• 제목/요약/키워드: Evaluation outcomes

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Evaluation of Crestal Bone Resorption of the TiUnite(R) Anodized Implant System

  • Kim, Young-Kyun;Ahn, Min-Seok;Lee, Yang-Jin;Yun, Pil-Young
    • Journal of Korean Dental Science
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    • 제1권1호
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    • pp.4-9
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    • 2008
  • Purpose : This study sought to examine the aspects of crestal bone resorption and to evaluate the clinical outcomes of the TiUnite$^{(R)}$ (Nobel Biocare, Sweden) anodized implant system. Materials and Methods : Among the 67 patients (211 fixtures) who were treated using TiUnite(r) implants at Seoul National University Bundang Hospital between March 2004 and January 2007, 26 (91 fixtures) were considered in this study. Initial and secondary stabilities were measured using Periotest$^{(R)}$ and Ostell(tm) Mentor. The radiographic evaluation of crestal bone resorption was carried out by measuring the change in crestal bone level at the time of surgery compared to that 1 year after loading. Panoramic radiograph and periapical radiograph were used. Based on the radiographic findings, the shapes of crestal bone resorption were classified. Results : The average amount of crestal bone resorption after 1 year of functional implant loading was 0.30 mm. There was no saucerization in 40 implant fixtures (43.9%), although more than 1 thread were exposed in 51 implant fixtures (56.6%). The success rate of the implants was 94.5%, and the survival rate was 100%. Conclusions : Good clinical outcomes and minor crestal bone resorption were noted in this study. Saucerization for the establishment of biological width was not a general finding in the TiUnite$^{(R)}$ anodized implant system.

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신인증기준 실시에 대한 제안 (The Proposal for the Execution KEC2005)

  • 강소연;최금진;함승연
    • 공학교육연구
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    • 제8권2호
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    • pp.52-63
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    • 2005
  • 공학교육의 문제점을 해소하고 국제적으로 인정받는 양질의 공학교육을 실시하기 위하여 도입된 공학교육 프로그램 인증은 해를 거듭할수록 참여하는 대학과 프로그램의 수가 급격하게 증가하고 있다. 이에 따라 공인원에서는 한국의 실정에 적합한 인증기준을 연구하여 KEC2005를 공표하였다. 이미 인증을 받은 대학이나 현재 인증 평가를 받기위해 인증을 준비하는 대학은 앞으로 이 인증기준을 적용하여 평가를 받아야 하므로 KEC2005를 기준으로 전환하는데 어려움을 안고 있다. 따라서 공인원에서 KEC2005를 실시하는데 있어서 몇 가지 제안을 하고자 한다. 첫째, 인증기준에 대한 요구사항을 구체적인 예시를 통하여 분명히 제시해 주어야 한다. 둘째, 학습성과에 대한 구체적인 모델과 방법론을 제시해야 한다. 셋째, 교수들의 자발적인 참여 속에 이상에 치우치지 않은 현실적이고 타당성있는 평가가 이루어져야 한다. 넷째, 평가자의 재교육 등의 전문성과 다양성 확보가 필요하다. 다섯째, 인증을 준비하는 대학에 대한 공인원의 적극적인 자문과 정확한 정보제공이 필요하다.

Treatment of Acute Acromioclavicular Joint Dislocation: Kirschner's Wire Trans-acromial Fixation versus AO Locking Hook Plate Fixation

  • Kim, Young-Jun;Chun, Yong-Min
    • Clinics in Shoulder and Elbow
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    • 제19권3호
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    • pp.149-154
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    • 2016
  • Background: The purpose of this study is to compare clinical and radiological outcomes between trans-acromial fixation with Kirschner's wire (K-wire) and AO locking hook plate fixation for acute acromioclavicular (AC) joint dislocation. Methods: This study included 61 patients who underwent either closed reduction and trans-acromial fixation with K-wire (group A, 23 patients) or open reduction and internal fixation with AO locking hook plate (group B, 38 patients). Pain on a visual analogue scale (VAS) score, the University of California Los Angeles (UCLA) shoulder score, the American Shoulder and Elbow Surgeons (ASES) score, and active range of motion (ROM) were used in the functional evaluation. For radiological evaluation, coracoclavicular distance (CCD) was measured on both clavicular anteroposterior view and compared between groups. Results: At one-year follow-up, no significant differences in VAS pain score, UCLA shoulder score, ASES score, and active ROM were observed between groups, despite five cases (22.7%, 5/23) of complication in group A. The side-to-side difference between normal and affected CCD was $2.4{\pm}2.2mm$ in group A and $0.2{\pm}0.7mm$ in group B. This difference showed a statistical significance between groups (p<0.001). Conclusions: For the treatment of acute AC joint dislocation, the K-wire trans-acromial fixation group showed a significantly greater CCD than the AO locking hook plate group. In addition, during the follow-up period, much higher incidence of complication related to implant was observed in the trans-acromial fixation group. Although clinical outcomes between groups were not significantly different, these results should be interpreted carefully.

체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가 (Evaluation of the Effect of Clinical Practice Guideline using Systematic Review)

  • 이선희;하귀염;김주혜;서주현;김현미
    • 한국병원경영학회지
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    • 제14권1호
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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Development and Psychometric Assessment of a Self-evaluation Questionnaire for Gastroesophageal Reflux Disease

  • Jung, Hye-kyung;Choi, Myung-Gyu;Baek, Myung-Ki;Wu, Justin CY
    • Journal of Neurogastroenterology and Motility
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    • 제24권4호
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    • pp.584-592
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    • 2018
  • Background/Aims There is uncertainty about how to measure outcomes reported by patients in gastroesophageal reflux disease (GERD). This study was conducted to develop an instrument and to determine of the definition of respondent for a patient reported outcomes to assess the efficacy of a treatment used for GERD treatment. Methods A structural process has developed a self-evaluation questionnaire for GERD (SEQ-GERD); health-related quality of life questionnaire for GERD (GERD-QOL) was translated through cross-cultural validation. Two-week reproducibility was evaluated and construct validity was assessed by correlating the SEQ-GERD with the Patient Assessment of Gastrointestinal Disorders (PAGI-SYM), the reflux disease questionnaire (RDQ), and GERD-QOL. Changes in SEQ-GERD scores were compared to assess the discriminative validity following 4 weeks of proton pump inhibitor administration. Results A total of 83 Korean patients were included (mean age $46{\pm}14$ years, females 61.4%). The internal consistency of the 19-item SEQ-GERD was good (alpha = 0.60-0.94) and the test-retest reliability was high (intra-class correlation coefficient = 0.67-0.95). The SEQ-GERD highly correlated with the GERD domain of the PAGI-SYM (correlation coefficient r = 0.894, P < 0.001), the RDQ-GERD (r = 0.877, P < 0.001), and GERD-QOL (r = -0.536, P < 0.05). SEQ-GERD scores significantly varied according to the overall treatment effectiveness scale of drug responsiveness and significantly decreased after drug treatment (mean differences according to the overall treatment effectiveness scale, P = 0.020). Conclusion This study supports that SEQ-GERD is reliable and valid, and can be used to evaluate the treatment response in patients with GERD.

광범위한 안면외상 환자에서의 미세술기를 이용한 재건술 (Microsurgical reconstruction of posttraumatic large soft tissue defects on face)

  • 백우열;송승용;노태석;이원재
    • 대한의사협회지
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    • 제61권12호
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    • pp.724-731
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    • 2018
  • Our faces can express a remarkable range of subtle emotions and silent messages. Because the face is so essential for complex social interactions that are part of our everyday lives, aesthetic repair and restoration of function are an important tasks that we must not take lightly. Soft-tissue defects occur in trauma patients and require thorough evaluation, planning, and surgical treatment to achieve optimal functional and aesthetic outcomes, while minimizing the risk of complications. Recognizing the full nature of the injury and developing a logical treatment plan help determine whether there will be future aesthetic or functional deformities. Proper classification of the wound enables appropriate treatment, and helps predict the postoperative appearance and function. Comprehensive care of trauma patients requires a diverse breadth of skills, beginning with an initial evaluation, followed by resuscitation. Traditionally, facial defects have been managed with closure or grafting, and prosthetic obturators. Sometimes, however, large defects cannot be closed using simple methods. Such cases, which involve exposure of critical structures, bone, joint spaces, and neurovascular structures, requires more complex treatment. We reviewed and classified causes of significant trauma resulting in facial injuries that were reconstructed by microsurgical techniques without simple sutures or coverage with partial flaps. A local flap is a good choice for reconstruction, but large defects are hard to cover with a local flap alone. Early microsurgical reconstruction of a large facial defect is an excellent choice for aesthetic and functional outcomes.

Evaluation of success criteria for temporomandibular joint arthrocentesis

  • Yilmaz, Onur;Candirli, Celal;Balaban, Emre;Demirkol, Mehmet
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권1호
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    • pp.15-20
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    • 2019
  • Objectives: The aim of this study was to use four sets of success criteria to evaluate the outcomes of arthrocentesis treatment with hyaluronic acid injection in patients with internal derangement (ID) of the temporomandibular joint (TMJ). Materials and Methods: The study included 40 patients diagnosed with unilateral Wilkes stage III TMJ dysfunction. Clinical parameters, including maximum mouth opening (MMO) and pain during function, were evaluated preoperatively, 6 months, and 1 year after TMJ arthrocentesis. Outcomes were assessed and compared using four sets of success criteria from the following: the American Association of Oral and Maxillofacial Surgeons (AAOMS; MMO ${\geq}35mm$ and visual analogue scale [VAS] score ${\leq}3$), Murakami et al.'s criteria (MMO >38 mm and VAS score <2), Emshoff and Rudisch criteria (MMO ${\geq}35mm$ and >50% pain reduction), and patient self-reports (self-evaluation of treatment as successful or unsuccessful). Results: Significant improvements in MMO and pain reduction during function were observed between the preoperative period and 6 months and 1 year postoperatively (P<0.01). The success rates of treatment determined using AAOMS (52.5%), Emshoff and Rudisch criteria (57.5%), and self-reported patient criteria (40.0%) were similar. Application of the Murakami et al. criteria reported the lowest success rate (12.5%). Conclusion: The AAOMS and Emshoff and Rudisch criteria are consistent with patient expectations and can be used to assess treatment efficacy.

Process Evaluation of a Mobile Weight Loss Intervention for Truck Drivers

  • Wipfli, Brad;Hanson, Ginger;Anger, Kent;Elliot, Diane L.;Bodner, Todd;Stevens, Victor;Olson, Ryan
    • Safety and Health at Work
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    • 제10권1호
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    • pp.95-102
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    • 2019
  • Background: In a cluster-randomized trial, the Safety and Health Involvement For Truck drivers intervention produced statistically significant and medically meaningful weight loss at 6 months (-3.31 kg between-group difference). The current manuscript evaluates the relative impact of intervention components on study outcomes among participants in the intervention condition who reported for a post-intervention health assessment (n = 134) to encourage the adoption of effective tactics and inform future replications, tailoring, and enhancements. Methods: The Safety and Health Involvement For Truck drivers intervention was implemented in a Web-based computer and smartphone-accessible format and included a group weight loss competition and body weight and behavioral self-monitoring with feedback, computer-based training, and motivational interviewing. Indices were calculated to reflect engagement patterns for these components, and generalized linear models quantified predictive relationships between participation in intervention components and outcomes. Results: Participants who completed the full program-defined dose of the intervention had significantly greater weight loss than those who did not. Behavioral self-monitoring, computer-based training, and health coaching were significant predictors of dietary changes, whereas behavioral and body weight self-monitoring was the only significant predictor of changes in physical activity. Behavioral and body weight self-monitoring was the strongest predictor of weight loss. Conclusion: Web-based self-monitoring of body weight and health behaviors was a particularly impactful tactic in our mobile health intervention. Findings advance the science of behavior change in mobile health intervention delivery and inform the development of health programs for dispersed populations.

체외막산소화장치 적용 중환자를 위한 근거기반 간호 프로토콜 개발 및 효과 평가 (Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients)

  • 김수미;김철규
    • 대한간호학회지
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    • 제53권3호
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    • pp.275-294
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    • 2023
  • Purpose: This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol. Methods: The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol's effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses' outcome variables were evaluated using a questionnaire. Results: First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001). Conclusion: This protocol may help prevent infections and pressure injuries in patients, and improve nurses' satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

Neuroimaging in Randomized, Multi-Center Clinical Trials of Endovascular Treatment for Acute Ischemic Stroke: A Systematic Review

  • Chong Hyun Suh;Seung Chai Jung;Byungjun Kim;Se Jin Cho;Dong-Cheol Woo;Woo Yong Oh;Jong Gu Lee;Kyung Won Kim
    • Korean Journal of Radiology
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    • 제21권1호
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    • pp.42-57
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    • 2020
  • Appropriate use and analysis of neuroimaging techniques is an inevitable aspect of clinical trials for patients with acute ischemic stroke. Neuroimaging examinations were recently used to define the core eligibility criteria and outcomes in acute ischemic stroke research. Recent clinical trials for endovascular treatment in acute ischemic stroke have also demonstrated the efficacy or safety of endovascular treatment using various imaging modalities as well as clinical indices. Furthermore, independent imaging reviews and imaging core laboratory assessments are essential to manage and analyze imaging data in order to enhance the reliability of the outcomes. Therefore, we systematically reviewed the use of neuroimaging in recent randomized clinical trials for endovascular treatment of acute ischemic stroke in order to provide a thorough summary, which would serve as a resource guiding the use of appropriate imaging protocols and analyses in future clinical trials for acute ischemic stroke. This review will help researchers select appropriate imaging biomarkers among the various imaging protocols available and apply the selected type of imaging examination for each study in accordance with the academic purpose.