• Title/Summary/Keyword: Evidence-Based Treatment

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Discussion on Classical Text-based Evidence in Guidelines for the Traditional Chinese Medical Treatment of COVID-19 (COVID-19의 중의(中醫) 진료방안에 반영된 문헌 근거에 대한 고찰)

  • Kim, Sanghyun
    • Journal of Korean Medical classics
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    • v.35 no.4
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    • pp.115-125
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    • 2022
  • Objectives : This study reviews whether the traditional medical thought process reflected in the Traditional Chinese Medical Treatment Plan for COVID-19 is based on existing classical texts, and examine concerns over the quality of evidence that the plan is based on. Methods : First, terminology and basic formulas composing the compound formulas in the COVID-19 TCM Treatment Plan were collected. Next, their usage in existing classical texts were searched in the medical classics database. Results : Infectious diseases similar to COVID-19 were understood as external disease due to Six Qi in the texts. Basic formulas used for treatment were those applied in Shanghan and Wenbing, among which cases where such formulas were applied in infectious diseases could be found in the classics. Conclusions : The level of evidence of the Treatment Plan suggested by various specialists could be evaluated as insufficient if we consider the literature. However, if application of such a plan could be supported institutionally, it could become a starting point for evidence generation.

A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines

  • Eom, Sang Soo;Choi, Wonyoung;Eom, Bang Wool;Park, Sin Hye;Kim, Soo Jin;Kim, Young Il;Yoon, Hong Man;Lee, Jong Yeul;Kim, Chan Gyoo;Kim, Hark Kyun;Kook, Myeong-Cherl;Choi, Il Ju;Kim, Young-Woo;Park, Young Iee;Ryu, Keun Won
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.3-23
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    • 2022
  • Countries differ in their treatment expertise and research results regarding gastric cancer; hence, treatment guidelines are diverse based on evidence and medical situations. A comprehensive and comparative review of each country's guidelines is imperative to understand the similarities and differences among countries. We reviewed and compared five gastric cancer treatment guidelines in terms of endoscopic, surgical, perioperative, and palliative systemic treatment based on evidence levels and recommendation grades, as well as the postoperative follow-up strategies for each guideline. The Korean, Chinese, and European guidelines provided evidence and grading of the recommendations. The United States guidelines suggested categories for evidence and consensus. The Japanese guidelines suggested evidence and recommendations only for systemic treatment. The Korean and Japanese guidelines described endoscopic treatment, surgery, and lymphadenectomy in detail. The Chinese, United States, and European guidelines more intensively considered perioperative chemotherapy. In particular, the indications for chemotherapy and the regimens recommended by each guideline differed slightly. Considering their medical situations, each guideline had some diversity in terms of adopting evidence, which resulted in heterogeneous recommendations. This review will help medical personnel to comprehensively understand the diversity in gastric cancer treatment guidelines for each country in terms of evidence and recommendations.

Evidence-based Treatment of Acute Lateral Ankle Sprain (근거에 기반한 급성 발목관절 외측 염좌의 치료)

  • Cho, Byung-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.4
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    • pp.135-144
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    • 2018
  • Acute lateral ankle sprain, which is the most common musculoskeletal injury, can be treated effectively with appropriate evidence-based initial care using PRICE (protection, rest, ice, compression, and elevation) and functional rehabilitation. Many systemic reviews reporting a high-level of evidence supporting the clinical usefulness and necessity of primary surgical repair for acute lateral ankle sprain have been insufficient. Regardless of the severity of ligament complex injuries, the surgical treatment for acute lateral ankle sprain without concomitant pathologies is not recommended and should be considered only in young professional athletes with complete ligament rupture (grade III) and severe instability.

What is Evidence-based Dentistry?

  • Park, Livingstone Sang
    • Journal of Korean Dental Science
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    • v.3 no.2
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    • pp.34-39
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    • 2010
  • In our daily practice, we think about the diagnosis of our patient and get into a situation wherein we have to make a clinical decision. Diagnosis and treatment come from the knowledge and experiences that each dentist should have, but sometimes, we can have doubts on our decisions. "On what evidence did I make such decision? Was that really right?" Drawing our attention these days as a possible answer to this question, evidence-based dentistry seeks to apply the best available evidence gained from the scientific method to medical decision making. To make a good decision, the strength of evidence is assessed. Specifically, randomized controlled trial, systematic review, and meta-analysis are considered the highest level of evidence; cohort study, case control study, case series, animal study, bench test, and biological plausibility follow. With the approach of evidence-based dentistry, we can make objective, scientifically sound clinical decisions. It is also patient-oriented, incorporating clinical experiences and stressing good judgments; thorough and comprehensive, it uses transparent methodology. That is the reason evidence-based dentistry can be better than other assessment methods when we make a clinical decision in modern dentistry.

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Self Care in Depression (우울증의 자기 관리 방법)

  • Lee, Sun-Hea;Park, Yong Chon
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.5-13
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    • 2007
  • Objectives : Depression disturbs the individual life from the loss of productivity to suicide. Furthermore the whole society is also influenced by depression in social and economic areas. Many scientific treatment methods are known to be effective in depression. But in reality more than half of patients with depression prefer self help treatment rather than medically based treatment. For the patients with mild depression and primary physicians, it is reasonable to provide the evidence based self care including self help or alternative treatment. This study is supported by the Korean Health 21 R&D Project for the Depression Center to establish the Korean treatment guideline for depression. Methods : The members of Depression Center including the authors attended the workshops where the methods of evidence based medicine such as literature search, quality evaluation of the articles, making the level of evidence were educated. The professional librarians helped the authors for get the searched articles. Among the total of 354 abstracts of systemic review and 300 abstracts of random controlled trials, 3 systemic reviews and 2 random controlled trials were the main structure of evaluation. Result : Among the 37 self care methods known to be effective for depression, 11 kinds of methods were worth of evaluation. The first step for the self care of mild depression is to use St. John's wort, exercise, bibliotherapy, and light therapy in depression during winter season. Acupuncture, negative ion therapy, massage, relaxation technique are known to be efective with evidence. Music therapy, hypnotherapy, and aromatherapy are known to be effective but until now the evidences is insufficient and further evaluations are needed. Conclusion : Among 11 listed self-care methods, several methods need more evidence especially in Korean situation. Exercise is the most recommendable evidence based self care method in Korea nowadays. St. John's wort is effective with evidence, but it is not the OTC drug in Korea, so it is not recommendable now. For the bibliotherapy, there is no book such as "Feeling Good" in Korea. Only the introductory book about depression is available. Publishing the self help book based upon cognitive behavioral approach or psychodynamic approach is needed. Light therapy is practiced in a few clinics, but not self-help style. Exposure to the sunlight is recommended in the level of commen sense. These self care methods are for the mild patient. Moderate to severe patients with depression should seek the professional treatment.

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Evidence-Based Practice Guideline for Surgical Treatment of Gastroesophageal Reflux Disease 2018

  • Seo, Ho Seok;Choi, Miyoung;Son, Sang-Yong;Kim, Min Gyu;Han, Dong-Seok;Lee, Han Hong
    • Journal of Gastric Cancer
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    • v.18 no.4
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    • pp.313-327
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    • 2018
  • The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.

Suggestions for developing Korean Medicine Clinical Practice Guideline for Allergic Rhinitis - Based on 2018 Chinese Clinical Practice Guideline (알레르기 비염 한의표준임상진료지침 방향 제언 - 2018 중국 임상진료지침을 바탕으로)

  • Kang, Jeong-In;Lee, Dong-Hyo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.4
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    • pp.130-140
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    • 2019
  • Objective : The purpose of this study is to examine the treatment of allergic rhinitis introduced in the Chinese guideline, and to find out the direction of evidence-establishment and applicability in developing Korean Medicine clinical practice guideline for allergic rhinitis. Method : We studied Traditional Chinese Medicine treatment of allergic rhinitis introduced in the 2018 Chinese society of allergy guidelines for diagnosis and treatment of allergic rhinitis. The treatment are classified into three categories; herbal medicines, acupuncture and the others. And we compared this guidelines with other guidelines for how they differ in description of the database, evidence of level, and strength of recommendation. Results : Herbal medicines are presented based on syndrome differentiation. The basic acupoints for allergic rhinitis are introduced as follows; Fengchi(GB20), Yingxiang(LI20), Feishu(BL13) and Taiyuan(LU9). And in comparison with other guidelines for allergic rhinitis, the Chinese guideline showed lack of description in the database, evidence of level, and strength of recommendation, though they used evidence-based models. Conclusions : Clinical practice guideline projects are also underway in Korea for benefit expansion and improving quality of medical services. It is important to develop guidelines which should be evidence-based and reflect Korean medical environment.

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

  • Kim, Gyeong-Cheol;Park, Sang-Woog;Song, Kyung-Hoon;Park, Joo-Yeon;Hong, Sang-Min;Lee, Hai-Woong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.2
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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.

Recent Trends in the Treatment of Voice Disorders: Evidence-based Practice and Translational Biology Research (음성 장애 치료 연구의 최근 동향: 증거에 기초한 임상 치료 및 전이 생물학적 연구)

  • Choi, Seong-Hee
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.99-112
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    • 2010
  • This study attempted to review the recent, high-quality evidence-based practical research related to the treatment effectiveness of voice disorders which focus on randomized controlled trials (RCTs) and translational research of vocal fold tissue engineering for vocal fold regeneration. Methodology including PICO (P; Populations or Patients, I; Interventions, C; Comparison group (control, placebo, gold standard), O; Outcomes or measures made) information for RCTs and animal models (species), regenerative therapy method, and outcomes of translational research for clinical application was summarized and discussed for future voice disorder research.

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Evaluation of Results and Workloads of the Horizon Scanning of the Emerging Health Technology in Korea (국내 신개발 유망의료기술 탐색활동 결과 및 업무량 분석)

  • Joo, Yea Il;Lee, Hyeong Il;Song, Yeong Chae;Park, Joo Yeon;Shin, Ho Gyun
    • The Journal of Health Technology Assessment
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    • v.6 no.2
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    • pp.156-161
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    • 2018
  • Objectives: To evaluate results and workloads of the horizon scanning of the emerging health technology since 2014 to 2016. Methods: In order to analyze the results of the emerging health technology, we identified the number of research procedure between 2014 and 2016. The sixteen findings were calculated annual workload by person, and categorized by medical phase, classification of disease, and healthcare technology. Results: An average of 5.67 personnel were involved over three years, assessment of each emerging healthcare technology was performed for each person of identifying 54 cases, filtering 2.4 cases, prioritizing 0.9 cases were performed. According to the mapping by healthcare technologies, nine medical devices (56.3%), six drugs (37.5%), and one material of the medical treatment (6.3%) were assessed. Among sixteen findings, fifteen cases were health technologies for treatment and only one case for diagnosis. Conclusion: Future plans of the horizon scanning of the emerging health technology is required appropriate manpower in charge each target number of assessment. And a legal basis should be provided for policy reflection rate. Furthermore, an evaluation criteria and procedures should be transparent to avoid a conflict of interest.