• 대한한방내과학회지
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• 제44권3호
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• pp.466-484
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• 2023

Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey. Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM. Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation. Conclusion: In this study, we were able to understand the clinical KMDs' perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

• 대한한의학회지
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• 제38권3호
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• pp.143-159
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• 2017

Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.1-12
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• 2020

Purpose: Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent. Methods: Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument. Results: Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80-90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100-110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient's initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C). Conclusions: This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

• 한방재활의학과학회지
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• 제32권3호
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• pp.141-151
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• 2022

Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

• 한방재활의학과학회지
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• 제31권4호
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• pp.129-143
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• 2021

Objectives This study was aimed to evaluate clinical practice guidelines (CPGs) of traffic injuries, which has already been developed at domestic or outside of country, and to explore the Korean medical treatments included in the CPGs. Methods Twelve electronic databases (PubMed, Cochrane library, China National Knowledge Infrastructure [CNKI {Chinese Academic Journals, CAJ}], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS], KoreaMed, Korean Medical Guideline Information [KoMGI), National Guideline Clearinghouse [AHRQ], Core Outcome Measures in Effectiveness Trials Initiative Website [COMET], Turning Research into Practice [TRIP], The National Institute for Health and Care Excellence [NICE], and Medical Research Information Center [MedRIC]) up to July 2021 were searched. Only systematically developed CPGs for traffic injuries were selected and appraised. The appraisal was conducted by using Appraisal of Guidelines for Research & Evaluation (AGREE) II tool. Results Six CPGs were included and evaluated. All CPGs were appraised as highly recommended because they exceeded 60% in more than 4 among 6 domains of AGREE II, including domain of 'rigor of development', and 30% in the rest. Recommendations related to Korean medicine treatments such as on manual therapy related to Chuna were given in 6 CPGs, 4 for acupuncture, 1 for Qigong and 1 for Taping. Conclusions The 6 CPGs were developed up to now through a systematic development methodology and there were many recommendations for Korean medical treatments related to manual (Chuna) treatment, acupuncture and Qigong. However, the evidence for the side effects and risk factors of Korean medical treatments was scantly reflected in CPGs. Therefore, it is considered that balanced CPG with benefits and risks should be developed, covering Korean medical diagnosis, treatment and prognosis.

• 한방안이비인후피부과학회지
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• 제29권4호
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• pp.95-113
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• 2016

Objectives : The purpose of this review is to introduce the recent advance in allergic rhinitis and to provide help in establishing strategy and selection of drugs for Korean medical treatment of allergic rhinitis. Methods : We searched articles about allergic rhinitis comprehensively in PubMed, CNKI, JStage, KISTI. And in order to reflect clinical situation, we also reviewed some profession's writing for practitioners. Results : This review discussed allergic rhinitis's epidemiology, pathophysiology, diagnosis, treatment, prognosis. We found many standardized clinical practice guideline have been published in this field. And some guideline reflected accumulation of medical evidence on interventions in Korean medicine. It suggested that acupuncture, herbal medicine, herbal patch are useful to prevention and alleviate allergic symptoms. But some interventions have heterogeneity due to each nation's medical background. Conclusions : Acupuncture therapy is now recommended world widely for treating allergic rhinitis. But other interventions of Korean medicine are not well recognized in the same manner. We need more research to identify mechanism and rigorous clinical trials to clarify efficacy and safety of Korean medicine intervention.

• 대한한방소아과학회지
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• 제35권4호
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• pp.1-15
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• 2021

Objectives The purpose of this study is to provide data for development of the korean medicine (KM) clinical practice guidelines (CPG) for growth disorder (GD) by identifying the awareness and knowledge needs of KM doctors (KMD) through online survey. Methods Survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed 18 questions regarding the current status of clinical care for GD, clinician's knowledge level about GD, and other details that clinicians use during practice. The survey was conducted from January 2021 to March 2021. An online survey was conducted on 101 KMDs from the association of pediatrics of KM. Results According to the survey, 96 respondents (40.3%) said the causation of GD without growth hormone deficiency needs to be included in CPG. 96 (23.5%) of the respondents wishes to utilize percentile in diagnosis and evaluation of the growth assessment. 24.7% of the clinicians were using the herbal medicine treatment. Currently, when treating with KM for GD, herbal medicine (100%) is the most widely used, followed by acupuncture (77.6%), and moxibustion (36.7%). In terms of a complex treatment, growth therapy efficacy (26.8%) is shown to be the most important factor to consider and needed to be included in CPG for the complex treatment, and diet (22.3%) is also considered to be important in GD. Conclusions In this study, we were able to understand the clinical KMDs' perception of GD, knowledge level, and the requirements in the CPG. The results of this study will provide the basic data for development of CPG for GD.

• Korean Journal of Radiology
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• 제22권2호
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• pp.263-280
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• 2021

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.

• 대한한방부인과학회지
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• 제35권2호
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• pp.16-27
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• 2022

Objectives: The purpose of this study is to analyze educational effect of ultrasound examination training with ultrasonic phantom in the department of Korean Medicine Obstetrics and Gynecology. Methods: All 4^th grade students in 2021 and 2022 of school of Korean Medicine, Dong-Shin University must be trained in the department of Korean Medicine Obstetrics and Gynecology according to ultrasound examination training guideline including Objective Structured Clinical Examination (OSCE). After completing ultrasound examination training, we distributed questionnaires to them about a confidence before OSCE and after OSCE, difficulty in using ultrasound, ultrasound reading, difficulty with probe manipulation and computer operation, ultrasound understanding, clinical usefulness. And then, we analyzed the related factors including descriptive statistics, frequency analysis, student's t-test and paired t-test by SPSS 12.0. Results: Confidence in using ultrasound showed differences among students by gender and year, but it was not statistically significant. The difficulty of ultrasound use and ultrasound reading was at a moderate level, and the gender difference was not significant, and the difference between the practical students by year was statistically significant. The difficulty of the operation of the ultrasonic probe was at a normal level, and the difference between the students in practice by gender and year was not statistically significant. Although they answered that they had a very good understanding of the use of ultrasound, there was a gender difference and it was statistically significant, and practical students by year was not statistically significant. They answered that the effect on clinical use was very sufficient, but it was not statistically significant. The appropriateness of the practice time was evaluated at a moderate level. Conclusions: The use and educational effect of ultrasound examination using ultrasonic phantom in the department of Korean Medicine Obstetrics and Gynecology clinical practice education was very effective.

• 한방비만학회지
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• 제12권1호
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• pp.48-58
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• 2012

Objectives These prescribing recommendations have been written to guide clinicians on the appropriate use of Bangpungtongseong-san(BT) and Bangkihwangki-tang(BH) in the treatment of obesity. These recommendation are aimed at providing evidence based information concerning diagnosis and management of obesity. Methods We collected all relevant references about treatment effect of BT and BH on obesity in the forms of meta-analysis, systematic review, randomized controlled trial, case-control study, observational study and practice guideline from international and domestic databases and paper journals. We examined treatment effect, side effects, recommendations for dose, indication and contraindication of BT and BH. Results The treatment effect of BT and BH on obesity has been proved through clinical trial. BT is indicated for obese patients (Body mass index, $BMI{\geq}25$) with strong abdomen and a tendency to constipation, BH is indicated for obese patients ($BMI{\geq}25$) with a fair skinned, soft muscled, edematous and sweat easily. Conclusion We wish the information contained in theses recommendations will help clinicians reach a reasonable and beneficial decision with evidence-based results. Further studies are strongly needed to develop better treatment strategies for herbal medicines on obesity.