• Title/Summary/Keyword: outcome criteria

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Unilateral cleft lip: evaluation and comparison of treatment outcome with two surgical techniques based on qualitative (subject/guardian and professional) assessment

  • Adetayo, Adekunle Moses;Adetayo, Modupe Olushola;Adeyemo, Wasiu Lanre;James, Olutayo O.;Adeyemi, Michael O.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.45 no.3
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    • pp.141-151
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    • 2019
  • Objectives: The outcomes of the treatment of unilateral cleft lip can vary considerably due to variations in repair techniques. The aim of this study was to evaluate and compare treatment outcomes of surgical repair of unilateral cleft lip using either the Tennison-Randall or Millard technique based on (qualitative) parent/subject and professional assessments. Materials and Methods: This was a prospective, randomized, controlled study conducted at Lagos University Teaching Hospital between January 2013 and July 2014. A total of 56 subjects with unilateral cleft lip presenting for primary surgery who satisfied the inclusion criteria were recruited for the study. Subjects were randomly allocated to surgical groups A or B through balloting. Group A underwent cleft repair with the Tennison-Randall technique, while group B underwent cleft repair with the Millard rotation advancement technique. Surgical outcome was assessed using qualitative evaluation by the guardian/subject and independent assessors based on a modified form of the criteria described by Christofides and colleagues. Results: Of the 56 subjects enrolled in this study, 32 were male, with a male to female ratio of 1.3:1. Fifteen of the guardians/subjects in the Tennison-Randall group were most bothered about the lower part of the residual lip scar, while 12 guardians/subjects in the in the Millard group were most bothered about the upper part of the scar. More noses were judged to be flattened in the Millard group than in the Tennison-Randall group. Assessors observed a striking disparity in scar transgression of the philtral ridges between the two groups. Conclusion: Essentially, there were no major difference in the overall results between Millard rotation-advancement and Tennison-Randall repairs. Both Millard and Tennison-Randall's techniques require significant improvements to improve the appearance of the scar on the upper part and lower part of the lip, respectively.

The Development of a Program Outcomes Assessment System for Utilization of Information and Communication Technology and the Latest Healthcare Technology in Nursing Education (정보통신과 최신 보건의료기술 활용에 관한 간호교육 프로그램 학습성과 평가체계 개발)

  • Jeong-Mi Jeong;Mi-Ra Nam
    • Journal of the Health Care and Life Science
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    • v.11 no.2
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    • pp.289-302
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    • 2023
  • This study is a methodological research aimed at developing a program outcome assessment system for 'Utilization of Information and Communication Technology and the Latest Healthcare Technology' as required for nursing education accreditation. To ensure the theoretical validity of the assessment system, Kim's evaluation model (2009) and Zimmaro's rubric development stages (2004) were applied. The program outcome assessment system for information and communication and healthcare technology was developed, encompassing performance criteria, performance level, achievement goals, curriculum, evaluation methods, criteria, and the Close-the-Loop. The resulting assessment system is anticipated to be effectively utilized in nursing education, demonstrating broad applicability. This study is significant in providing specific directions for the development of program outcome assessment systems in undergraduate nursing programs. Further research is expected to evaluate and analyze program outcomes based on the applied assessment system.

Endoscopic Spinal Surgery for Herniated Lumbar Discs

  • Shim, Young-Bo;Lee, Nok-Young;Huh, Seung-Ho;Ha, Sang-Soo;Yoon, Kang-Joan
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.241-245
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    • 2007
  • Objective : So called "minimally invasive procedures" have evolved from chemonucleolysis, automated percutaneous discectomy, arthroscopic microdiscectomy that are mainly working within the confines of intradiscal space to transforaminal endoscopic technique to remove herniated epidural disc materials directly. The purpose of this study is to assess the result of endoscopic spinal surgery and favorable indication in the thoracolumbar spine. Methods : The records of 71 patients, 73 endoscopic procedures, were retrospectively analysed. Yeung Endoscopic Spine Surgery system with 7 mm working sleeve and $25^{\circ}$ viewing angle was used. The mean follow up period was 6 months [range, 3-9]. Results : Operated levels were from T12-L1 disc down to L5-L6 of S1 disc. Of 71 cases, 2 patients underwent transforaminal endoscopic surgery twice due to recurrence after initial operation. MacNab's criteria was used to assess the outcome. Favorable outcome, excellent of good, was seen in 78% [57 procedures] of the patients. Among 11 fair outcomes, only 1 procedure was followed by secondary open procedure, laminectomy with discectomy. Two of 5 poor outcomes were operated again by same procedure which resulted in fair outcomes. One patient with aggravated cauda equina syndrome remained poor and a lumbar fusion procedure was performed in other patient with poor outcome. There were 2 postoperative discitis that were treated with conservative care in one and anterior lumbar interbody fusion in the other. Conclusion : Evolving technology of mechanical, visual instrument enables minimal invasive procedure possible and effective. The transforaminal endoscopic spinal surgery can reach as high as T12-L1 disc level. The rate of favorable outcome is mid-range among reported endoscopic lumbar surgery series. Authors believe that the outcome will be better as cases accumulate and will be able to reach the fate of standard open microsurgery.

Analysis of Recent Clinical Studies to Establish Korean Herbal Medicine Clinical Trial Guidelines for the Common Cold (감기 임상시험 가이드라인 제정을 위한 최신 임상시험 연구 분석)

  • Kim, Kwan-il;Lee, Ho-jung;Lee, Beom-joon;Jung, Hee-jae;Jung, Sung-ki;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.109-134
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    • 2016
  • Objectives: The aim of this study was to help develop a guideline for the common cold. We searched recent clinical studies of the common cold in Western medicine and reviewed their objectives, inclusion and exclusion criteria, primary outcome, secondary outcome, and assessment tools to establish evidenced-based guideline.Methods: We searched electronic databases (Cochrane Library, MEDLINE, EMBASE) to identify eligible randomized controlled trials (RCTs) about the common cold for the last 10 years. We included 29 RCTs and showed their research summary via their objectives, participants, interventions, control, treatment duration, and results. We also analyzed the definition of the common cold presented in the article, inclusion and exclusion criteria, primary and secondary outcomes, and assessment tools.Results: We reported the aforementioned areas in detail. At first, the definition of the common cold was confused across the articles. Second, herbal medication clinical trials for the common cold have been extensively studied recently. Third, the eligibility criteria frequently included the Jackson Symptom score. Fourth, validated assessment tools (i.e., the Wisconsin Upper Respiratory Symptom Survey-21) have only been used in a few recent studies.Conclusions: Our research will be helpful to establish Korean herbal medicine clinical trial guidelines for the common cold.

The Current State of Registration of Interventional Clinical Trials for Children and Adolescents with Precocious Puberty (성조숙증 소아 대상 중재 임상시험의 등록 현황 보고 -Clinicaltrial.gov, WHO ICTPR, CRIS를 중심으로-)

  • Shim, Soo Bo;Seo, Hyun Sik;Lee, Hyun Hee;Lee, Hye Lim
    • The Journal of Pediatrics of Korean Medicine
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    • v.36 no.3
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    • pp.1-18
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    • 2022
  • Objectives The purpose of this study was to investigate the current status of interventional clinical trial registration for children with precocious puberty and to secure basic data for the design of clinical trials for traditional Korean medicine treatment of precocious puberty. Methods The following resources were used to search for data: Clinicaltrial.gov, World Health Organization International Clinical Trials Registry Platform (WHO ICTRP), and Clinical Research Information Service (CRIS), using the search terms, 'Precocious puberty', 'child'. All clinical trials which were registered as of June 2022 were used. Results For the intervention and clinical trial design, gonadotropin releasing hormone (GnRH) analog was reported in 41.7% of trials, and single group assignment was performed in 66.7% of the studies. Prior consent had not been reported in 50% of the studies. Tanner stage and GnRH stimulation tests were reported by multiple trials as inclusion criteria, and prior treatment experiences for trial drugs were reported as exclusion criteria. The peak serum concentration of luteinizing hormone following GnRH stimulation test was used as a primary outcome in 45.8% of clinical trials, and other growth-related indicators such as growth rate, height, and predicted adult height were also reported. Conclusions In consideration of the design, eligibility criteria, and outcome measurement of the existing clinical trials identified in this study, it should be referred to in the design of clinical trials for traditional Korean medicine treatment of precocious puberty.

Theoretical Review of Environment-Oriented Land Suitability Analysis and Setting of EOLSA Criteria and Classification System (토지환경성평가의 이론 및 기준·지도작성에 관한 연구)

  • Lee, Dong-Kun;Jeon, Seong-Woo;Lee, Sang-Moon
    • Journal of the Korean Society of Environmental Restoration Technology
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    • v.7 no.1
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    • pp.116-127
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    • 2004
  • The objectives of this study are to build up the concept of Environment-Oriented Land Suitability Assessment(EOLSA) and to develop the EOLSA mapping system by applying the EOLSA criteria to the case study area. In order to draw out the EOLSA critera, this study adopted the Delphi method including the experts' awareness survey to urban planners as well as environmental researchers in May and June 2001. As a result, the concept of EPLSA was defined as a process of land use planning to scientifically assess the physical and environmental value of land and to classify conservation aptitude into several grades for the sustainable management of environmental resources. With an outcome of applying the EOLSA criteria with five degrees to the Seoul Metropolitan Area (SMA), Grade I, indicating the highest conservation value, accounted for 57.76% of the SMA. Then, Grade II reached up to 15.06%, Grade III 3.12%, Grade IV 15.92%, and Grade V, the lowest conservation value, 7.99% respectively. And also, the case analysis showed that the share of Grade I area was the highest in Gapyong county and Yangpyong county, Pochon county, Yeonchon county, Yongin city in the order and the lowest in Kwangmyong city, Osan city, Kunpo city, Kuri city, and Buchon city.

A Study on Improved Assessment System for a Program Outcome on the Cultivation of Internationality (국제성함양과 관련된 프로그램 학습성과 평가체계 개선 연구)

  • Kim, Bok-Ki;Min, Sang-Won;Yi, Keon-Young;Yoon, Woo-Young;Kang, Sang-Hee
    • Journal of Engineering Education Research
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    • v.12 no.2
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    • pp.63-70
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    • 2009
  • In this paper, a process model for assessing, evaluating and improving a program outcome on the cultivation of internationality is proposed by analyzing the present outcome assessment system. By setting up performance scaled levels and specifying the target level for the performance criterion, the proposed model can help programs to demonstrate effectively that each of their graduates meets the required the program outcome levels. By allowing effective Continuous Quality Improvement(CQI) for the performance criterion, the model can help save operational expense associated with running of the program CQI. In addition, it is discussed that one of the most important aspect is logical and objective approaches when establishing the outcome assessment system. It is hoped that the proposed model can ultimately help to meet the program outcomes requirements in the engineering accreditation criteria.

Overview of Risk-Sharing Schemes: Focusing on Anticancer Drugs (위험분담제도에 대한 고찰: 항암제 사례를 중심으로)

  • Sohn, Hyun Soon;Shin, Hyun Taek
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.89-96
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    • 2013
  • This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

Performance of attachments used in implant-supported overdentures: review of trends in the literature

  • Lee, Damian J.
    • Journal of Periodontal and Implant Science
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    • v.43 no.1
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    • pp.12-17
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    • 2013
  • The purpose of this review is to examine the performance of attachments used in implant-supported overdenture (IOD) in both clinical and in vitro settings and report the compiled findings, comparisons, and trends in the research literature. Articles published in PubMed on IOD attachment systems and performance were reviewed. Non-original articles were excluded. For each article included, the type of study, number of implants, number of attachment systems, and study outcome were recorded. Of the 283 articles found, 158 met the inclusion criteria. Ninety-four articles were clinical studies and 64 articles were in vitro studies. Studies on retention were the most common for in vitro studies, and four or more attachment systems were compared in most articles with significant differences in outcome. A clinical outcome of one attachment system was most common for clinical studies, while most studies had neutral outcomes overall. Ball attachment was the most commonly tested IOD attachment system. The trend in the literature showed that there is a large discrepancy between the study designs and outcomes between the clinical and the in vitro studies for IOD. Further clinical studies that can validate in vitro research should be encouraged to address this discrepancy between the two areas.

Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.338-343
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    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.