• 대한암한의학회지
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• 제21권2호
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• pp.1-35
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• 2016

Objectives : The aim of this preliminary study is to suggest a clinical approach on prostate cancer through the analysis of existing clinical practice guidelines or clinical studies. Materials and Methods : The data related on the treatment of prostate cancer were collected using various search engines such as Pub Med, KIOM OASIS, CNKI. Then, data were analyzed to evaluate the validity of recommendation of treatment. Results : Prostate cancer has the highest prevalence around the world. Recently, the incidence of prostate cancer in Korea is rapidly increasing. Especially, it was reported that incidence rate rose up to 80% by age 80 years. In recent studies, applying combined traditional and conventional medicine were reported to improve the survival, quality of life, immune function, and suppress of tumor growth in prostate cancer. However there has not been an objective and systemic clinical guideline for prostate cancer in Korean Medicine. Accordingly, it has been difficult for doctors to apply optimized therapeutic treatment in clinics. This study will show a preliminary approach to establish clinical practice guideline for prostate cancer of Korean Medicine. Conclusion : Further objective and systemic clinical studies by Korean Medicine are needed to develop more advanced clinical practice guidelines of prostate cancer.

• 한국임상약학회지
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• 제29권1호
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• pp.18-24
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• 2019

Background: Although a growing number of guidelines and clinical researches are available for immunosuppressive treatment of post-transplantation, there is no clinical practice guideline for the care of kidney transplant recipients in Korea. Selection of a researchable question is the most important step in conducting qualified guideline development. Thus, we aimed to formulate key questions for Korean guideline to aid clinical decision-making for immunosuppressive treatment. Methods: Based on previous published guidelines review, a first survey was constructed with 29 questions in the range of immunosuppressive treatments. The experts were asked to rate the clinical importance of the question using a 5-point Likert scale. The questions reached 60% or more from the first survey and additional new questions were included in the second survey. In analyzing the responses to items rated on the 9-point scale, consensus agreement on each question was defined as 75% or more of experts rating 7 to 9. Results: In the first survey, 50 experts were included. Among the 29 questions, 27 were derived to get 60% or more importance and 3 new questions were additionally identified. Through the second survey, 9 questions were selected that experts reached consensus on 75% and over of the options. Finally, we developed key questions using PICO (patient, intervention, comparison, and outcome) methodology. Conclusion: The experts reached a high level of consensus on many of key questions in the survey. Final key questions provide direction for developing clinical practice guideline in the immunosuppressive treatment of transplantation.

• 동서간호학연구지
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• 제23권1호
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• pp.53-62
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• 2017

Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensive care units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study to evaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guideline was poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure ranged from 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which might contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.

• 대한한방내과학회지
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• 제33권4호
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• 사상체질의학회지
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• 제26권1호
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• pp.1-10
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• 2014

Objectives This study was aimed to develop the clinical practice guideline for Soeumin symptomatology. This was the first clinical practice guideline, which focuses on symptomatology, not disease. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Results & Conclusions By researching and discussing the Soeumin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.

• 사상체질의학회지
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• 제27권1호
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• pp.1-12
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• 2015

Objectives This study was aimed to develop the clinical practice guideline for Taeeumin, Taeyangin symptomatology. This was the second clinical practice guideline, which focuses on symptomatology. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Results and Conclusions By researching and discussing the Taeeumin, Taeyangin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.

• 사상체질의학회지
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• 제26권3호
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• pp.213-223
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• 2014

Objectives This study was aimed to develop the clinical practice guideline for Soyangin symptomatology. It discussed the principle and method of application of clinical practice guideline for Soyangin symptomatology which focuses on symptomatology, not disease. Methods Based on the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Member of writing committee reviewed and examined "Donguisusebowon" and many articles for developing clinical practice guidelines. Draft of clinical practice guideline was reviewed by advisory committee and approved by Society of Sasang Constitutional Medicine. Results & Conclusions By researching and discussing the Soyangin symptomatology, we establish the evaluation criteria for diagnosis including classification, definition and develop diagnostic algorithm and treatment assessing tool.

• 대한한의학회지
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• 제38권3호
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• pp.124-142
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• 2017

Objectives: This study aimed to learn what should be considered in [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer)] by analyzing the existing guidelines and clinical trials. Methods: The development committee searched guidelines for herbal medicinal product or gastric cancer developed already. Then, clinical trials for gastric cancer using herbal medicine were searched. The searched trials were analyzed in terms of inclusion and exclusion of participants, intervention, comparator, outcomes and trial design. Then, we compared the results of analysis with the regulations and guidelines of Ministry of Food and Drug Safety to suggest the issue that we will have to consider when making the [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer]. Results: As a result, few guidelines for anti-tumor agent and clinical trial with herbal medicinal product were searched in the national institution homepage. In addition, 10 articles were searched by using the combination following search term; 'stomach neoplasm', 'herbal medicine', 'Medicine, Korean traditional', 'Medicine, Chinese Traditional', 'TCM', 'TKM', 'trial'. Most trials included gastric cancer participants with medical history of operation. The type of intervention was various such as decoction, granules, and fluid of intravenous injection. Comparators were diverse such as placebo, conventional treatment including chemotherapy and nutritional supplement. The most frequently used outcome for efficacy was quality of life. Besides, the symptom score, tumor response, and survival rate were used. Safety was investigated by recording adverse events. Conclusion: We found out some issue by reviewing the existing guidelines and comparing it with clinical trials for gastric cancer and herbal medicinal products. These results will be utilized for developing [Guideline of Clinical Trial with Herbal Medicinal Product for Gastric Cancer].

• 임상간호연구
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• 제21권2호
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• pp.196-206
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• 2015

Purpose: This study was done to use a guideline adaptation process to develop a Korean evidence-based diabetic foot care clinical practice guideline for diabetic foot prevention and management. Methods: The guideline adaptation process was conducted according to the guideline adaptation manual developed by the National Evidence-Based Healthcare Collaborating Agency. The process consists of three main phases, with 9 modules including a total of 23 steps. Results: The newly developed diabetic foot care clinical practice guideline consisted of an introduction, description of diabetic foot, summary of recommendations, recommendations, references, appendices, and glossary. There were 165 recommendations in 4 sections (risk assessment for diabetic foot ulcers, prevention of diabetic foot ulcers, wound assessment of diabetic foot ulcers, and management of the diabetic foot). In grading by recommendations, for A there were 30 (18.2%), B, 8 (4.8%), C, 30 (18.2%) D, 97 (58.8%). Conclusion: This guideline can be used as educational material for healthcare workers and diabetic patients. It can also be utilized as a practice guideline for healthcare workers in the hospital and community setting.

• 대한암한의학회지
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• 제21권1호
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• pp.1-14
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• 2016

The incidence rate of cervical cancer in Korea is still higher than in other developed countries, notwithstanding the national mass screening program. Cervical cancer prognosis is good due to an effective treatment such as surgery or radiation therapy, concurrent chemotherapy in the early stage. However, it is still a poor prognosis when advanced stage or recurrent. Some studies said that combined oriental and western medicine can improve the survival, quality of life, immune function, and decrease side effects in cervical cancer. In the western medical part, clinical practice guideline was published in 2006, 2007 and 2010 in Korea. In China, oriental medicine clinical practice guideline have been published in 2014. But there is no Korean medicine clinical practice guideline. This study will introduce the methods of diagnosis and the medical therapeutics which is commonly utilized for cervical cancer in Korea, and existing Korean medicine clinical practice guideline for Disease Analysis and Treatment (辨證論治). This study will be a meaningful study to establish clinical practice guidelines of Korean Medicine for cervical cancer.