• 동의신경정신과학회지
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• 제33권2호
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• pp.181-214
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• 2022

Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

• Journal of Acupuncture Research
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• 제26권3호
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• pp.115-131
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• 2009

Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

• 한국의료질향상학회지
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• 제5권1호
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• pp.152-165
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• 1998

Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

• Journal of Digestive Cancer Research
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• 제4권1호
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• pp.10-16
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• 2016

There were no Korean evidence-based multidisciplinary guidelines for gastric cancer. Experts from related societies developed guidelines de novo to meet Korean circumstances and requirements, including 23 recommendation statements for diagnosis (n=9) and treatment (n=14) based on relevant key questions. The quality of the evidence was rated according to the GRADE evidence evaluation framework and the recommendation grades were classified as either strong or weak. The topics of the guidelines cover diagnostic modalities (endoscopy, endoscopic ultrasound, and radiologic diagnosis), treatment modalities (surgery, therapeutic endoscopy, chemotherapy, and radiotherapy), and pathologic evaluation. Major limitation of the present guideline is that there is no enough evidences in Korea. Therefore, clinical studies about gastric cancer for evidence generation should be conducted.

• Journal of Korean Neurosurgical Society
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• 제56권3호
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• pp.175-187
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• 2014

The purpose of this clinical practice guideline (CPG) is to provide current and comprehensive recommendations for the medical and surgical management of primary intracerebral hemorrhage (ICH). Since the release of the first Korean CPGs for stroke, evidence has been accumulated in the management of ICH, such as intracranial pressure control and minimally invasive surgery, and it needs to be reflected in the updated version. The Quality Control Committee at the Korean Society of cerebrovascular Surgeons and the Writing Group at the Clinical Research Center for Stroke (CRCS) systematically reviewed relevant literature and major published guidelines between June 2007 and June 2013. Based on the published evidence, recommendations were synthesized, and the level of evidence and the grade of the recommendation were determined using the methods adapted from CRCS. A draft guideline was scrutinized by expert peer reviewers and also discussed at an expert consensus meeting until final agreement was achieved. CPGs based on scientific evidence are presented for the medical and surgical management of patients presenting with primary ICH. This CPG describes the current pertinent recommendations and suggests Korean recommendations for the medical and surgical management of a patient with primary ICH.

• Korean Circulation Journal
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• 제53권5호
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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.

• Korean Journal of Acupuncture
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• 제39권4호
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• pp.184-190
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• 2022

Objectives : In our previous study, we developed the prototype of a lesson plan for meridian and acupuncture clinical skills education by applying the rapid prototyping to instructional systems design. The present study aimed to develop a teaching-learning manual, including the lesson plans, practice notes, and instructions for devices. We also aimed to present a guideline on how to use the manual in class. Methods : The manual and materials for teachers and learners were developed based on the solutions and the prototype derived from our previous study. Practical classes on meridian and acupuncture points consist of four major subjects, and the lesson plan and practice note were designed according to each topic. Results : Flipped learning, George's five-step method, peer role-play, and peer-led objective structured clinical examination (OSCE) were applied as main methodologies in the meridian and acupuncture points practical class. The teaching-learning manual, including practice notes, detailed lesson plan, OSCE checklist, and instruction manual for devices, was developed to be utilized at each stage of the learning activity. Conclusions : The application of the teaching-learning manual is expected to provide effective clinical skills education, strengthen learners' communication skills, establish professional identity, assess learners' performance, and provide immediate feedback. The educational effect of the manual for the existing class should be identified, and its feasibility should be verified by implementing it on another group. This manual could be helpful in designing classes for other subjects of Korean medicine, especially for clinical skills education.

• 대한한방부인과학회지
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• 제30권3호
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• pp.92-116
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• 2017

Objectives: The purpose of this study were to researched a Korean medicine doctors' recognition about coldness of hands and feet, and developing of korean medicine clinical practice guidelines (CPG) for coldness of hands and feet. Methods: We conducted a questionnaire survey targeting 399 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 1. 86.86% of the respondents agreed about the necessity of CPG for coldness of hands and feet. 2. 84.2% of respondents wanted coding of Korean Standard Classification of Diseases (KCD) on coldness of hands and feet. 3. To diagnosis a coldness of hands and feet, the respondents used a Subjective symptoms (98.5%), Infrared thermographic imaging device (DITI) (26.32%) Heart rate variablity test (HRV) (17.04%), Thermometer (9.77%), Cold stress test (2.76%) 4. Causing of coldness of hands and feet, the respondents considered a constitution or heredity (84.71%), stress (73.66%), lack of exercise (64.91%), irregular eating habits (51.63%), Cold meals (32.83%), depression (31.33%), etc. 5. Treating coldness of hands and feet, the respondents used a herbal medicine (66.85%), acupuncture (70.7%) Pharmacopuncture (23.85%) and moxibustion (60.08%) for $10.91{\pm}8.03week$. Conclusions: We researched a Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment on a coldness of hands and feet, and policy they required.

• 임상간호연구
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• 제22권3호
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• pp.285-293
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• 2016

Purpose: The purpose of this study was aimed to develop evidence-based nursing practice guideline for preventing intermittent urinary catheterization (IUC) related complications using guideline remake process. Methods: Guideline remake process was conducted according to guideline adaptation manual developed by Gu et al (2012) which consisted of three main phases and 9 modules including a total of 24 steps. Results: Newly developed IUC guideline consists of introduction, overview of intermittent catheterization, summary of recommendations, recommendations, references, and appendices. There were 50 recommendations in 5 sections including assessment, equipments, catheterization, complications management, and education/consult. Three recommendations (6%) were graded A, and five (10%) and 41 recommendations(82%) were B and C, respectively. Conclusion: The IUC remade-guideline was developed based on evidence-based nursing and therefore, this guideline is recommended to be disseminated and utilized by nurses nationwide to improve the quality of care for IUC and to decrease the IUC related complications.

• Journal of Acupuncture Research
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• 제39권4호
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• pp.249-257
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• 2022

This study aimed to evaluate clinical practice guidelines (CPGs) for ankle sprains using the Appraisal of Guidelines for Research and Evaluation II tool, using electronic databases (GIN, PubMed, EMBASE, NCKM, CNKI, CiNii, WanFang database, RISS, and SCOPUS), to suggest strategies for improvement in the future. The search was performed on April 23, 2021 and 10 CPGs were selected for evaluation. Three CPGs were recommended without modification (Class A scores), five were recommended with modification (Class B), and two were not recommended (Class C scores). The CPG domain that received the lowest score was "applicability." The traditional medicine CPGs scored higher [Class A (n = 1) and Class B (n = 1)] than the conventional Western medicine CPGs [Class A (n = 2), Class B (n = 4), and Class C (n = 2)] and were considered to be more methodical. In the future, more research into traditional medicine is required.