• Title/Summary/Keyword: Evidence-based assessment

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The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research (일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로-)

  • Park, Jong-Ku;Kang, Myung-Guen;Lee, Seong-Soo;Kim, Dal-Rae;Choi, Seo-Young;Han, Chang-Ho;Yoo, Jun-Sang;Kim, Min-Gi;Kim, Chun-Bae
    • The Journal of Internal Korean Medicine
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    • v.22 no.4
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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Analysis of Studies on Palmul-tang for Establishment of Evidence Based Medicine (EBM 기반 구축을 위한 팔물탕 문헌 연구 분석)

  • Ma, Choong-Je;Lee, Nam-Hun;Ma, Jin-Yeul;Ha, Hye-Kyung;Yu, Young-Beob;Shin, Hyun-Kyoo
    • Herbal Formula Science
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    • v.15 no.2
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    • pp.35-45
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    • 2007
  • Objective : The purpose of this report was to provide the information activity and safety of Palmul-tang by analyzing domestic/international papers and theses about Palmul-tang, Methods: Domestic/international papers and theses related to Palmul-tang were reviewed and analyzed, These papers were then classified by year, experimental method and subject, Results: The following results were obtained in this study. 1. The study of Palmul-tang started from 1985 and was continuously increased. The study was mainly forcused on experimental model rather than clinical study. 2. As these studies were classified by subject, papers related to immune intensification were most abundant by 20 papers, Besides there were several papers related to cardiovascular activity, reproductive activity, anti-apoptotic activity and cerebral hemodynamics. 3. Among the papers related to immune intensification. the studies on recovery of fatigue were mostabundant by 10 papers and the studies of on immune cell and cytokine express were six. In addition to. several studies were associated with anti-cancer activity and anti-allergic activity. Recovery of fatigue was determined by measurement of fatigue markers in a living body such as lactate. CPK, pyruvate and triglyceride and assessment of exercise capability of animals such as swimming test. slopped plate test. Rota-rod test, and activity cage test after Palmul-tang treatment. 4. According to experimental data. it is supported that Palmul-tang has been used as Qi and Blood intensifier with immune intensification and recovery of fatigue. 5. The paper related to safety of Palmul-tang was only one paper which is studied on acute toxicity of Palmul-tang with experiment with ICR mouse. There was no study on evaluating safety by observing liver and kidney functions after Palmul-tang treatment Conclusion: Palmul-tang is being used in various ways associating with immune intensification. cardiovascular activity and reproductive activity. However. studies on efficacy and mechanism of Palmul-tang should be conducted at the molecular biology level and studies on safety of Palmul-tang need to be completed at the clinical level.

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Past and Future Regional Climate Change in Korea

  • Kwon, Won-Tae;Park, Youngeun;Min, Seung-Ki;Oh, Jai-Ho
    • The Korean Journal of Quaternary Research
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    • v.17 no.2
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    • pp.161-161
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    • 2003
  • During the last century, most scientific questions related to climate change were focused on the evidence of anthropogenic global warming (IPCC, 2001). There are robust evidences of warming and also human-induced climate change. We now understand the global, mean change a little bit better; however, the uncertainties for regional climate change still remains large. The purpose of this study is to understand the past climate change over Korea based on the observational data and to project future regional climate change over East Asia using ECHAM4/HOPE model and MM5 for downscaling. There are significant evidences on regional climate change in Korea, from several variables. The mean annual temperature over Korea has increased about 1.5∼$1.7^{\circ}C$ during the 20th century, including urbanization effect in large cities which can account for 20-30% of warming in the second half of the 20th century. Cold extreme temperature events occurred less frequently especially in the late 20th century, while hot extreme temperature events were more common than earlier in the century. The seasonal and annual precipitation was analyzed to examine long-term trend on precipitation intensity and extreme events. The number of rainy days shows a significant negative trend, which is more evident in summer and fall. Annual precipitation amount tends to increase slightly during the same period. This suggests an increase of precipitation intensity in this area. These changes may influence on growing seasons, floods and droughts, diseases and insects, marketing of seasonal products, energy consumption, and socio-economic sectors. The Korean Peninsular is located at the eastern coast of the largest continent on the earth withmeso-scale mountainous complex topography and itspopulation density is very high. And most people want to hear what will happen in their back yards. It is necessary to produce climate change scenario to fit forhigh-resolution (in meteorological sense, but low-resolution in socio-economic sense) impact assessment. We produced one hundred-year, high-resolution (∼27 km), regional climate change scenario with MM5 and recognized some obstacles to be used in application. The boundary conditions were provided from the 240-year simulation using the ECHAM4/HOPE-G model with SRES A2 scenario. Both observation and simulation data will compose past and future regional climate change scenario over Korea.

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Correlates of life satisfaction in the Elderly : Systematic Review and Meta-analysis (노인의 생활 만족도 영향 요인: 체계적 문헌고찰 및 메타분석)

  • Mo, Jin-A;Lee, Kyung-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.517-526
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    • 2018
  • The purpose of this study is to provide convenience to the senior center staff and policy makers through a research of "Life satisfaction" in the senior centers with a systematic review and meta-analysis of the considerations of the elderly, published in foreign journals for the past 10 years. We searched published studies in the Medline Complete, Pub-med central and Scopus databases from January 2007 to November 2017. The main key words used "Elderly AND(And OR aged) AND Personal Satisfaction/ or life satisfaction" and out of 595 searched articles a total of 6 studies were selected. After qualitative analysis of the contents of the study, meta - analyzes were conducted for factors with more than three quantitative values. The factors affecting life satisfaction of the elderly were physical health (pooled effect size 0.582, p = .000), mental health (pooled effect size 0.423, p = .000), economic problems (r = .51, p =. 001), social activities, and daily living. It is expected that this study which provides an understanding of life satisfaction of the elderly would contribute to provide general information for developing social consensus on the employment in the super aging society should help improve the quality of welfare facilities for senior citizens in the future.

Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1313-1320
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    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

Effect of exercise program on activity of daily living in patients with dementia : A Systematic Review (운동프로그램이 치매환자의 일상생활활동에 미치는 효과에 대한 체계적 고찰)

  • Kim, Jae-Nam;Lee, chang dae;Park, Ji-Hyuk
    • Therapeutic Science for Rehabilitation
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    • v.4 no.2
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    • pp.7-15
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    • 2015
  • Objectives : The aim of this study was to assess the clinical effect of exercise program used for treatment of activity of daily living skill in patients with dementia. Methods : We searched foreign studies registered from 2007 to 2014 based on PubMed database, using the following search terms : dementia, alzheimer disease, cognitive impairment, exercise program, physical activity, activity of daily living, ADL. Total 5 studies included from 215 studies after analysis papers. Results : selected paper's average pedro score was 6, Katz index of ADLs, Bathel ADL index, IADL activity of daily living assessment tool were used. there was significant improves of activity of daily living skill in the use of exercise program groups and it prevent decreased of activity of daily living skill. Conclusion : This study provide evidence of exercise program applied in clinical use and demonstrate effective on activity of daily living ability. This results expected to help suggesting basic data for exercise program to improve activity of daily living ability and making effective treatment approach method in the future.

The Role of M&A in Restructuring Korea's Distressed Firms (경제위기 이후 부실기업 구조조정에 있어서의 M&A의 역할 - 주식인수 및 영업양수 방식에 의한 기업결합을 중심으로 -)

  • Choi, Yong-Seok
    • KDI Journal of Economic Policy
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    • v.26 no.2
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    • pp.179-208
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    • 2004
  • With the outbreak of the financial crisis in mid-1997, the Korean government has removed a majority of M&A-related regulations in order to facilitate M&A transactions. This was based upon the belief that M&As are one of the most efficient ways to restructure financially distressed firms compared to other government-driven restructuring programs. In this paper, we try to empirically assess the role of M&A in restructuring distressed firms in Korea following the financial crisis. In doing so, three empirical analyses have been conducted. The first analysis attempts to identify financial characteristics of the insolvent M&A targets. The second exercise directly tests the change in performance of insolvent M&A targets before and after such M&A transactions. The third analysis is a more general assessment on the role of M&A transactions to determine if being involved in an M&A transaction (regardless of its motivate) has reduced the probability of becoming insolvent in the future. Overall, we find some evidence supporting that M&A activities after the financial crisis have played a positive role in restructuring financially distressed firms in Korea.

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Improving Course Evaluation System of Engineering Education (이공계 강의평가 결과의 실증적 분석을 통한 강의평가제도 개선방안)

  • Kim, Hak-Il;Kim, Sung-Sook;Kwon, Oh-Yang;Lee, Cheon;Row, Kyung-Ho
    • Journal of Engineering Education Research
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    • v.10 no.4
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    • pp.58-77
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    • 2007
  • An evaluation system of teaching is one of authentic assessment tools for improving the quality of higher education. The purpose of this study is to cultivate the class evaluation system in the college of engineering based on the empirical analysis of the results of the class evaluation. Especially, this study investigates the validity evidence using the confirmatory factor analysis of the class evaluation. The data used in this study were acquired from 49,127 student's evaluation responses of 471 courses offered in colleges of natural science and engineering at a university in Korea. The reliabilities are quite good for every construct by producing an index value from 0.92 to 0.98. The results provides a guideline for an appropriate measurement model to report the information, to clarify quality and appropriateness of instrument items, to make recommendations for which items should be left or merged in the revised instrument. A special suggestion for improving student's evaluation of each course is to prepare a well-designed instruction for students explaining why and how to evaluate the course in order to produce reliable and valid results.

Occupational Therapy Intervention for Improving Play of Children : A Systematic Review (아동의 놀이 향상을 위한 작업치료 중재에 관한 체계적 고찰)

  • Lee, Sun-Hee;Park, Hae Yean
    • The Journal of Korean Academy of Sensory Integration
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    • v.15 no.2
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    • pp.93-106
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    • 2017
  • Objective : The purpose of this study is to provide an evidence for clinical practice by systemic analysis on occupational therapy interventions for improvement of children's play. Methods : Articles used in this study were collected from database of Pubmed, ProQuest, EBSCOhost, Scopus, RISS, KISS, and National Library of Korea. The key words used in the search were "Play AND Occupational Therapy AND (Intervention OR Treatment)" and the publication period was limited from January 2007 to April 2017. 11 articles in total were selected for the systematic review analysis. Results : The results revealed that the majority of studies was one-group non-randomized study and the majority of intervention used was play-based intervention in case of that play itself was the intervention goal. The most frequently used environment for the intervention was parallel setting of home and treatment room. The majority of studies was for children with ADHD and the most commonly used assessment tool was Test of Playfulness (ToP). Dependent variables measured along with play were language skills, social interactive skills, communication and pragmatic skills, problem-solving skills, caregiver responsiveness, and parent-child interaction. Conclusion : This study help to understand the current state of occupational therapy intervention for improvement of children's play. Starting with the understanding, it is expected that various studies on play of children will be done in the future.

Measuring Quality of Life in Cerebral Palsy Children According to the Severity Using the Visual Analogue Scale, Time Trade-Off, and EQ-5D-Y Proxy (뇌성마비 환아 중증도별 시각화척도, 시간교환법, EQ-5D-Y Proxy를 이용한 삶의 질 측정)

  • Lee, Go-Eun;Kim, Nam Kwen;Yun, Young Ju;Wang, Hye Min;Kim, Jeong Hun;Lee, Dong Hyo
    • Journal of Oriental Neuropsychiatry
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    • v.28 no.2
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    • pp.49-59
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    • 2017
  • Objectives: To measure the quality of life in patients according to virtual cerebral palsy severity by using the Korean version of EQ-5D-Y proxy, Visual Analogue Scale (VAS), and Time Trade-Off method (TTO). Methods: The study was conducted in parents of children and adolescents aged 4 to 15 years in Seoul. We analyzed the difference in the utility value according to five levels of cerebral palsy severity in the Gross Motor Function Classification System (GMFCS) and test-retest reliability. Results: 1. There were significant differences in VAS, TTO, and EQ-5D-Y proxy according to the cerebral palsy severity (p<.001). 2. VAS was significantly different according to the respondent's visit to the medical institution, the presence of disease in the respondent, a visit to the child's medical institution, the age of the child, and the sex of the child. The value of TTO was significantly different according to the respondent's visit to the medical institution, respondent's sex, and the age of the child. Also, EQ-5D-Y proxy was significantly different according to the age of the child. 3. Intraclass correlation coefficient values were more than 0.6 for both VAS and TTO at all stages. But for the EQ-5D-Y proxy, the value was less than 0.6 at all stages. Conclusions: The quality of life assessment using EQ-5D-Y proxy showed significant differences in the severity of cerebral palsy. However, large-scale studies using EQ-5D-Y proxy are needed because of low test-retest reliability.