• 제목/요약/키워드: clinical guideline

검색결과 828건 처리시간 0.036초

경항통에 대한 매선 임상연구의 중국 현황 분석 (Research Trends on the Thread Embedding Therapy of Neck pain in Traditional Chinese Medicine)

  • 전푸르메;김수란;류연;박지은;정소영;한창현
    • 동의생리병리학회지
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    • 제31권5호
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    • pp.284-293
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    • 2017
  • Thread embedding therapy is used increasingly for various disease including neck pain. However, the evidence of thread embedding therapy on neck pain and the assessment of their methodology are still limited. This study aimed to investigate the clinical research methodology using thread embedding therapy on neck pain. Thread embedding therapy is used increasingly for various disease including neck pain. However, the evidence of thread embedding therapy on neck pain and the assessment of their methodology are still limited. This study aimed to investigate the clinical research methodology using thread embedding therapy on neck pain. Total 31 studies were included in analysis. Thread embedding therapy usually was used once a week(32.3%), once per 10days(29.0%), once per two weeks (25.8%). The most common concurrent treatment used with thread embedding therapy was Chinese medicine. Among acupuncture points, EX-B2 (61.3%) was most commonly used, followed by GV14(45.2%), GB20(29.0%), GB21(22.6%). For control group, acupuncture were most commonly used(58.1%). All studies reported that the effect of thread embedding therapy was more effective compared to control group. and 11 studies reported side effects. Only 13 studies(41.9%) reported the appropriate randomization method, and the mean Jadad score of included studies was 1.52. Previous clinical trials included in this study showed the effect of thread embedding therapy for neck pain. However, the quality of the studies was not high. Further rigorous clinical trials are need to assess the effect of thread embedding therapy.

국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰 (A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea)

  • 이소영;조은
    • 한국임상약학회지
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    • 제29권3호
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    • pp.193-201
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    • 2019
  • Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

트랄로키누맙과 두필루맙의 매칭 조정 간접 비교 (Matching-adjusted Indirect Comparison (MAIC) of Tralokinumab Versus Dupilumab for the Treatment of Moderate to Severe Adult Atopic Dermatitis)

  • 김태경;신근수;김효진;김유진;최이정;이동훈
    • 한국임상약학회지
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    • 제33권3호
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    • pp.178-185
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    • 2023
  • Objective: Atopic dermatitis (AD) is a chronic, recurrent inflammatory skin disease. Both tralokinumab and dupilumab have been recommended in the European Guideline for the treatment of adult patients with severe AD. In Korea, dupilumab has been approved for patients with moderate to severe AD, and reimbursed for those with severe AD. Since there is no clinical trial directly comparing tralokinumab and dupilumab, we conducted indirect comparison to assess the clinical usefulness in patients with AD. Methods: We selected clinical trials for indirect comparison through a systematic literature review. Individual patient data were available for the tralokinumab clinical trial, and aggregated data were available for the dupilumab clinical trial. Therefore, we employed the Matching-Adjusted Indirect Comparison (MAIC) method. The treatment efficacy was assessed based on whether patients achieved a 75% reduction on the Eczema Area and Severity Index (EASI 75) after drug administration. Results: The difference in the proportion of patients achieving EASI 75 between tralokinumab and dupilumab was 4.7% (95% CI: -7.9 to 17.3). Considering the non-inferiority margin for the EASI 75 achievement rate is -10%, tralokinumab is deemed non-inferior to dupilumab as the lower bound of the CI for the difference in the EASI 75 achievement rate between tralokinumab and dupilumab was within -10%. Conclusion: We conducted a MAIC analysis comparing tralokinumab and dupilumab based on EASI 75 achievement. The findings of this study show that tralokinumab is non-inferior to dupilumab and can be implemented in Korean clinical settings with a therapeutic position comparable to dupilumab.

전립선증식증(Benign Prostatic Hyperplasia)의 한의 임상 진료 현황 조사를 위한 온라인 설문 조사 (Clinical Practice Patterns for Benign Prostatic Hyperplasia: An Online Survey)

  • 백지수;신선미;조충식
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.703-725
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    • 2023
  • Objectives: This study investigated Korean medicine doctors' perspectives on clinical practice patterns in the process of developing Korean medicine clinical practice guidelines for benign prostatic hyperplasia. Methods: A questionnaire was developed for Korean medicine doctors. A total of 323 oriental medicine doctors participated in the survey, which was live for a total of 9 days from September 22, 2022, to September 30, 2022. Results: Regarding awareness of treatments for benign prostatic hyperplasia, 63.8% of respondents showed high awareness of Korean medical treatments. However, items such as diagnostic criteria (17.7%), evaluation methods (17.0%), and Western medical treatments (22.9%) showed low recognition rates. In clinical practice, 76.2% of respondents were found to treat five or fewer patients with benign prostatic hyperplasia per month, and the average treatment period was 1 to 3 months for most at 41.2%. Korean medicine doctors diagnosed benign prostatic hyperplasia based on clinical features. The main interventions used were acupuncture, herbal medicine (prescription medicine), and moxibustion. This study has several limitations because of the low response rate for this survey; therefore, the participants are not representative of all Korean medicine doctors. In addition, because the study was conducted broadly on various topics related to benign prostatic hyperplasia, sufficient quality management was not carried out. Further studies that include a larger sample size and more in-depth studies on benign prostatic hyperplasia are needed. Conclusions: It is necessary to develop appropriate and reasonable Korean medicine clinical practice guidelines for benign prostatic hyperplasia.

최신 치아우식 진단기준 : International Caries Detection and Assessment System (ICDAS) (International Caries Detection and Assessment System (ICDAS))

  • 최연희
    • 대한치과의사협회지
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    • 제49권8호
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    • pp.451-460
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    • 2011
  • Dental caries has been widely prevalent with presence of cavitation on teeth. For the last several decades, the prevalence of dental caries in developed countries has rapidly decreased so there has been needed a new and detailed diagnostic guideline to differentiate the severity of dental caries, especially for early status of caries. The cariology specifically requires the development of an integrated definition of dental caries and uniform systems for measuring the caries process in the fields of clinical diagnosis and treatment, epidemiological researches, and dental education and so forth. The international Caries Detection and Assessment System (ICDAS) optically measures the enamel surface changes and potential histological depth of carious lesions by relying on surface characteristics of teeth. ICDAS is a visual classification system that was developed to diagnose the subtle changes of enamel surface, predict the progress direction of early caries, allow standardized data collection in relation to caries in different settings, and to enable better comparison of oral health between countries worldwide and research studies.

메토트렉세이트 치료에 실패한 류마티스관절염 환자에서 에타너셉트 사용에 대한 비용-효과 분석 (Cost-Effectiveness Analysis of Etanercept in the Treatment of Methotrexate-resistant Rheumatoid Arthritis)

  • 김종주;박은자;박세정;성윤경;배상철;이의경
    • 약학회지
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    • 제50권2호
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    • pp.70-77
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    • 2006
  • A cost effective analysis was performed for comparing leflunomide+methotrexate, etanercept monotherapy and etanercept+methotrexate for 6 months. For the patients with methotrexate-resistant RA, ACR20 data were extracted from the published clinical trials searched from Pubmed. The direct medical cost was estimated based on ACR guideline and Korean National Health Insurance reimbursement. Combination therapy of etanercept+methotrexate was found to be more cost-effective than etanercept monotherapy, which meant it was a better therapeutic strategy for methotrexate- resistant RA.

FDG-PET을 이용한 암 치료 효과의 평가 (Evaluation of Cancer Treatment Using FDG-PET)

  • 류진숙
    • 대한핵의학회지
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    • 제36권1호
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    • pp.64-73
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    • 2002
  • FDG-PET has potential as an effective, non-invasive tool to measure tumor response to anticancer therapy. The changes in tumor FDG uptake may provide an early, sensitive guide to the clinical and subclinical response of tumors to cancer treatment, as well as functional assessment of residual viable tumor. This may allow the evaluation of subclinical response to anticancer drugs in early clinical trials and improvements in patients management. However, monitoring tumor responses with FDG-PET is still in its infancy. The methods of measurement of FDG uptake are currently diverse and timing with respect to anti cancer therapy variable. Therefore, there is a need for larger-scale trials along with standardized methodology and a collection of reproducibility data. The recent guideline from the European group seems to be the most comprehensive. In future, the combination of morphological and metabolic images may improve the quantitative nature of these measurements by relating tumor viability to total tumor mass. More data on sensitivity and specificity of FDG-PET technique are needed along with continued advancement of PET methodology.

Caries Management by Risk Assessment (CAMBRA) 모형에 따른 임상 예방치과 및 치위생 진료 (Clinical Preventive Dental and Dental Hygiene Practice by Caries Management by Risk Assessment (CAMBRA))

  • 조영식
    • 치위생과학회지
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    • 제12권6호
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    • pp.545-557
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    • 2012
  • Dental caries is biofilm induced disease throughout life and is recognized significant oral health problem. This article reviewed new trends in dental caries management by risk assessment, including history, protocol/guideline, and collaborated model. Dental caries prevention and treatment according to caries management by risk assessment (CAMBRA) model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into clinical dental hygiene education based on dental hygiene process of care as standard of dental hygiene practice and education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

Repetitive transcranial magnetic stimulation for neuropathic pain

  • Kim, Sooyoung;Lee, Eun Kyoung;Sohn, Eunhee
    • Annals of Clinical Neurophysiology
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    • 제24권2호
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    • pp.53-58
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    • 2022
  • Noninvasive stimulation of the nervous system for treating chronic neuropathic pain has received attention because of its tolerability and relative efficacy. Repetitive transcranial magnetic stimulation (rTMS) is a representative method of noninvasive brain stimulation. Evidence-based guidelines on therapeutic use of rTMS have been proposed recently for several neurological diseases. These guidelines recommend treating neuropathic pain by applying high-frequency (≥ 5 Hz) rTMS to the primary motor cortex contralateral to the painful side. This review summarizes the mechanisms and guidelines of rTMS for treating neuropathic pain, and proposes directions for future research.