• Title/Summary/Keyword: Evidence based medicine

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The Review on the Evidence-Based Study of Acupuncture - Systematic review and Meta-analysis - (침(鍼)의 근거중심적(根據中心的) 연구동향(硏究動向)에 관(關)한 고찰(考察) - Systematic review & Meta-analysis를 중심으로 -)

  • Back, Yong-Hyeon;Park, Dong-Seok;Kang, Sung-Keel
    • Journal of Acupuncture Research
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    • v.19 no.3
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    • pp.138-155
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    • 2002
  • Objective : The purpose of this study is to work on the problems and on the direction of the study regarding the evidence-based study of Acupuncture. Methods : We reviewed the PubMed electronic database. Eight articles of systematic review without meta-analysis and six articles without meta-analysis were selected. Results : In the study of eight articles of systematic review without meta-analysis, there were two articles on effectiveness of acupuncture and one on non-effectiveness of acupuncture. Four articles were about the changes according to the quality of randomized controlled trials. Also, one article was about the side-effect of acupuncture. In the study of six articles of systematic review with meta-analysis, there were two articles on Odds Ratio, two on Relative Risk, one on number-needed-to-treat, and two on 18 predefined methodological criteria. Conclusion : As the quality of RCTs was high, positive response decreased and as the quality of RCTs was low, positive response increased. For the study of evidence-based acupuncture, it is necessary that we conduct research on well-planned placebo acupuncture, large sample size, statistical method, method of searching and assessing literature and method of meta-analysis.

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A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine (사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰)

  • Oh, Hyunjoo;Lee, Jeongyun;Lee, Hyeri;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.34 no.2
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

Clinical research methodology for Traditional Korean Medicine treatment of lung cancer : Evidence-based approach (폐암(肺癌)의 한방치료 임상연구 방법론)

  • Kim, Kyung-Suk;Kim, Sme-Hyun;Eo, Wan-Kyu;Cheon, Seong-Ha;Eom, Seok-Ki;Jo, Hak-Jun
    • Journal of Korean Medical classics
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    • v.23 no.4
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    • pp.39-62
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    • 2010
  • Background : I investigated clinical research methodology of Traditional Korean Medicine(TKM) for treatment of lung cancer with Evidence Based Medicine(EBM) approach. Methods : I conducted the internet search of National Central Library, the National Assembly Library, Korea Education & Research Information Service, Korea Institute of Science and Technology Information for Korean theses and papers, and MEDLINE for the outside articles. Conclusion : In addition to outcomes of clinical trial, abundant clinician's experience and patients' preference are also considered. Pragmatic trials and quasi-experimental trials are better than clinical trials to plan clinical design of TKM for lung cancer and appropriate endpoints includes overall survival, disease-free survival, patient reporting outcome.

The PSA Testing Debate in the U.S and Flexible Evidence-Based Medicine (미국의 PSA 진단검사 논쟁과 유연한 근거중심의학)

  • Hyun, Jae Hwan
    • Journal of Science and Technology Studies
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    • v.13 no.1
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    • pp.77-109
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    • 2013
  • The global diffusion of Evidence-Based Medicine (EBM) is changing the landscape of medicine and the healthcare system. STS scholars have shown how EBM works when put into practice. In continuing to add to the literature of previous scholars, this paper traces the historical process and debate over Prostate-Specific Antigen (PSA) testing as an early screening test for prostate cancer in the U.S. This study will reveal that both pros and cons of the testing using EBM as a crucial resources of the debate, and in the process both 'flexibly' interpret and mobilize the hierarchy of scientific evidence for EBM despite the fact the hierarchy is imagined to being scientific criteria that is rigid. Furthermore, this paper will argue that this phenomenon, for which EBM currently seems to support the cons side of PSA screening, was constructed in the context of appraisal of the value 'quality of life' in the EBM system. This case study proposes that those who study the debate of medical technology in the EBM era should contextualize and analyze EBM as part of this debate rather than simply taking EBM for granted.

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Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency

  • Guen Young Lee;Ji Young Hwang;Na Ra Kim;Yusuhn Kang;Miyoung Choi;Jimin Kim;Eun Ju Ha;Jung Hwa Baek
    • Korean Journal of Radiology
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    • v.20 no.6
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    • pp.909-915
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    • 2019
  • The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.

Forensic DNA methylation profiling from evidence material for investigative leads

  • Lee, Hwan Young;Lee, Soong Deok;Shin, Kyoung-Jin
    • BMB Reports
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    • v.49 no.7
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    • pp.359-369
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    • 2016
  • DNA methylation is emerging as an attractive marker providing investigative leads to solve crimes in forensic genetics. The identification of body fluids that utilizes tissue-specific DNA methylation can contribute to solving crimes by predicting activity related to the evidence material. The age estimation based on DNA methylation is expected to reduce the number of potential suspects, when the DNA profile from the evidence does not match with any known person, including those stored in the forensic database. Moreover, the variation in DNA implicates environmental exposure, such as cigarette smoking and alcohol consumption, thereby suggesting the possibility to be used as a marker for predicting the lifestyle of potential suspect. In this review, we describe recent advances in our understanding of DNA methylation variations and the utility of DNA methylation as a forensic marker for advanced investigative leads from evidence materials.

Research Trends in Evidence Based Medicine on Acupuncture -Randomized Controlled Trial- (침 관련 근거중심의학의 연구 동향 - Randomized Controlled Trial을 중심으로 -)

  • Lee, Ro-Min;Nam, Sang-Su;Lee, Sang-Hoon;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.26 no.2
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    • pp.147-158
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    • 2009
  • Objectives : The purpose of this study is to review the recent research trends of evidence based medicine, especially human randomized controlled trials on acupuncture. Methods : The articles were collected by retrieving the database of Pubmed and Journal of Korean Acupuncture & Moxibustion Society. The retrieving period was from October 2003 to September 2008, and the search term was 'acupuncture'. The articles were classified according to their publication journals, countries, publication years, targeted diseases, types of acupuncture and types of control. Results : In total, 558 articles in Pubmed and 35 articles in Journal of Korean Acupuncture & Moxibustion Society were searched. The number of articles on acupuncture research has increased with higher rate since 2000, but the Qualitative development has not achieved the same amplitude. Studies in Korea were insufficient both in Qualitative and Quantitative aspects. In countries, China had the most papers, and in targeted diseases, pain diseases were most dominant. In the types of acupuncture, classical acupuncture, and in the types of control, conventional western treatment showed the highest frequency. Conclusions: We need to do many-sided and more high Quality researches on acupuncture. For that, well-designed randornized trials are absolutely necessary.

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The Primary Process and Key Concepts of Economic Evaluation in Healthcare

  • Kim, Younhee;Kim, Yunjung;Lee, Hyeon-Jeong;Lee, Seulki;Park, Sun-Young;Oh, Sung-Hee;Jang, Suhyun;Lee, Taejin;Ahn, Jeonghoon;Shin, Sangjin
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.5
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    • pp.415-423
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    • 2022
  • Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.