• 제목/요약/키워드: evidence-based medicine (EBM)

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Use of Likelihood Ratios in Evidence-based Clinical Decision Making

  • Kim, Eu-Tteum;Pak, Son-Il
    • 한국임상수의학회지
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    • 제25권3호
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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.

여성 성기능장애 관련 최근 국내외 한의학 연구 동향에 대한 고찰 (A Review of Recent Oriental Medicine Studies on Female Sexual Dysfunction)

  • 최민선;김동일
    • 대한한방부인과학회지
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    • 제24권3호
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    • pp.171-189
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    • 2011
  • Objectives: Female Sexual Dysfuction(FSD) is a common gynecologic condition and its prevalence is more higher than men. Despite its high prevalence and clinical importance, research on FSD is not enough in both of oriental and western medicine. The purpose of this study is to review research tendency of recent oriental medicine studies on FSD and to suggest the following research on FSD. Methods: We searched oriental medicine papers related to FSD published in the last 10 years(2001-2011) through Korean Medicine Gynecology Society database, KISS, RISS, NDSL, CNKI(China National Knowledge Infrastructure), and Pubmed. Results: 26 papers were searched, then 18 papers of them were related to Traditional Chinese Medicine(TCM), 8 papers of them were related to Korean Medicine(KM). In classification according to paper type, 16 papers were clinical study, 1 paper was experimental study, 2 papers were bibliographic study, and 7 papers were the other study. Then 5 papers of clinical study was Randomized Controlled Trial(RCT). Conclusion: There was a lack of oriental medicine research on FSD. On the base of this study, so further research is needed. Especially, Clinical trials such as RCT have strong objective evidence power in the viewpoint of Evidence Based Medicine(EBM) are needed.

한방소아과학회지에 출판된 임상연구논문에 대한 분석 (Trend Analysis of Clinical Studies Published in the Journal of Pediatrics of Korean Medicine)

  • 양두화;박장경;성현경;성수현
    • 대한한방소아과학회지
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    • 제32권4호
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    • pp.141-162
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    • 2018
  • Objectives The purpose of this study is to provide evidence of traditional Korean medicine treatment in children and adolescents by reviewing previous studies published in the journal of pediatrics of Korean medicine. Methods We have reviewed clinical studies of children and adolescents in the journal of pediatrics of Korean medicine from 2008 to 2017. Results Eighty-seven clinical studies of children and adolescents were reviewed. Total number of patients were 1644 in the studies. Among these, top 5 most commonly reported diseases in children and adolescents were atopic dermatitis, growth, autism, juvenile idiopathic arthritis and obesity. The most common intervention to treat those was taking herbal medicine. Most of the clinical studies showed effectiveness of this approach in treating children and adolescents. Conclusions More double-blinded randomized controlled clinical trials of Korean medicine interventions treating children and adolescents are needed to establish evidence-based treatment.

EBM을 기반으로 한 한약처방 복약지도 지침에 대한 구성안 연구 (A Study on the Development of Medication Teaching of Herbal Formulas Based on Evidence)

  • 이남헌;유영법;하혜경;이호영;정다영;최지윤;마진열;신현규
    • 대한한의학회지
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    • 제28권3호통권71호
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    • pp.144-155
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    • 2007
  • Background : In western medicine, there has been much interest in medication teaching since the separation of dispensary from medical practice in 2000. On the other hand, few investigations have been carried out about medication teaching for herbal medicine. Objectives : The purpose of this study wasto investigate the current status of medication teaching of herbal medicine and develop a better guide. Methods : Pharmaceutical affairs law in Korea was searched and some medication teaching guides were compared and analyzed to develop a better guide suitable for herbal medicine. Results and Conclusions : The future guide should be based on scientific evidence and include the following: (1)the origin of each herbal formula (2)the constitution of each herbal formula and proportion of each herb included (3)the chief virtue of each herbal formula (4)the efficacy of each herbal formula (5)the safety of each herbal formula (6)combined treatment with herbal formulas and western drugs (7)the way of decocting each herbal formula (8)the way of safekeeping and period of circulation of each herbal formula (9)a summary and evaluation for each herbal formula (10)references of each herbal formula.

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근거 중심 Kampo medicine 임상진료지침의 현황 (Evidence-based Clinical Practice Guidelines On Kampo (Japanese Herbal) Medicine : The Current State of Kampo Clinical Practice Guidelines)

  • 사사키 유이;황정운;김경한;박유리;심호종;박동선;전윤정;김지환;장보형;신용철;고성규
    • 대한예방한의학회지
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    • 제20권1호
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    • pp.55-64
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    • 2016
  • Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

EBM 구축을 위한 쌍화탕의 실험 연구 문헌 분석 (Analysis of Studies on Ssanghwa-tang for Establishment of Evidence Based Medicine)

  • 이준경;이남헌;하혜경;이호영;서창섭;정다영;이진아;신현규
    • 한국한의학연구원논문집
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    • 제14권3호
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    • pp.41-47
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    • 2008
  • Objective : The purpose of this report was to provide the information about activity and safety of Ssanghwa-tang by analyzing domestic papers and theses about Ssanghwa-tang. Methods : Domestic papers and theses related to Ssanghwa-tang were reviewed and analyzed. These papers were then classified by year, experimental method, and activity subject. Results : The following result s were obtained in this study. 1. The study of Ssanghwa-tang started from 1981 and continued steadily 1990s and it was decreased 2000s. 2. The paper of Ssanghwatang was entire domestic paper, 20 volumes. 3. In classified by experimental method and animal of Ssanghwa-tang paper, more than a half study used rat in vivo experiment. Furthermore clinical experiments were performed about anti-fatigue effect of Ssanghwa-tang and Ssanghwatang was proved a safety herbal medicine in acute toxicity experiment. 4. Decursin, glycyrrhizin, paeoniflorin were determined in Ssanghwa-tang by using HPLC analysis. 5. As these studies were classified by subject, papers related to anti-fatigue effect were most abundant by 7 papers. Besides there were several papers related to liver funtion, anti-inflammatory, alleviation, smooth muscle relaxation effect and so on. 6. According to experimental data, it is supported that Ssanghwa-tang was safety herbal medicine and it has a several activity about anti-fatigue, anti-inflammatory, alleviation, smooth muscle relaxation. Conclusion : Many study of basic science experiments and clinical experiments were performed and reported on Ssanghwa-tang in domestic journal. Ssanghwa-tang is being used in various ways associating with anti-fatigue, anti-inflammatory, alleviation and smooth muscle relaxation. furthermore Ssanghwatang was proved a safety herbal medicine in acute toxicity experiment. However, studies on randomized controlled trials of Ssanghwatang need to be completed at the clinical level.

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한의원에서 사용 가능한 정량적인 월경곤란증 평가지표 개발 (A Study for Suggestion of Quantitative Scale for Dysmenorrhea in Clinics)

  • 박정수;박선주;김경훈;김운지;최형심;최한석;최윤경;조정훈;신용철;고성규
    • 대한한방부인과학회지
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    • 제24권1호
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    • pp.144-161
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    • 2011
  • Objectives: Oriental Medicine has thousands years of history. But this era, every medical decision should be based on scientific evidence, that is evidence-based medicine (EBM). This study is to suggest quantitative case report form for dysmenorrhea that can be easily used in clinics. Methods: First, to search published papers in Korea and overseas, OASIS, KISS and NCBI(pubmed) database. Second, to search clinical trials in clinical trial register website, ISRCTN and clinicaltrials.gov. Result: Visual Analogue Scale(VAS) is the most commonly used scale. Conclusion: The main scales for dysmenorrhea are Visual Analogue Scale(VAS), Multidimensional verbal Rating scale(MVRS), pain-killer intake amount and restriction of daily life activities. To measure the effect of herbal medicine, more than 2 menstrual cycle is recommended.

Current Research Trends in Randomized Controlled Trials Investigating the Combined Effect of Korean Medicine and Western Medicine Treatment

  • Ha, Dohyung;Kim, Seoyeon;Baek, Yong Hyeon;Won, Jiyoon;Nam, Seri;Shin, Jeeyoung;Kwon, Oh-Hoon;Kim, Soo-Yeon;Lee, Hyangsook
    • Journal of Acupuncture Research
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    • 제37권1호
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    • pp.13-18
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    • 2020
  • This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (n = 47; 51%), and 19% (n = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (n = 16; 17%), and mental and behavioral disorders (n = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.

여성 과민성 방광의 한방 임상에 관한 고찰 (A Study on Korean Medical Clinical Management of Female Overactive Bladder)

  • 최민선;김동일
    • 대한한방부인과학회지
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    • 제27권2호
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    • pp.83-102
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    • 2014
  • Objectives: This study aimed to review Korean medical clinical management of female overactive bladder (OAB). Methods: We reviewed domestic and foreign papers related to Korean Medicine Treatment for OAB and literatures on Korean Medicine added clinical views of authors. Results: OAB is usually diagnosed to Deficiency pattern (Kidney qi deficiency-cold, Spleen-Lung qi deficiency et al.). The primary treatment goals of OAB is improvement of urinary symptom. But a comprehensive treatment approach including improvement of accompanied symptoms such as depression, insomnia, sexual dysfunction and improvement of quality of life is needed. Warming and tonifying herbal medicine, electro-acupuncture and moxibustion using acupoints specially acting bladder function in lower abdomen and lumbar-sacral area and behavioral therapies such as lifestyle modification, bladder training are usually primary treatments. Treatment period is recommended about 3~6 months to recover and stabilize bladder function. Conclusions: OAB is a clinical area that Korean Medicine tend to be more effective. but additional research about Korean Medical Clinical Management of OAB is needed.

텍스트 마이닝 기법을 활용한 인공지능과 헬스케어 융·복합 분야 연구동향 분석 (Research Trend Analysis by using Text-Mining Techniques on the Convergence Studies of AI and Healthcare Technologies)

  • 윤지은;서창진
    • 한국IT서비스학회지
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    • 제18권2호
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    • pp.123-141
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    • 2019
  • The goal of this study is to review the major research trend on the convergence studies of AI and healthcare technologies. For the study, 15,260 English articles on AI and healthcare related topics were collected from Scopus for 55 years from 1963, and text mining techniques were conducted. As a result, seven key research topics were defined : "AI for Clinical Decision Support System (CDSS)", "AI for Medical Image", "Internet of Healthcare Things (IoHT)", "Big Data Analytics in Healthcare", "Medical Robotics", "Blockchain in Healthcare", and "Evidence Based Medicine (EBM)". The result of this study can be utilized to set up and develop the appropriate healthcare R&D strategies for the researchers and government. In this study, text mining techniques such as Text Analysis, Frequency Analysis, Topic Modeling on LDA (Latent Dirichlet Allocation), Word Cloud, and Ego Network Analysis were conducted.