• 제목/요약/키워드: clinical guideline

검색결과 828건 처리시간 0.026초

성장기 부정교합환자의 근신경계 부조화를 해소한 증례: 교정치료 과정과 결과를 모니터링하기 위한 근전도검사(EMG)의 임상적 응용 (Clinical Application of Electromyography for Monitoring Procedure and Result of Orthodontic Treatment ; A of Three Cases)

  • 차봉근;이남기;최동순;김상호
    • 구강회복응용과학지
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    • 제22권1호
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    • pp.89-100
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    • 2006
  • Traditionally, goals of orthodontic treatment fall into four categories: good tooth alignment, improvement of skeletal profile and good soft tissue, and rehabilitation of the normal function. Electromyography (EMG) has proven as useful tool in evaluating masticatory function among the maxillomandibular relationship and could be useful in accompanying orthodontic treatment objectives. But in pursuit of clinical application, it is necceassry to systemize clinical guideline for diagnosis by EMG records in evaluating the effects of orthodontic, orthopedic, or surgical treatment. This study present 3 orthodontic cases, which treatment results, ie neuromuscular balances of masticatory muscle, could be moitered by EMG procedure.

요양병원 입원 노인을 위한 신체 억제대 프로토콜의 수용개작 (Evidence-based Clinical Practice Protocol of Physical Restraints by Adaptation Process for Patients in a Geriatric Hospital)

  • 박미화;송경애
    • 재활간호학회지
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    • 제19권2호
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    • pp.118-127
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    • 2016
  • Purpose: This study was to develop an evidence-based clinical practice protocol of physical restraints by adaptation process for patients with a geriatric hospital. Methods: Protocol adaptation process was conducted in accordance with manual for guideline adaptation version 1.0 by ADAPTE collaboration. Results: The adapted physical restraint protocol was consisted of 3 domains and 37 recommendations. The number of recommendations in each domain were: 7 nursing assessment, 19 nursing intervention, and 11 nursing evaluation. More than half (56.8%) of the recommendations were rated as grade B, 37.8% as grade C, and 5.4% were rated as grade D. Conclusion: The adapted physical restraint protocol is expected to contribute as an evidence-based clinical practice protocol for healthcare workers in geriatric hospitals for reducing and improving efficiency of appropriate physical restraints use.

방사선사진 검사 선택기준에 대한 고찰 (Review of Radiographic Selection Criteria : The update is necessary)

  • 이병도
    • 대한치과의사협회지
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    • 제51권1호
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    • pp.39-45
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    • 2013
  • Radiographic examinations are used to discover and define the type and extent of disease in many clinical situations. Currently, it is common for dental patients to receive dental radiographic examinations on a routine schedule with little variation in spite of different patient signs and symptoms. Such routine scheduling of radiographic examinations may result in unnecessary patient exposure. There is also the possibility of under-utilization of radiography; this can result in inadequate or excessively delayed diagnosis. Patient selection criteria are descriptions of clinical conditions derived from patient signs, symptoms and history that identify patients who are likely to benefit from a particular radiographic examination. It makes possible making individual decisions based on history, clinical examination and risk factors. The radiographic selection criteria of dentistry have been revised in accordance with recent guidelines and peer-reviewed research in USA and Europe, but the studies of these subjects are not sufficient in our nation. In this review article, the relating factors and update necessity of radiographic selection criteria are discussed.

Clinical Year in Review 2014: Critical Care Medicine

  • Lee, Jeong Moon;Lee, Heung Bum
    • Tuberculosis and Respiratory Diseases
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    • 제77권1호
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    • pp.6-12
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    • 2014
  • Severe sepsis is the most common cause of death among critically ill patients in non-coronary intensive care units. In 2002, the guideline titled "Surviving Sepsis Campaign" was published by American and European Critical Care Medicine to decrease the mortality of severe sepsis and septic shock patients, which has been the basis of the treatment for those patients. After the first revised guidelines were published on 2008, the most current version was published in 2013 based on the updated literature of until fall 2012. Other important revised guidelines in critical care field such as 'Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit' were revised in 2013. This article will review the revised guidelines and several additional interesting published papers of until March 2014, including the part of ventilator-induced lung injury and the preventive strategies.

Consolidated Standards of Reporting Trials의 소개: 무작위 대조군 연구의 보고 지침 (Consolidated Standards of Reporting Trials: The Reporting Guideline for Randomized Controlled Trials)

  • 정회인;김희은
    • 치위생과학회지
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    • 제14권3호
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    • pp.269-275
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    • 2014
  • 세계 유수의 의학관련 연구 저널의 편집자들은 제출된 원고의 질을 관리하기 위하여 연구진행의 가이드라인 역할을 할 수 있는 보고 지침을 개발하여 평가에 적용하고 있다. 따라서 본 연구는 RCTs를 위한 보고 지침인 CONSORT의 2010년 개정판 내용과 특징을 소개함으로써 치위생 연구의 계획 및 수행에 도움을 주고 더 나아가 EBP의 활성화에 기여하고자 하였다. CONSORT는 시험 보고의 질을 향상시킬 수 있도록 논문 저자들에게 보고 지침을 제공한다. 이 보고 지침은 RCTs 보고서에 반드시 포함되어야 할 필수 항목인 25개의 체크 리스트와 연구 과정의 도식화를 위한 순서도를 제시한다. 저자들은 연구 설계 시점부터 CONSORT의 각 항목을 참고함으로써 연구의 질을 향상시킬 수 있다. 따라서 우리 치위생계에서도 이러한 보고지침을 준수함으로써 치위생 연구의 타당성을 높이고, 이러한 연구 결과를 질 높은 근거 기반적 치위생 실무로 접목시켜 발전시킬 수 있을 것으로 생각된다.

갱년기장애 진단기기 사용에 대한 지침 개발 : 문헌검토 및 설문조사 (Development of a Guideline for the Application of Diagnostic Devices for Menopausal Syndrome: Literature Review and Questionnaire Survey)

  • 백선은;박은지;김동일;이인선;유정은
    • 대한한방부인과학회지
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    • 제30권3호
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    • pp.65-78
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    • 2017
  • Objectives: This study was aimed to develop a guideline for the application of diagnostic devices for menopausal syndrome. Methods: We conducted a literature review and a questionnaire survey on diagnostic devices including Digital Infrared Thermal Imaging (DITI), pulse diagnosis device, Heart Rate Variability (HRV), body composition analyzer, Yangdorak. Results: We retrieved some clinical values for usage of devices from the articles. Especially, DITI was useful to identify the pattern of body temperature distribution. The respondents answered that they diagnosed menopausal syndrome by using body composition analyzer (62.3%), DITI (60%), HRV (60%), pulse diagnosis device (45.7%), Yangdorak (34.3%). The respondents answered that they don't use diagnostic devices when they diagnosed menopausal syndrome because of absence of device, cost, difficulty of interpretation, substitution of another diagnostic method. After experts survey, it was recommended to use DITI, HRV, body composition analyzer. There was no consensus on the use of pulse diagnosis device, Yangdorak in diagnosing menopausal syndrome. Conclusions: We developed a guideline for the application of diagnostic devices for menopausal syndrome.

화병 진료지침 개발을 위한 한약 임상시험 방법론 연구 (The Systematic Review of Clincal Trial(s) Intervening Traditional Korean Herbal Medicine: Extension of Developing Clinical Guideline for Hwa-byung)

  • 김석환;박보라;최금애;임현주;이상룡;정대규;김락형;김태헌;김경옥;정인철
    • 동의신경정신과학회지
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    • 제20권2호
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    • pp.163-176
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    • 2009
  • Objectives : To address most probable and suitable method for designing clinical trial intervening Traditional Korean Herbal Medicine on hwa-byung. Study Design : A systematic review of research studies of complementary and/or alternative medical(CAM) treatment of depression, and of domestic clinical trials of Traditional Korean Medicine, and of Chinese clinical trials of Traditional Chinese Medicine. Methods : Randomized, controlled trials(RCTs) of treatment of depression intervening herbal medicine were searched through MEDLINE, Cochrane Library, and CNKI databases. Also, domestic RCTs intervening Traditional Korean Herbal Medicine were searched through Korean Traditional Knowledge Portal and Korean studies Information Service System(KISS). Studies were evaluated using Iadad scale and self-designed tool for this study. Results : Thirty four RCT studies( 10 from MEDLINE, 16 from CNKI, 8 domestic studies) of herbal medicine met inclusion criteria. Mean Jadad score of studies published in English was 2.8${\pm}$0.79, in Chinese 1.94${\pm}$0.77, and in Korean 2.75${\pm}$0.71. Twenty one percent of studies included pattern differentiation in their inclusion criteria. Twenty nine percent of studies used combined treatment of herbal and conventional medicine. Among studies on depression, 9% included Complementary Medical assessing tools. Conclusions : There is shortage of domestic clinical trial involving herbal medicine. In China, studies tend to focus on investigating effect of Combined treatment of herbal and conventional medicine on depression. Clinical trial(s) of hwa-byung should provide good internal validity by describing methodology for randomization, double-blinding, and attrition. Also, specific guideline for clinical trial, including Traditional Korean Medical aspects across inclusion criteria, and assessing tools is needed.

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약학교과과정의 개국약국실습 방향에 관한 연구 (The Study on Identifying the Components of Community Pharmacy Externship Based on Korean Community Pharmacists' Consensus)

  • 김성현;오정미
    • 한국임상약학회지
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    • 제9권2호
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    • pp.109-118
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    • 1999
  • The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

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Evaluation of Interfering Substances in Routine Chemistry Tests Using Toshiba TBA-C8000 Chemistry Analyzer

  • Park, Jum Gi;Joo, Kyeng Woong
    • 대한임상검사과학회지
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    • 제43권1호
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    • pp.6-11
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    • 2011
  • In clinical chemistry tests, the interfering substances such as hemoglobin, lipid, bilirubin, and drugs, etc. can cause the changes of test results performed by spectrophotometrical methods. We evaluated the effects of interfering substances on the test results by adding interfering substances on the samples in the 19 kinds of clinical chemistry tests such as aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, gamma-glutamyltransferase, total protein, albumin, glucose, total cholesterol, total bilirubin, triglyceride, uric acid, calcium, inorganic phosphours, high density lipoprotein cholesterol, low density lipoprotein cholesterol, creatinine, blood urea nitrogen, and C-reactive protein using newly implemented automatic chemical analyzer Toshiba TBA-C8000 under the direction of CLSI EP07-A guideline. Hemolytic samples show increased concentration of total protein, aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase and reduced concentration of total bilirubin, alkaline phosphatase by interfering effect. Hyperlipemic samples show increased concentration of total protein and alkaline phosphatase and reduced concentration of low density lipoprotein cholesterol. The samples with conjugated bilirubinemia show increased concentration of inorganic phosphours, otherwise the samples with unconjugated bilirubinemia show no interference or allowable range in the test result.

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사상체질병증 진단도구 개발 연구 (A Study on the Development of Diagnostic Tools for Sasang Constitutional Patterns)

  • 이혜리;이준희
    • 사상체질의학회지
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    • 제33권3호
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    • pp.95-126
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    • 2021
  • Objectives The purpose of this study was to develop diagnostic tools for Sasang Constitutional patterns based on the middle classification of the Sasang Constitutional patterns. Methods Diagnosis and assessment indicators of Soeumin, Soyangin, Taeeumin, and Taeyangin patterns were extracted based on the 『Clinical Practice Guideline for Sasang Constitutional Medicine Symptomatology』 and 『Donguisusebowon』. An online survey was conducted on the 'importance of diagnosis and assessment indicators' by the Sasang Constitutional Medicine expert group. Results Based on the expert consultation results, the importance weight for each diagnosis and assessment indicators symptom was calculated, and the importance was ranked to develop diagnostic tools for Soeumin, Soyangin, Taeeumin, and Taeyangin patterns. Diagnostic tool consisted of 58 questions for Soeumin patterns, 68 questions for Soyangin patterns, 81 questions for Taeeumin patterns, and 42 questions for Taeyangin patterns. The final total score was calculated by reflecting each response score and the weight of each question. Conclusions The developed 'Diagnostic Tools for Sasang Constitutional patterns' can be used to make an effective and objective diagnosis in the clinical site. In the future, if the reliability and validity of these diagnostic tools are tested through clinical study, it will be possible to improve clinical applicability and contribute to standardization of diagnosis.