• Korean Journal of Clinical Pharmacy
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• v.23 no.2
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• pp.89-96
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• 2013

This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

• The korean journal of orthodontics
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• v.54 no.2
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• pp.89-107
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• 2024

Objective: This systematic review aimed to provide a comparative analysis of the treatment outcomes, including hard and soft tissues, postoperative stability, temporomandibular disorders (TMD), and quality of life (QoL), in patients with facial asymmetry who underwent orthognathic surgery. Methods: The primary objective was to address the question, "How do different factors related to surgery affect the outcomes and stability of orthognathic surgery in the correction of facial asymmetry?" A meta-analysis was conducted on the outcome parameters, such as skeletal, dental, and soft tissue symmetry, TMD, QoL, and relapse, using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Subgroup analyses were conducted considering surgery-related factors such as surgical techniques (one-jaw vs. two-jaw), use of the surgery-first approach, utilization of computer simulation, and analytical methods employed to evaluate asymmetry (2D vs. 3D). Results: Forty-nine articles met the inclusion criteria. The metaanalysis demonstrated a significant improvement in the symmetry of hard and soft tissues. The subgroup analysis indicated that the treatment outcomes showed significant improvement, regardless of the factors related to surgery. Changes in TMD signs and symptoms varied according to the surgical technique used. Quality of life improved in the facial, oral, and social domains. Skeletal relapse was observed during the follow-up. Conclusions: Our findings support the positive outcomes of orthognathic surgery in the treatment of facial asymmetry in terms of skeletal and soft tissue improvements, stability, relief of TMD symptoms, and enhancement of QoL. However, most of the included studies showed a low certainty of evidence and high heterogeneity.

• Journal of Society of Preventive Korean Medicine
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• v.21 no.1
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• pp.9-17
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• 2017

Objectives : Comparative review was rendered to evaluate strengths and weaknesses of two common treatment approaches of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. A typical symptom of headache from hypertension was chosen for substantial approach of this review. Methods : Pros and cons of two different approaches to disease were evaluated based on literatures and texts focusing treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease. Headache can be correlated with hypertension yet it can be induced by multiple other factors, and headache may/may not accompany hypertension. Hypertension is an example of treatment based on syndrome differentiation from disease and headache can be an example of treatment based on syndrome differentiation. Results : Treatment based on syndrome differentiation can give more autonomy and flexibility in approach to the disease, Intuition, experience, and traditional medical theory can be applied with ease. However, management and eradication of diseases are difficult and standardization of treatment is not easy among practitioners. Treatment based on syndrome differentiation from disease incorporated merits of both eastern and western medicines, achieving more evidence based diagnosis and treatment. Eradication and standardization of disorders are possible with the latter approach. Conclusions : Comparing two systems of treatment based on syndrome differentiation and treatment based on syndrome differentiation from disease with emphasis on hypertension and headache yielded medical values. Treatment based on syndrome differentiation from disease appears to be superior in medical values and effectiveness, but further evaluation and interest are needed to make advancement in Korean traditional medicine.

• Journal of Korean Clinical Health Science
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• v.5 no.4
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• pp.1009-1014
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• 2017

Purpose. This study compared the awareness of the evidence-based practice(EBP) in 100 physical and occupational therapists. Methods. A questionnaire on awareness was conducted to examine the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. A questionnaire consisted of items on the general characteristics, the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP of the subjects. Data analysis was made by IBM SPSS Statistics Ver. 20. The EBP awareness was examined by the independent t-test. Results. For the attitude toward EBP, there was a statistically significant difference in the item of 'Therapists should judge whether they apply study results to individual patient. For the educational experience of EBP, there was no statistically significant difference in all items. For the performance ability of EBP, there was a statistically significant difference in the item about the ability to understand patient's desire for treatment and treatment preference and the item about the ability to determine appropriate treatment process in cooperation with patients. Conclusions. Both two groups showed very low results in the attitude toward EBP, the educational experience of EBP, and the performance ability of EBP. Therefore, it is necessary to enhance EBP education in undergraduate programs and the clinical field.

• Journal of Physiology & Pathology in Korean Medicine
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• v.29 no.1
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• pp.79-84
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• 2015

The aim of this review is to investigate studies of Korean medical treatment of carpal tunnel syndrome published in Korea and the evidence of it's effects in order to suggest a better research method in the future. Four Korean web databases were searched by using key words such as 'carpal', and checked relevant Korean journals. The papers were classified into the field of study, publish date, diagnostic methods, evaluation methods and analysed the study tendency. There are 9 case studies, 4 controlled studies. The paper was published almost every year more than once. Acupucture, pharmacopuncture, acupotomy, warm needle acupuncture, taping, etc. were used as treatment tools. The two most commonly used diagnostic method for carpal tunnel syndrome are Phalen's test and Tinel's sign. The two most commonly used evaluation method are VAS(Visual Analog Scale) and subjective symptoms. Korean medical treatment of carpal tunnel syndrome was effective in all studies. Korean medical treatment of carpal tunnel syndrome was effective in all studies. So it is possible that Korean medical treatment of carpal tunnel syndrome is useful as therapeutic medicine, but there are not sufficient evidence based papers, so there should be further studies.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.4
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• pp.82-95
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• 2021

Objectives The purpose of this study is to analyze clinical studies on the effectiveness of TCM (traditional Chinese medicine) for pompholyx treatment and provide evidence for Korean medicine use. Methods Randomized controlled trials (RCT) which used TCM as a treatment for pompholyx were searched in China National Infrastructure (CNKI) platform. The risk of bias of studies was assessed by using Cochrane risk of bias (RoB) 2.0 tool. Results The selected 10 RCTs showed that the experimental group treated with either TCM alone or with a combination of TCM and Western medicine showed more significant therapeutic effect compared to the control group which Western medicine alone. Conclusions Based on the studies from China, TCM may be an effective treatment for pompholyx. This provides evidence for Korean medicine use, and its possible effectiveness in treating pompholyx

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.3-10
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• 2023

This review aimed to update our knowledge of the classification, pathophysiology, prognosis, and treatment of trigeminal neuralgia (TN), with the intention of establishing better treatment protocols. The latest version of the International Classification of Headache Disorders uses an etiology-based approach to characterize TN patients, potentially contributing to the development of targeted treatment measures. Noticeable changes in the recent European Academy of Neurology guidelines for the management of TN include the use of magnetic resonance imaging for exclusion of secondary TN and differentiation of idiopathic and classical TN. Additionally, the use of botulinum toxin type A as an addon therapy for mid-term treatment of TN has also been included. Though there has been limited recent progress in the treatment of TN, previous studies emphasize the importance of customized, multidisciplinary management protocols that include drug therapy optimization; provision of continuous education and support; and timely referral of medically refractory patients for surgery in order to achieve favorable prognosis. Furthermore, slow but growing evidence on gene mutations will help elucidate the pathophysiology of TN and contribute to the development of targeted drugs that are effective and safe.

• The Journal of the Korean dental association
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• v.52 no.2
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• pp.69-74
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• 2014

Many patients have been suffering the continued hypersensitivity and pain of teeth after operative or endodontic treatment. The primary purpose of this paper is to examine the causes of the pain and the hypersensitivity of teeth, and to resolve conflicts between dentists and patients. The secondary aim of this paper is to prevent medical disputes. Evidence-based dentistry and making a good relationship with patients will reduce disputes on dental treatment.

• Journal of Korean Foot and Ankle Society
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• v.23 no.2
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• pp.43-51
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• 2019

Despite the increasing number of osteochondral lesions of the talus, there are a lack of definite evidence-based treatment protocols. Several types of treatments are available, each having their advantages and disadvantages. First-line therapy consists of well-conducted conservative treatment. Surgical treatment is the second choice. Treatments are chosen based on the size of the lesion, location, chronicity, and the condition of the neighboring cartilage. This article reviews the current updates in the treatment of osteochondral lesions of the talus to help clinicians use the available treatment strategies more efficiently.

• Korean Circulation Journal
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• v.53 no.5
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.