• 대한예방의학회:학술대회논문집
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• 2005.10a
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• pp.494-494
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• 2005

• Journal of Society of Preventive Korean Medicine
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• v.16 no.1
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• pp.1-13
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• 2012

The objective of this study is to discuss the role of integrative medicine (IM) in contemporary health care settings, and how and which factors affect and facilitate the success of IM in terms of the integration of complementary and alternative medicine (CAM) and conventional medicine in primary health care (PHC). IM is meant to provide the best possible health care, for both patient and physician. The way of IM use in the developed countries presents various ways that IM can be provided, and it appears that strategies have been successfully developed to facilitate integration. Although few of the barriers to the integration of CAM and conventional medicine have been resolved, concerns over the legitimacy of CAM in health care (e.g., safety, biomedical evidence, and efficacy) are being overcome by the use of evidence-based practice in IM delivery. There are dominant models of IM that have been developed. The model types signify different levels of equity between CAM and conventional medicine in regard to the power, autonomy, and control held by each. However, the factors common to all IM models, whether describing CAM as supplementary or complementary to conventional medicine, is the concept of a health care model that aspires to be client-centred and holistic, with focus on health rather than disease as well as mutual respect among peer practitioners. Finally, this study concluded that the growth and viability of traditional Korean medicine(TKM) depend on evidence-based practices and identifying the successful influences on the integration of TKM and conventional medicine for recognition of its inherent value in PHC. Some recommendations for the integration of TKM and conventional medicine were suggested.

• The Journal of Korean Medicine
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• v.38 no.3
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• pp.143-159
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• 2017

Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

• Clinical Endoscopy
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• v.57 no.2
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• pp.141-157
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• 2024

Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

• The Journal of Korean Medicine
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• v.37 no.1
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• pp.1-9
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• 2016

Objectives: Objectives : This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with Post-stroke Urinary Retention; PSUR. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUR compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: 4 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUR. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as SP6, CV3, CV6, CV4, SP9, BL28, BL23, BL22, KI3 or BL67, for 15-30 minutes. 20-140Hz frequency and 10-20 minutes of treatment is suggested if electro-acupuncture treatment is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for PSUR.

• Journal of Gastric Cancer
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• v.23 no.1
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• pp.3-106
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• 2023

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

• Journal of Korean Biological Nursing Science
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• v.14 no.3
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• pp.221-230
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• 2012

Purpose: Quality of nursing research should be evaluated before it is applied as an evidence for evidence-based nursing practice. This study attempted to analyze and to compare tools for the quality assessment and reporting standards of nursing research using CONSORT and STROBE checklist by types of research design. Methods: We searched the tools for quality assessment in nursing research based on the National Evidence-based Healthcare Collaborating Agency (NECA) publication. Then, we analysed and compared the tools for quality evaluation by types of research design. Results: According to the analysis using CONSORT checklist, ROB shows coherence in 17 items, Jadad shows coherence in 3 items, SIGN (for RCT) shows coherence in 26 items, and Downs & Black shows coherence in 24 items. According to the analysis using STROBE checklist, MINORS shows coherence in 25 items, NOS shows coherence in 21 items, SIGN (for Cohort studies & Case-control studies) shows coherence in 29 items, and RoBANS shows coherence in 21 items. Conclusion: Based on our analysis, we recommend that nursing researchers should report according to the reporting standards of tools for quality evaluation. We hope that our analysis can be helpful to develop evidence-based nursing.

• Journal of Veterinary Clinics
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• v.25 no.3
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• pp.146-151
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• 2008

During the clinical decision making practitioners are often faced with performing diagnostic tests to solve the presenting problems seen in the patients. The diagnostic utility of a test has traditionally been described by technical terms such as sensitivity, specificity, and positive (PPV) and negative predictive value (NPV). Although well known, clinicians are frequently unclear about the concept and application of these terms in everyday evidence-based clinical decision making. Sensitivity and specificity, which are intrinsic properties of diagnostic tests, summarizes the characteristics of the test over a population. The PPV and NPV are greatly dependent on the population prevalence of disease, and thus they do not transferable to different patients or clinical settings. Besides, considering the fact that clinicians more often interested in knowing the extent to which a test result could confirm or exclude of a condition under consideration (posttest probability), these measures do not provide answers on this question. The likelihood ratios (LR) using the information contained in sensitivity and specificity are becoming increasingly popular for reporting the usefulness of diagnostic tests because this term provide an indication of posttest probability as a function of the pretest probability. In this article, clinical applications of LR are illustrated with some practical examples. Discussion is also included of the inherent limitations regarding diagnostic test characteristics.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6103-6108
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• 2014

Many studies have reported ${\beta}$-catenin involvement in the development of esophageal carcinoma (EC), but its prognostic significance for EC patients remains controversial. Therefore, we conducted this meta-analysis to explore the issue in detail. After searching PubMed, EMBASE, Web of Science, and Chinese Biomedical Literature Database, we included a total of ten relevant studies. We pooled the overall survival (OS) data using RevMan 5.2 software. The results showed that aberrant expression of ${\beta}$-catenin was associated with a significant increase of mortality risk (hazard ratio 1.71, 95%CI 1.46-2.01; p<0.00001). Subgroup analyses further suggested that aberrant expression of ${\beta}$-catenin resulted in poor OS of EC patients regardless of histological type of EC, study location or criteria for aberrant expression of ${\beta}$-catenin, and the sensitivity analyses revealed that the result was robust. The meta-analysis revealed that aberrant expression of ${\beta}$-catenin could be a predicative factor of poor prognosis for EC patients.

• Journal of Digital Convergence
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• v.13 no.10
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• pp.549-559
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• 2015

This study aimed to find the problems of evidence-based complementary and alternative medicine and seek the future development direction by evaluating the quality of oriental medicine related systematic review(SR) studies using AMSTAR tool. The 26 SR studies related to oriental medicine were searched from the database of DBPIA, OASIS, and KISS, and they were evaluated on the basis of AMSTAR. The average of AMSTAR for the quality assessment of SR studies was 6.0 point, and the 26 studies included 2 high quality studies (7.7 %), 21 normal quality studies (80.8 %), and 3 low quality studies (11.5 %). The quality of studies was not correlated with the publication years. The quality of oriental medicine related SR studies need to be improved steadily. Furthermore, continued efforts to promote the evidence-based practice in the field of Oriental Medicine will help to establish foundation for the convergence approach in the healthcare sector.