, interventions, control, treatment duration, and results. We also analyzed the definition of the common cold presented in the article, inclusion and exclusion criteria, primary and secondary outcomes, and assessment tools.Results: We reported the aforementioned areas in detail. At first, the definition of the common cold was confused across the articles. Second, herbal medication clinical trials for the common cold have been extensively studied recently. Third, the eligibility criteria frequently included the Jackson Symptom score. Fourth, validated assessment tools (i.e., the Wisconsin Upper Respiratory Symptom Survey-21) have only been used in a few recent studies.Conclusions: Our research will be helpful to establish Korean herbal medicine clinical trial guidelines for the common cold.

미성년자 대상 임상시험에 관한 법적 문제점 (Legal Issues in Clinical Trial on Minor)

  • 송영민
    • 의료법학
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    • 제17권2호
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    • pp.125-144
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    • 2016
  • 모든 형태의 임상시험은 시험 자체가 불확실하며, 리스크가 다양하므로 피험자를 보호하기 위한 제도가 완비되어 있어야 한다. 그럼에도 불구하고 현행 임상시험에 관한 법률은 약사법과 의료기기법에서 일정한 규정을 두고 있으나 이는 '의약행정'을 원활하게 수행하기 위한 법목적에 비추어 피험자 보호에는 일정한 한계가 있다. 더 나아가 미성년 피험자를 대상으로 하는 임상시험은 약사법 등에서 직접적인 규정을 두지 않고, '소아를 대상으로 하는 임상시험 평가 가이드라인'이나 '의약품임상시험관리기준' 등에서 일정 부분 규율하고 있으나 이는 법적 효력이 없는 권고사항이라는 점에서 일정한 한계가 있다. 미성년자 대상 임상시험에 대한 법흠결 문제는 인체침습의 정도 면에서 통상적인 의료행위의 경우보다 강한 장기이식법상의 미성년자 취급제도와 기타 외국법상의 미성년자 임상시험 제도를 검토함으로서 입법적 해결이 가능하다고 할 것이다. 그러나 근본적으로는 현행법 체계상 약사법, 의료기기법 기타 가이드라인을 중심으로 이루어지고 있는 임상시험 규율체계를 이른바 "피험자보호법"이라는 법률제정을 통해 해결하는 것이 바람직하다고 본다.

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근거중심 급성 뇌졸중 간호 가이드라인 수용개작 (Adaptation of the Evidence Based Nursing Practice Guideline)

  • 김지현;송소이;김미경;조명숙
    • 임상간호연구
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    • 제17권2호
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    • pp.176-191
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    • 2011
  • Purpose: This methodological study translated, adapted, and validated the evidence based guideline of RNAO (Registered Nurses Association of Ontario) in Canada, for acute stroke care to domestic circumstances. Methods: Quality of the RNAO guideline was evaluated using AGREE tool. Then the guideline was translated into Korean and a preliminary guideline was established After checking content validation by an expert group, the Korean version of the guideline was applied to clinical settings to see its applicability. Results: The RNAO guideline in Korea was deemed appropriate. The Korean version of the guideline was drawn up with 56 items in 3 areas in stroke system related nursing, nursing of acute stroke inpatients, and stroke nursing assessment. A questionnaire survey was performed on appropriateness, enforceability, and applicability of those recommendations. A total of 54 recommendations were finalized after deleting 2 items below CVI 0.7 and correcting 3 items by taking professional advices. After trial application of the guideline to 40 stroke patients hospitalized at a ward of a hospital in Seoul, its performance was improved but was not statistically significant. Conclusion: This guideline is expected to contribute to improving nursing quality by offering it as a guide to evidence based practices for acute stroke care in Korea.