• Title/Summary/Keyword: Evidence-based protocol

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The Effectiveness and Safety of Dokwhalkisaeng-tang Combined with the Medication on Rheumatoid Arthritis: A Study Protocol for Systematic Review and Meta-analysis (류마티스 관절염 치료제와 병용한 독활기생탕의 효과 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Chae, Soo-Yeon;Jung, Chan-Yung;Kim, Joo-Hee;Kim, Eun-Jung;Seo, Byung-Kwan;Hwang, Min-Seop;Park, Seong-Sik;Kim, Kyung-Ho;Yoon, Jong-hwa;Sung, Won-Suk
    • Herbal Formula Science
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    • v.30 no.2
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    • pp.95-100
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    • 2022
  • Objectives : Recent studies reported that Dokwhalkisaeng-tang (DHJST) could relieve the clinical rheumatoid arthritis (RA) symptoms and the level of RA-related blood test. However, evidence-based review on effectiveness and safety of DHJST with medication on RA was not yet provided. Methods : Searching randomized controlled trials on the use of DHJST for RA will be performed using multiple electronic databases, manual search, and contact to author. Studies will be selected according to the pre-defined criteria and collected data on study participants, interventions, control groups, outcome measurements, the results, adverse events, and risk of bias will be summarized. Primary outcome will be the disease activity score (including effective rate, swollen joint count, tender joint count, and morning stiffness), and the secondary outcomes will be RA-related blood test and adverse events. We will use Review Manager software to perform a meta-analysis, Cochrane Collaboration "risk of bias" tool for assessing the risk of bias, and Grades of Recommendation, Assessment, Development and Evaluation for the determination of quality of evidence. Results : We are going to investigate the effectiveness and safety of DHJST with medication for RA. Conclusion : This study will provide reliable evidence on whether DHJST combined with medicine is more effective on RA than medicine monotherapy.

The Effectiveness of Non-pharmacologic Interventions for Chronic Nonspecific Low Back Pain: A Systematic Review and Meta-analysis (국내 비특이적 만성 요통 환자에게 적용한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Mijung;Lee, Haein
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.1-16
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effectiveness of non-pharmacologic interventions for chronic nonspecific low back pain (CLBP) in adults aged 18-64 years. Methods: We searched for potentially relevant randomized controlled trials and non-randomized controlled trials through five Korean electronic databases (i.e., Korean Studies Information Service System, Research Information Sharing Service, Korean Medical Database, KoreaMed, and National Assembly Library) published from January 2010 to May 2019. Two investigators independently selected the studies based on the criteria and assessed risk of bias in the included studies. We estimated the effect size of interventions using Comprehensive Meta Analysis 3.3. Results: Of 10,151 studies, 26 studies met the inclusion criteria and 15 studies were included in the meta-analysis. Exercise reduced low back pain (Hedges's g=-1.53, 95% CI: -2.22 to -0.85) and pain-related disabilities (Hedges's g=-0.92, 95% CI: -1.40 to -0.45). We found that taping was effective in decreasing low back pain (Hedges's g=-1.12, 95% CI: -1.51 to -0.73) and pain-related disabilities (Hedges's g=-0.50, 95% CI: -0.93 to -0.07). Manual therapy yielded a marginally significant reduction in low back pain (Hedges's g=-2.32, 95% CI: -4.64 to 0.00), the therapy was not effective in decreasing pain-related disabilities. Conclusion: Although there was little evidence for the effectiveness of manual therapy in adults with CLBP, exercise and taping were effective to relieve pain and pain-related disabilities. Based on these findings, we suggest the development of non-pharmacologic interventions or a nursing intervention protocol for the CLBP management. Also, nurses should consider implementation of effective non-pharmacologic interventions for CLBP.

Family Member's Perceptions of Side Rail Use in Geriatric Hospital (노인요양병원에서의 침대난간(Side Rail) 사용에 대한 환자가족의 인식)

  • Lee, Keum-Jae;Park, Gyeong-Sook;Park, Yeon-Suk
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.503-513
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    • 2016
  • The purpose of this study is to figure out family member's perceptions of side rail use in geriatric hospital by Cavanagh's content analysis with in-depth interview. This finding of the study suggests that the six themes of these perceptions are precautionary safety supervision, movement convenience, ritualistic nursing, physical restraint, danger of wounds, and alternative methods in an older person ward, and that the cause of recognized perceptions is not based on actual events, but rather on relatives' perceived protective value. With the transition of medical industry environment, there is a significant emphasis on efficacy and effectiveness of practice, risk management and evidence-based practice. However, the issue of side rail use and physical restraints remains unsolved in care of older people. Nurses claim the necessity of regimented protocol and clarification from professional organization regarding the side rail use.

Shading Algorithm Evaluation based on User Perception (사용자 인지 실험 기반 쉐이딩 알고리즘 평가)

  • Byun, Hae-Won;Park, Yun-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.6
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    • pp.106-115
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    • 2011
  • In this paper, we evaluate the effectiveness of previous shading algorithms in depicting shape of 3d objects. We perform a study in which people are shown an image of one of ten 3D objects shaded with one of eight styles and asked to orient a gauge to coincide with the surface normal at many positions on the object's surface. The normal estimates are compared with each other and with ground truth data provided by a registered 3D surface model to analyze accuracy and precision. Our experiments suggest that people interpret certain shape differently depending on shading of 3d object. This paper offers substantial evidence that current computer graphics shading algorithms can effectively depict shape of 3d objects where the algorithms have the properties of lots of tone steps and uniformly distributed tone steps. This type of analysis can guide the future development of new CG shading algorithms in computer graphics for the purpose of shape perception.

The Effects of a Physical Activity Reinforcement Program on Exercise Compliance, Depression, and Anxiety in Continuous Ambulatory Peritoneal Dialysis Patients (신체활동 강화프로그램이 복막투석환자의 운동이행, 우울, 불안에 미치는 효과)

  • 이숙정;유지수
    • Journal of Korean Academy of Nursing
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    • v.34 no.3
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    • pp.440-448
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    • 2004
  • Purpose: This study was to evaluate the effects of a physical activity reinforcement program on exercise compliance, depression, and anxiety in continuous ambulatory peritoneal dialysis(CAPD) patients. Method: A nonequivalent control group with a pre-post test was designed. Data collection was done from December, 2002 to June, 2003 at a hoapital. The degree of depression and anxiety of the patients was assessed by the score of SCL-90-R, and exercise compliance was measured by exercise period, frequency, time and intensity. The experimental group was composed of 19 participants who were educated based on an exercise education protocol and carried out walking exercises two to four times a week after hearing verbal persuasion biweekly through the telephone or a face-to-face interview for 12 weeks, while 17 participants in control group received no intervention. Result: 1. The experimental group showed significant improvement in self-efficacy of exercise compliance (U=79.00, p=.01), exercise period ($x^2$=20.84, p=.00), exercise frequency ($x^2$=9.03, p=.0l), exercise time ($x^2$=9.03, p=.0l) and exercise intensity ($x^2$=11.09, p=.00) compared to those of the control group. 2. The experimental group showed a lower depression score (U=84.50, p=.01) than the results of the control group. 3. However, there were no changes in anxiety level compared to the control group. Conclusion: The physical activity reinforcement program was found to have an effect on exercise compliance and the depression score of CAPD patients. The results provided evidence for the importance of physical activity and verbal persuasion in CAPD patients.

Sedation at Sedation Clinic of Department of Dentistry in Hanyang University Medical Center (II) (한양대학교 치과 진정요법클리닉에서의 진정요법(II))

  • Chun, Jae-Yoon;Bing, Jung-Ho;Park, Chang-Joo;Hwang, Kyung-Gyun;Shim, Kwang-Sup
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.7 no.1
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    • pp.13-17
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    • 2007
  • At Sedation Clinic of Department of Dentistry in Hanyang University Medical Center, total 92 dental treatments under intravenous conscious sedation using midazolam alone for 80 patients were carried out from March 2006 to February 2007. Following the previous article concerning our sedation protocol, the retrospective analyses of our cases were presented in detail. By the evidence-based approach, we hope that our study will help the general dental practitioners perform the intravenous conscious sedation using midazolam alone safely and effectively.

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A Study of the Trends in Korean Nursing Research on Critical Care in the Last 10 Years (2008-2017) Using Integrated Review and Key Word Analysis (통합적 고찰과 키워드 분석을 이용한 최근 10년(2008-2017) 동안의 국내 중환자간호 연구 동향 분석)

  • Kang, Jiyeon;Kim, Soo Gyeong;Cho, Young Shin;Ko, Hyunyoung;Back, Ji Hyun;Lee, Su Jin
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.75-85
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    • 2018
  • Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

Relationship between Lateral Position Change and Sternal Complications after Cardiac Surgery through Median Sternotomy (정중 흉골 절개술을 이용한 심장수술 후 환자의 체위변경과 흉골 합병증 발생과의 관계)

  • Kang, Young Ae;Bae, Su Jin;Song, Chie Eun
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.66-76
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    • 2016
  • Purpose: This study was conducted to examine the relationship between lateral position change and sternal complications after cardiac surgery through median sternotomy. Methods: This study was a retrospective descriptive case-control study, involving 241 patients who underwent cardiac surgery through median sternotomy. Data from October 2011 to September 2014 were collected. Results: Sternal complications (i.e. dehiscence, sternal instability, mediastinitis) developed in 33 patients (13.7%). Primary symptoms of complications were discharge and erythema, and the mean time difference from surgery to appearance of symptoms was 15 days (range, 1-138 days). The factors associated with sternal complications were cancer comorbidity (${\chi}^2=5.22$, p=.039), internal mammary artery procedure (${\chi}^2=4.16$, p=.041), and duration of extra-corporeal membrane oxygenation (p=.033). Position change was not related to incidence of sternal complications (${\chi}^2=0.14$, p=.704). Pressure ulcers appeared in 63 patients (26.1%). Mean time difference from surgery until occurrence of ulcers was 6.7 hours (range, 0-323.0 hours), but position change was started from 132.4 hours (range, 27.1-503.2 hours) after intensive care unit admission. Conclusions: These results provide baseline data to create a standard position change and activity protocol for patients after median sternotomy. Furthermore, the study could help clinical practitioners establish evidence-based nursing practices.

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Ginseng consumption and risk of cancer: A meta-analysis

  • Jin, Xin;Che, Dao-biao;Zhang, Zhen-hai;Yan, Hong-mei;Jia, Zeng-yong;Jia, Xiao-bin
    • Journal of Ginseng Research
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    • v.40 no.3
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    • pp.269-277
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    • 2016
  • Background: The findings of currently available studies are not consistent with regard to the association between the risk of cancer and ginseng consumption. Therefore, we aimed to evaluate this association by conducting a meta-analysis of different studies. Methods: To systematically evaluate the effect of ginseng consumption on cancer incidence, six databases were searched, including PubMed, Ovid Technologies, Embase, The Cochrane Library, China National Knowledge Infrastructure, and Chinese VIP Information, from 1990 to 2014. Statistical analyses based on the protocol employed for a systematic review were conducted to calculate the summary relative risks (RRs) and 95% confidence intervals (CIs). Results: We identified nine studies, including five cohort studies, three case-control studies, and one randomized controlled trial, evaluating the association between ginseng consumption and cancer risk; these studies involved 7,436 cases and 334,544 participants. The data from the meta-analysis indicated a significant 16% lower risk of developing cancer in patients who consumed ginseng (RR = 0.84, 95% CI = 0.76-0.92), with evidence of heterogeneity (p = 0.0007, $I^2$ = 70%). Stratified analyses suggested that the significant heterogeneity may result from the incidence data for gastric cancer that were included in this study. Publication bias also showed the same result as the stratified analyses. In addition, subgroup analyses for four specific types of cancer (colorectal cancer, lung cancer, gastric cancer, and liver cancer) were also performed. The summary RRs for ginseng intake versus no ginseng consumption were 0.77 for lung cancer, 0.83 for gastric cancer, 0.81 for liver cancer, and 0.77 for colorectal cancer. Conclusion: The findings of this meta-analysis indicated that ginseng consumption is associated with a significantly decreased risk of cancer and that the effect is not organ specific.

Long-term assessment of periodontal disease progression after surgical or non-surgical treatment: a systematic review

  • Sanz-Martin, Ignacio;Cha, Jae-Kook;Yoon, Sung-Wook;Sanz-Sanchez, Ignacio;Jung, Ui-Won
    • Journal of Periodontal and Implant Science
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    • v.49 no.2
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    • pp.60-75
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    • 2019
  • The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.