• Title/Summary/Keyword: clinical guideline

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Development of a Guideline for the Application of a Diagnostic Tool for Menopausal Syndromes Based on the Use of Systemic Review and Delphi Method (체계적 문헌고찰과 델파이 기법을 활용한 갱년기장애 변증(辨證)진단 도구 개발을 위한 기초 연구)

  • Lee, In-Seon;Kim, Dong-Il;Yoo, Jeong-Eun;Kang, Chang-Wan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.4
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    • pp.175-202
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    • 2017
  • Objectives: This study was conducted towards developing a screening tool for syndrome differentiation in the diagnosis of menopause in menopausal and perimenopausal women. Methods: We conducted a literature review of studies on menopausal diagnosis based on syndrome differentiation, and examined well-founded differentiated syndromes and their respective clinical symptoms. Based on the findings, we created a questionnaire through consultations with Oriental medicine experts in physiology, pathology, and diagnostics. Finally, the research team conducted an expert Delphi study on differentiated syndromes and the associated clinical symptoms. Results: Seven differentiated syndromes were selected, including Liver Depression (肝鬱), Kidney Yin Deficiency (腎陰虛), Kidney Yang Deficiency (腎陽虛), Liver and Kidney Yin Deficiency (肝腎陰虛), Kidney Yin and Yang Deficiency (腎陰陽兩虛), Heart-Kidney Noninteraction (心腎不交), and Dual Deficiency of Heart and Spleen (心脾兩虛); 4 disease locations, including liver (肝), heart (心), spleen (脾), and kidney (腎); and 3 disease natures, including Yin Deficiency (陰虛), Qi Stagnation (氣滯), and Blood Deficiency (血虛). In addition, we added 3 supplemental disease natures, including Yang Deficiency (陽虛), Qi Deficiency (氣虛), and Heat (火熱), in consideration of syndrome differentiation categories that may possibly be added in a follow-up clinical questionnaire. Conclusions: This resulted in a total of 7 differentiated syndromes, 4 disease locations, and 6 disease natures. We translated the clinical symptoms of these 17 categories into Korean Hangeul. After consulting with 5 Oriental medicine experts and a psychology expert, we produced a questionnaire for use in diagnosing menopause based on syndrome differentiation. The calculation of scores for the syndrome differentiation screening tool will be confirmed through clinical research based on the results of a review of existing literature.

A Survey on Korean Medicine Doctor' Opinion and Treatment for Developing Korean Medicine Clinical Practice Guideline for Premenstrual Syndrome (월경전증후군 한의표준임상진료지침 개발을 위한 한의사의 의견과 치료에 대한 실태조사)

  • Kim, Nu-Ree;Kim, Jeong-Hun;Jung, Seo-Yoon;Kim, Pyung-Wha;Lee, Eun-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.35 no.4
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    • pp.77-90
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    • 2022
  • Objectives: This study was aimed to figure out korean medicine doctors' opinion and treatment of Korean medicine clinical practice guidelines (CPG) for premenstrual syndrome (PMS). Methods: We conducted a questionnaire survey targeting korean medicine doctors belonging to the Korean Association of Oriental Medicine by e-mail and text and analyzed the answers. Results: 1. The average monthly number of patients visiting the respondents' clinics for PMS was 2.7, the main age group was 20-30s (80.8%) and the treatments the patients given before were mostly western treatments such as painkiller and combined oral contraceptives. 2. The treatment period for PMS was mostly less than 3 months (69%), and the frequency of acupuncture treatment was the most twice per week (41.1%). 3. The most effective herbal medicine for affective symptoms was Soyo-san, and for physical symptoms was Gyejibokryung-hwan. The most commonly used acupuncture point was 三陰交 (SP6). 4. Other opinions of the clinicians about Korean medicine clinical practice guideline of PMS were the need for promotion of PMS, convenience of taking herbal medicines and price competitiveness. Conclusions: We figured out korean medicine doctors' opinion of PMS CPG, clinical diagnosis and treatment.

Novel CAD/CAM hybrid blocks: PICN and RNC (새로운 CAD/CAM 블록의사용 : PICN and RNC)

  • Ko, Kyung-Ho
    • The Journal of the Korean dental association
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    • v.56 no.3
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    • pp.167-174
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    • 2018
  • The development of dental materials has widened the scope of materials by changes in processing methods. CAD/CAM processing enables the use of zirconia as a dental material. Recent esthetic materials development has been made. For aesthetic purposes, a block for CAD/CAM processing by mixing polymer and ceramic materials are fabricated. However there is no guideline of how these materials should be used in actual clinical practice. Mechanical properties, wear and clinical studies were reviewed.

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Appraisal of Clinical Practice Guidelines of Temporomandibular Disorders Using AGREE II (Appraisal of Guidelines for Research & Evaluation II) (AGREE II를 이용한 턱관절 장애의 국내외 기개발 임상진료지침의 평가)

  • Yoon, Ye-Ji;Park, Hye-Sung;Kim, Hyungsuk;Jeon, Junyung;Park, Jae-Hyun;Shin, Woochul;Kim, Seyoon;Bae, Jun-hyeong;Yun, Jung-min;Kim, Koh-Woon;Ha, In-Hyuk;Lee, Yoon-Jae;Kim, Me-riong;Song, Mi-Yeon;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.4
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    • pp.67-74
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    • 2017
  • Objectives This study is aimed to identify and evaluate the already developed clinical practice guidelines (CPGs) of temporomandibular disorders (TMD) and contribute to making decisions in developing Korean medicine CPG of TMD. Methods We searched electronic database and selected CPGs of TMD according to the inclusion and exclusion criteria. Then, we made appraisal of selected CPGs by using AGREE II (Appraisal of Guidelines for Research & Evaluation II). Results Four CPGs are included and appraised with AGREE II. Among 6 domains of AGREE II, all CPGs failed to score over 60% in four domains. Only one CPG mentioned acupuncture as an adjunctive treatment for myofascial TMD. Conclusions It is difficult to indicate that included CPGs are with sufficient quality to recommend and it appears not to be appropriate to apply these already developed CPGs in Korean medicine clinical fields. Therefore, developing a new Korean medicine clinical practice guideline of TMD is required.

Liposome-Mediated Cancer Gene Therapy: Clinical Trials and their Lessons to Stem Cell Therapy

  • Lee, Jung-Hoon;Lee, Min-Jae
    • Bulletin of the Korean Chemical Society
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    • v.33 no.2
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    • pp.433-442
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    • 2012
  • The promise of stem cell therapy for various clinical applications seems getting realistic. An increasing number of researchers, from virtually every discipline of natural sciences, are flocking into this new world. Only ten years ago, gene therapy was the medicine for the 21st century. The possibility was endless. Although the science itself underlying gene therapy was very young, the field was exploding under the optimism that this new medicine would revolutionize both the basic and clinical sciences. For many reasons, the initial target was cancer. Here, we will focus on the results of cancer gene therapy clinical trials using liposome or nonviral gene carrier, hoping that the lesson from here will be a guideline for the new generation of cell-based therapies.

A Study on Participation in Clinical Decision Making by Home Healthcare Nurses (가정전문간호사의 임상적 의사결정 참여도에 관한 연구)

  • Kim, Se-Young
    • Journal of Korean Academy of Nursing
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    • v.40 no.6
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    • pp.892-902
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    • 2010
  • Purpose: This study was done to identify participation by home healthcare nurses in clinical decision making and factors influencing clinical decision making. Methods: A descriptive survey was used to collect data from 68 home healthcare nurses in 22 hospital-based home healthcare services in Korea. To investigate participation, the researcher developed 3 scenarios through interviews with 5 home healthcare nurses. A self-report questionnaire composed of tools for characteristics, factors of clinical decision making, and participation was used. Results: Participation was relatively high, but significantly lower in the design phase (F=3.51, p=.032). Competency in clinical decision making (r=.45, p<.001), perception of the decision maker role (r=.47, p<.001), and perception of the utility of clinical practice guidelines (r=.25, p=.043) were significantly correlated with participation. Competency in clinical decision making (Odds ratio [OR]=41.79, p=.007) and perception of the decision maker role (OR=15.09, p=.007) were significant factors predicting participation in clinical decision making by home healthcare nurses. Conclusion: In order to encourage participation in clinical decision making, education programs should be provided to home healthcare nurses. Official clinical practice guidelines should be used to support home healthcare nurses’ participation in clinical decision making in cases where they can identify and solve the patient health problems.

The Characteristics of Hwa-byung Patients Based on Hwa-byung Epidemiologic Data (화병역학연구 자료를 기반으로 한 화병 환자의 특성)

  • Kim, Jong-Woo;Chung, Sun-Yong;Suh, Hyun-Uk;Jung, In-Chul;Lee, Seung-Gi;Kim, Bo-Kyoung;Kim, Geun-Woo;Lee, Jae-Hyuk;Kim, Lak-Hyung;Kim, Tae-Heon;Kang, Hyung-Won;Kim, Se-Hyun
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.2
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    • pp.157-169
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    • 2010
  • Objectives : The aim of this study was to investigate the characteristics of Hwa-Byung(HB) patients, draw the clinical key issue of HB, and provide the data as the basis for development of Clinical Guideline of HB. Methods : The study participants included 151 subjects who thought they have HB in 9 site. For all patients, we used HB epidemiologic study protocol, which include the Korean version of the Structured Clinical Interview for the DSM-IV Diagnosis (SCID-1), diagnostic criteria of HB, symptoms check list, pattern identification tool, psychiastric psychological questionaires, and Framingham coronary risk score(FRS). Results : 1. For all participants, 62 % of subjects were diagnosed with HB. These patients had comorbid DSM-IV diagnoses with depression (65%) and anxiety (27%). But 22% of these patients had only HB. 2. HB patients had various physical symptoms when visiting, were diagnosed as various disease, and undergone medical treatments in the past. Among the diagonsed illness, Gastronitestinal diseases (51.6%), psychiatric disorders(40.9%), endocrine diseases(39.8%) were being the most frequent. The frequent physical symptoms of HB patients reported were chest discomfort, head ache, pallpitation, frequent sigh, amnesia, shoulder pain, dry mouth, eye fatigue etc. 3. HB patients had high scores in psychologic questionares, CES-D, STAI, and STAXI. It means that HB patients might be low-level emotional stability. 4. Participant had negative opinion about the treatment of HB that it would be difficult or impossible (65.7%), but they neglect the need of medical treatment. Conclusions : This result shows that HB is comorbid with various psychiatric disease, but it has different physio-psychological symptoms from others and there were only HB patients. so we identify HB is independent disease. Moreover, there were the wrong perception of HB which blocking treatments. These problems support that the neccesity of development of Clinical Guideline of HB.

A Survey on Patient's Experience on Health Care Utilization and Perception of Health Care System for Developing of a Korean Medicine Clinical Practice Guideline for Traffic Injuries (교통사고상해증후군 한의표준임상진료지침 개발을 위한 환자의 의료이용 경험과 의료체계 인식도 설문조사 연구)

  • Park, Sun-Young;Lee, Sang-Hyun;Heo, In;Hwang, Man-Suk;Kim, Koh-Woon;Cho, Jae-Heung;Park, Kyoung Sun;Ha, In Hyuk;Shin, Byung-Cheul
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.2
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    • pp.139-152
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    • 2020
  • Objectives To explore the traffic injury patients' experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients' requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries.

Study on the Clinical Trial Practice of Drugs at the Designated Hospitals (국내 임상시험 실시기관의 의약품 임상시험 관리현황 분석)

  • Lee Eui-Kyoung;Jang Sun-Mee;Huh Soon-Im
    • Korean Journal of Clinical Pharmacy
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    • v.5 no.2
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    • pp.33-49
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    • 1995
  • The purpose of this study is to understand present situation of clinical trials, and evaluate the preparedness of the desiRnated institutions to abide by GCP(Good Clinical Practice) standards during clinical trials. Survey on the status of clinical trials was conducted for the desienated 83 clinical trial hospitals, and response rate was $95.2\%$. The results showed that 39 hospitals have conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Most of them were trials on Phase III. Only $46.8\%$ of the institutions had sufficient human resources to perform the clinical trials. Institutions which established IRB(Institutional Review Board) accounted for 41 or $51.9\%$, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12, and 21 Places, respectively. Regarding supervision of the investigational drugs, less than 30 institutions designated pharmacist as a supervisor. In conducting clinical trials, $97.4\%$ of trials had high rates of prior consent of testees, but only part of them-$61.7\%$-gave written consent. The level of conducting GCP is found to be unsatisfactory. Institutions must build the appropriate infrastructure and government must prepare in order to protect testees' rights as well as to ensure validity of the results.

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Caries Management by Risk Assessment CAMBRA (위험도에 따른 우식 조절)

  • Lee, Justin Jae-Cheoun
    • The Journal of the Korean dental association
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    • v.49 no.1
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    • pp.16-21
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    • 2011
  • Now it is time to move from the scientific basis of CAMBRA into practical methods for dentists to the incorporate concepts into practice. The aim of this article is to provide a clinical guideline for assessment of caries risk and for application for growing children.