• Journal of Chest Surgery
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• 제49권6호
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• pp.413-420
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• 2016

Doctors are often faced with difficult decisions and uncertainty when patients need a certain treatment. They routinely rely on the scientific literature, in addition to their knowledge, experience, and patient preferences. Clinical practice guidelines are created with the intention of facilitating decision-making. They may offer concise instructions for the diagnosis, management (medical or surgical treatments), and prevention of specific diseases or conditions. All information included in the final version are the result of a systematic review of scientific articles and an assessment of the benefits and costs of alternative care options. The final document attempts to meet the needs of most patients in most circumstances and clinicians, aware of these recommendations, should always make individualized treatment decisions. In this review, we attempted to define the intent and applicability of clinical practice guidelines, expert consensus documents, and registry studies, focusing on the management of patients with thoracic aortic disease.

• 대한한방소아과학회지
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• 제34권2호
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• pp.75-85
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• 2020

Objectives Although clinical practice guidelines (CPGs) are becoming crucial in medical decision-making worldwide, there are very few development guidelines for children. Therefore, this preliminary study aimed to assess the status of worldwide except east asia-CPGs recommending complementary and alternative medicine interventions (CAM-i) in children worldwide except east asia in order to help developing Korean medicine CPGs (KMCPGs) for children. Methods To identify the current status of CPGs including CAM-i that have been developed so far, the author searched the related databases, and selected CPGs for children. The data related to the status of evidence-based CPGs, the materials related to the characteristics of CAM-i, and the details of recommendations for CAM-i were selected from the obtained findings. Results A total of 106 CPGs were identified based on the searches, of which 11 were finally selected as pediatric CPGs. These pediatric CPGs have been developed since 2007 to target various diseases. The countries developing these CPGs include the United Kingdom, Scotland, Australia, and the United States, with the U.K. having the largest share. The majority of CPGs used MEDLINE, Embase, and Cochrane library as databases. The most frequently recommended topic was acupuncture, followed by herbal medicine. Many CPGs suggested that more research was needed. Conclusions Through this study, the author was able to identify the characteristics of the developed pediatric CPGs that include CAM-i. More preceding studies are needed for the development of pediatric KMCPGs. It is hoped that this report can be used as the foundation for future development of pediatric KMCPGs.

• Journal of Hospice and Palliative Care
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• 제13권2호
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• pp.69-75
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• 2010

Hospice is defined by the National Hospice and Palliative Care Organization (NHPCO, USA) and WHO, as a program of care that provides comprehensive medical, nursing and support services to dying patients and their family. Despite its broad definition, however, hospice care in Korea has been focused mostly on terminal cancer patients. Thus hospice eligibility for patients with advanced cancer is relatively easier to predict than those with other fatal chronic illnesses such as heart, lung, renal or liver diseases, and dementia. This makes it more difficult for patients and families to prepare for death and gain full benefits of hospice care. This article introduces the medical guidelines for selected non-cancer patients who are expected to live for only six months, this making it possible for patients, who are nearing the end of life, to avoid unwarranted suffering.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제34권2호
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• pp.141-149
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• 2023

Objectives: Most developmental screening tests have been built as parent-performed questionnaires. However, they often do not guide parents on how to answer the questionnaire. This study aimed to develop easily applicable parent guidelines. Methods: We implemented the Delphi procedure with 20 panelists. The development of the initial questionnaire was based on the results of two surveys of parents and experts provided by a policy research report that investigated the item adequacy of the Korean Developmental Screening Test. Round one included 33 items comprising all possible measurements in six categories that were identified as difficult to understand or confusing. Round two merged and modified some items and included 32 items. We defined consensus as a median agreement value of one or less and convergence and stability values of 0.5 or less. The subjective usefulness of the parent guidelines was examined based on their previous test experiences. Results: Consensus was reached after the second round, reflecting the items with the highest level of accuracy in each category. Of the 167 parents who participated in the survey, 113 (67.7%) affirmed the usefulness of the guidelines, while 10 (6.0%) answered that they were not useful. Items that recommended a different scoring strategy in answering the questionnaire from their previous measurements were found to be more useful by the parents. Conclusion: The parent guidelines, composed of five bullet points, drew on the consensus of the experts. Further studies are required to assess whether these guidelines improve the accuracy of screening tests in clinical settings.

• Journal of Information Science Theory and Practice
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• 제6권2호
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• pp.24-35
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• 2018

Developing countries may pay attention to bibliometric indicators in accordance with their scientific development plans. Bibliometrics research topics and bibliometric indicators have grown dramatically in Iran since 2000 as a part of the post-war reconstruction programs. This paper aims to highlight how scientometrics may attract attention in developing countries such as Iran in response to national movements in education and science. An in-depth review on available guidelines for promotion of innovation, science, and technology in Iran was done followed by a review on previous research in this topic. Further data were gathered from Scopus and other sources. The findings show a considerable growth in research output of Iran in recent years and expansion of bibliometrics studies and jobs accordingly. Combined with research output measures, more attention was found in academia about cross-section development of science and technology in Iran. The demand in society has led to the foundation of scientometrics programs in Iranian universities as well as scientometrics departments in central libraries and research deputies in major academic institutions. The changing image of science and research in Iran has a relation with the growth of scientometrics academic and professional departments. The lessons taught from this mutual collaboration can be used in other developing nations.

• 국제초고층학회논문집
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• 제7권4호
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• pp.313-325
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• 2018

Concrete-filled steel tubular (CFST) members are commonly used as composite columns in modern construction. However, the current guidelines for members' fire design (EN1994-1-2) have been proved to be unsafe in case the relative slenderness is higher than 0.5. In addition, the simplified design methods of Eurocode 4 are limited to circular and square CFST columns, while in practice columns with rectangular and elliptical hollow sections are being increasingly used because of their architectural aesthetics. In the last years a large experimental research has been carried out at Coimbra University on the topic. They have been tested concrete filled circular, square, rectangular and elliptical hollow columns with restrained thermal elongation. Some parameters such as the slenderness, the type of cross-section geometry as well as the axial and rotational restraint of the surrounding structure to the column have been tested in order to evaluate their influence on the fire resistance of such columns. In this paper it is evaluated the influence of the boundary conditions (pin-ended and semi-rigid end-support conditions) on the behavior of the columns in case of fire. In these tests it could not be seen a marked effect of the tested boundary conditions but it is believed that the increasing of rotational stiffness increases the fire resistance of the columns.

• 한국의학물리학회지:의학물리
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• 제31권3호
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• pp.124-134
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• 2020

Here we review the evolutionary history of radiation therapy technology through the festschrift of articles in celebration of the 30th anniversary of Korean Society of Medical Physics (KSMP). Radiation therapy technology used in clinical practice has evolved over a long period of time. Various areas of science, such as medical physics, mechanical engineering, and computer engineering, have contributed to the continual development of new devices and techniques. The scope of this review was restricted to two areas; i.e., output energy production and functional development, because it is not possible to include all development processes of this technology due to space limitations. The former includes the technological transition process from the initial technique applied to the first model to the latest technique currently used in a variety of machines. The latter has had a direct effect on treatment outcomes and safety, which changed the paradigm of radiation therapy, leading to new guidelines on dose prescriptions, innovation of dose verification tools, new measurement methods and calculation systems for radiation doses, changes in the criteria for errors, and medical law changes in all countries. Various complex developments are covered in this review. To the best of our knowledge, there have been few reviews on this topic and we consider it very meaningful to provide a review in the festschrift in celebration of the 30th anniversary of the KSMP.

• The Korean Journal of Pain
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• 제31권4호
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• pp.253-260
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• 2018

Background: One of the most frequent problems caused by diabetes is the so called painful diabetic neuropathy. This condition can be treated through numerous types of therapy. The purpose of this study was to analyze, as a meta-analysis, different treatments used to alleviate painful diabetic neuropathy, with the aim of generating results that help making decisions when applying such treatments to tackle this pathology. Methods: A search was conducted in the main databases for Health Sciences, such as PUBMED, Web of Science (WOS), and IME biomedicina (Spanish Medical Reports in Biomedicine), to gather randomized controlled trials about treatments used for painful diabetic neuropathy. The analyzed studies were required to meet the inclusion criteria selected, especially those results related to pain intensity. Results: Nine randomized controlled trials were chosen. The meta-analysis shows significant positive effects for those treatments based on tapentadol [g: -1.333, 95% CI (-1.594; -1.072), P < 0.05], duloxetine [g: -1.622, 95 % CI (-1.650; -1.594), P < 0.05], pregabalin [g: -0.607, 95% CI (-0.980; -0.325), P < 0.05], and clonidine [g: -0.242, 95 % CI (-0.543; -0.058), P < 0.05]. Conclusions: This meta-analysis indicates the effectiveness of the treatments based on duloxetine, gabapentin and pregabalin, as well as other drugs, such as tapentadol and topic clonidine, whose use is better prescribed in more specific situations. The results provided can help increase the knowledge about the treatment of painful diabetic neuropathy and also in the making of clinical practice guidelines for healthcare professionals.

• 대한한의학원전학회지
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• 제23권4호
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• pp.63-102
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• 2010

Purpose : To propose various types of clinical research which is feasible for botanical new drug (IND) development processes, and suggest essential steps to development of study protocol for IND. Methods : Literature-based discussions and one research group's experience is given regarding domestic act, regulation, and system. Results : In order to get an approval of IND for botanical drug in Korea there are several types of clinical research to conduct. In quality control steps for standardized medicinal herbs, case reports or case series can be conducted, and for good manufacturing practice(GMP) steps, we can conduct case reports, case series, and retrospective cohort studies. In addition, as long as we gathered good laboratory practice(GLP) data we can conduct up to quasi-experimental studies and clinical trials including investigator initiated trials. In order to conduct these studies development of study protocol is essential. First, we obtain historical evidence including target disease and indication, efficacy, safety, and endpoints by reviewing medical classics. Second, we obtain clinically and statistically important data by conducting non-clinical studies, observation studies, and quasi-experimental studies. Third, we generate research hypotheses and purposes and explore methodologies, endpoints, clinical practice guidelines, cost-effectiveness, and commercial potential. Finally, we develop study protocol with aid of biostatistician or expert in contract research organization. Discussions and conclusions : This study have obvious limitations in that most thoughts, suggestions, and proposes are from one research group's experience. Therefore, we hope to see various types of research in this topic and process from other research group as well.

• 의학교육논단
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• 제17권2호
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• pp.78-87
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• 2015

Mongolia is suffering from the inadequate capacity of medical doctors due to a poor education and training system. The purpose of this article is to evaluate the effect of a clinical training program for capacity building of medical doctors in Mongolia, and to suggest an effective model for continuing professional development in developing countries. Based on the results of a needs assessment, Korean and Mongolian medical experts developed a clinical training program and trained the trainers on 32 topics regarding major clinical problems in 6 specialties, including cardiology, endocrinology, pediatrics, obstetrics and gynecology, neurology, and emergency medicine. Surveillance survey and pre/post-test were used on every topic to evaluate the satisfaction and achievement, respectively, of the trainees. Six months after the clinical training program, we interviewed a sample of medical professionals to evaluate the change and impact. A total of 612 (person-year) medical doctors participated in the training, and the average score for satisfaction was 7.69 out of 8. The average score of the pre-test was 46.9 out of 100, while the post-test was 82.4. After the training, the medical doctors were applying their new knowledge and skills to their practice, and using the materials as guidelines, which improved their practice and increased patient satisfaction. They also started their own training program and adopted new equipment at their hospitals. The satisfaction and achievement of the trainees were very high, and there was significant change in the medical practice, education system, and infrastructure after the training program. This training program can be an effective model for capacity building of medical doctors in developing countries.