• 제목/요약/키워드: the Hierarchy of Evidence

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근거기반설계 연구의 근거 특성과 의료건축의 근거기반실무를 위한 시사점 - HERD의 연구경향 분석을 중심으로 (The Characteristics of Evidence in Evidence-based Design Research and Their Implications to the Evidence-based Practice of Healthcare Architecture - Focused on Health Environments Research & Design Journal)

  • 김덕수
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제28권4호
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    • pp.21-30
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    • 2022
  • Purpose: To prove the credibility of EBD, it is necessary to define concepts regarding the nature of credible knowledge and the hierarchy of evidence. In addition, the relationship between EBD and EBP needs to be addressed through a practical viewpoint. Methods: The systematic review is applied to define the nature of knowledge and the characteristics of research papers in architectural EBD while analyzing the field of study, knowledge focus and types of keywords of the first author. Results: As a whole, the types of research focus evaluated using the most frequent keywords include function(40.86%), specialized knowledge(30.52%), professional practice(21.37%), and health(5.78%). Empirical research(83.72%) is more likely to be found than theoretical research(13.95%). The EBD research papers ranked as top-tier are only 7(2.03%) among a total of 344, while the research papers ranked in the third to fourth tiers are 276(80.23%). Implications: There is a deficiency of reliable 1-2 tier research papers. From a practical viewpoint, it would be realistic to recommend that healthcare architects appropriately evaluate the quality of EBD research and apply it in practice, rather than to conduct EBD research themselves. This systematic review illustrates the nature of EBD research.

Evidential Analytic Hierarchy Process Dependence Assessment Methodology in Human Reliability Analysis

  • Chen, Luyuan;Zhou, Xinyi;Xiao, Fuyuan;Deng, Yong;Mahadevan, Sankaran
    • Nuclear Engineering and Technology
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    • 제49권1호
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    • pp.113-123
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    • 2017
  • In human reliability analysis, dependence assessment is an important issue in risky large complex systems, such as operation of a nuclear power plant. Many existing methods depend on an expert's judgment, which contributes to the subjectivity and restrictions of results. Recently, a computational method, based on the Dempster-Shafer evidence theory and analytic hierarchy process, has been proposed to handle the dependence in human reliability analysis. The model can deal with uncertainty in an analyst's judgment and reduce the subjectivity in the evaluation process. However, the computation is heavy and complicated to some degree. The most important issue is that the existing method is in a positive aspect, which may cause an underestimation of the risk. In this study, a new evidential analytic hierarchy process dependence assessment methodology, based on the improvement of existing methods, has been proposed, which is expected to be easier and more effective.

미국의 PSA 진단검사 논쟁과 유연한 근거중심의학 (The PSA Testing Debate in the U.S and Flexible Evidence-Based Medicine)

  • 현재환
    • 과학기술학연구
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    • 제13권1호
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    • pp.77-109
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    • 2013
  • 현재 의료체계의 주된 변화로 근거중심의학(Evidence-based Medicine: EBM)의 전지구적확산을 꼽을 수 있다. 최근 STS 연구들은 EBM이 실제 의학 실행 속에서 어떻게 사용되고 작동하는지에 대한 검토를 수행했는데, 이 글은 이러한 맥락 속에서 전립선암 특이항원(Prostate-specific Antigen: PSA) 의 조기진단 검사 도구 사용 여부를 둘러싸고 미국에서 벌어진 논쟁을 추적한다. 본 연구는 EBM이 PSA 검사 조기진단의 지지자와 반대자 양측에서 논쟁의 자원으로 이용되었으며, 그 과정에서 '확고한 과학적 기준'을 제시할 것으로 기대되던 EBM의 과학적 증거 위계가 행위자들의 의도에 따라 사실상'유연하게' 해석되고 동원되었음을 보일 것이다. 나아가, 이 글은 현재 EBM이 PSA 검사 반대자를 지지하는 것처럼 보이는 일은 삶의 질이라는 가치가 EBM의 체계 내에 주요한 변수로 부상하는 역사적 맥락에 의해 만들어진 결과임을 드러낼 것이다. 본 사례 연구는 EBM 시대에 의료기술에 관한 논쟁을 검토하는 연구자들이 EBM이라는 대상을 주어진 것으로 간주하기 보다는 논쟁 속에서 맥락화하여 논쟁과 함께 분석해야 함을 시사한다.

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AHP에서의 응답일관성 모수의 통계적 특성과 활용 방안 (Statistical Characteristics of Response Consistency Parameters in Analytic Hierarchy Process)

  • 고길곤;이경전
    • 한국경영과학회지
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    • 제26권4호
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    • pp.71-82
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    • 2001
  • Using the computer simulation method, we invest19ate the probability distribution of maximum eigenvalue of pair-wise comparison matrix, which has been used as a parameter for measuring the consistency of responses in analytic hierarchy process (AHP). We show that the shape of the distribution of the maximum eigenvalue is different according to the dimension of the matrix. In addition, we cannot find any evidence that the distribution of the Consistency Index is a Normal distribution, which has been claimed in the Previous literature. Accordingly, we suggest using so called K-index calcu1ated based on the concept of cumulative distribution function lather than based on that of arithmetic mean because the probabilistic distribution cannot be assumed to be a Normal distribution. We interpret the simulation results by comparing them with the suggestion of Saaty[11]. Our results show that using Saaty's value could be too generous when the dimension of the matrix is 3 and strict over 4. Finally, we propose new criteria for measuring the response consistency in AHP.

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간호사의 근거중심실무역량에 대한 영향요인 (Factors Influencing Competency in Evidence-based Practice among Clinical Nurses)

  • 김연숙;김지미;박미미
    • 간호행정학회지
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    • 제21권2호
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    • pp.143-153
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    • 2015
  • Purpose: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. Methods: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. Results: The overall mean score for competency in EBP was $3.03{\pm}0.53$. Factors influencing competency in EBP were education (${\beta}=0.23$, p<.001), attendance at lectures on EBP (${\beta}=0.18$, p<.001), intellectual eagerness & healthy skepticism (${\beta}=0.27$, p<.001) among CTD, and hierarchy-oriented OC (${\beta}=0.14$, p=.005), which explained about 35% of the total variance. Conclusion: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

초등과학 영재의 논증활동에서 사용된 증거의 수준 분석 (An Analysis on the Level of Evidence used in Gifted Elementary Students' Debate)

  • 조현준;양일호;이효녕;송윤미
    • 한국과학교육학회지
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    • 제28권5호
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    • pp.495-505
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    • 2008
  • 이 연구의 목적은 초등 과학영재들의 논증활동에서 활용되는 증거들의 전개 양상과 수준을 Perella's Hierarchy of Evidence를 바탕으로 분석하는 것이다. 연구를 위하여 K대학 부설 과학영재교육원 초등과학 영재반 (5학년 5명, 6학년 10명) 15명을 연구 대상으로 선정하였으며 논증과제를 2주전 미리 부여한 뒤, 논증과제에 대한 찬성 또는 반대의 입장을 학생들이 각자 자유롭게 선택하여 총 2시간 동안 논증활동을 하였다. 연구자는 논증과정을 관찰하고 촬영, 녹음한 뒤 전 과정을 전사하여 분석하였다. 전사한 자료를 발화순서에 따라 Protocol Number를 부여한 뒤, 찬성팀과 반대팀이 논증활동을 전개하는 흐름을 파악하고 그 과정에서 나타나는 특징을 살펴보았다. 그리고 주장이나 반론, 답변 등에 사용되는 증거를 Perella's Hierarchy of Evidence 에 따라 Level 1부터 Level 6까지 등급화하여 각 수준별 빈도수를 구하였다. 이 연구 결과를 통하여 초등 과학영재들은 전체적으로 주장-반론-재반론의 순서가 반복되는 논증활동을 하며 사용된 50%이상의 증거가 Level 1과 Level 2였으며 Level 4 이상의 높은 수준의 증거는 20% 내외인 것을 알 수 있었다. 초등과학영재들은 논증과제에 대한 찬성, 반대 입장에 관계없이 통계 자료나 연구결과와 같이 신뢰할 수 있는 객관적 증거들을 사용하기 보다는 개인의 생각이나 경험, 타인의 경험, 개인의 추측 등 출처와 진위 여부를 확인할 수 없는 낮은 수준의 증거를 사용하여 약한 논증을 하고 있었다. 반면에, 상대방의 주장에 따르는 증거가 신뢰할 수 없거나 납득하기에 부족할 때에는 증거가 부족함을 지적하면서 상대방의 주장을 반박하는 상반되는 모습을 보이기도 하였다. 그리고 상대방이 상황이나 용어에 대한 인식이 부족하여 질문을 하거나 구체적 설명 또는 주장에 따르는 증거 제시를 요청할 경우, 답변을 하기도 하지만 답변이 어렵거나 증거가 부족하면 요청을 무시하고 새로운 화제로 급전환하였다. 또한 논증활동 중에 상대방이 자신의 주장에 대해 실험 연구 결과와 같은 높은 수준의 증거를 제시하며 반론할 경우, 수용하거나 재반론하기 보다는 자신의 주장을 반복하여 진술하거나 갑자기 다른 주장으로 돌려 회피하려 하였으며 논증활동 중에 주장의 일치에 도달하지 못하고 계속적으로 대립될 경우, 수 초간 침묵이 흐르다가 의견이 합의되지 않은 채 다른 화제로 전환하는 경향이 있었다. 이러한 연구 결과로부터 초등 과학영재들이 보다 높은 수준의 증거를 사용하여 강한 논증을 할 수 있도록 논증과정을 활용한 교수 프로그램 및 교사 인식 재고를 위한 교사 교육 프로그램을 개발할 필요가 있다.

CBAM과 AHP를 이용한 아키텍처 평가 (Architecture Evaluation Utilizing CBAM and AHP)

  • 이지현;강성원;조진희;김진삼
    • 정보처리학회논문지D
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    • 제13D권5호
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    • pp.683-690
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    • 2006
  • CBAM(Cost Benefit Analysis Method)은 아키텍처 전략을 평가할 때 전략으로 인하여 얻게 될 이익(Benefit)뿐만 아니라 비용(Cost) 스케줄, 위험을 함께 고려하여 최적의 아키텍처 전략을 결정하도록 하기 위한 방법이다. 그러나 CBAM은 아키텍처 전략을 평가하는 과정이 이해당사자들의 합의나 투표, 경험적 직관에 의존하고 있어 결정에 대한 명시적인 정량적 증거를 제시하고 있지 못하다. 본 연구에서는 CBAM에서 제시한 이해당사자들의 합의나 투표를 수행하는 과정에 계층분석적 의사 결정 방법인 AHP(Analytic Hierarchy Process)를 도입하여 아키텍처 전략 결정의 증거를 명시적으로 제시할 뿐만 아니라 주관적 판단 오류의 가능성을 줄이고자 한다.

Evidence based practice within the complementary medicine context

  • McLean, Lisa;Micalos, Peter Steve;McClean, Rhett;Pak, Sok Cheon
    • 셀메드
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    • 제6권3호
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    • pp.15.1-15.4
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    • 2016
  • Evidence based practice (EBP) is a system of applying the most current and valid high quality evidence to support clinical decision making in a healthcare setting. In the twenty five years since its inception, EBP has become the accepted benchmark for excellence in healthcare. Although the system emerged within the biomedical sciences, in the years since EBP has become normative across all healthcare modalities from dentistry, allied health to complementary and alternative medicine (CAM). Practicing evidence based medicine within any modality potentially offers the patient the best available care based on high quality evidence. Yet it is the nature of the evidence that provokes some questions about the suitability of EBP across all modalities of healthcare. The meta analysis of randomized controlled trial (RCT) stands at the pinnacle of the hierarchy of evidence in EBP. This forms a challenge to CAM due to the difficulty in reducing the elementals of a holistic naturopathic assessment of a patient into an answerable question to be tested within a RCT. On one level this makes EBP paradigmatically incompatible with CAM, yet on another level it presents the opportunity to redefine the parameters of what is considered high level evidence. EBP has become a tool, and at times a weapon wielded by governments and health insurance companies to direct healthcare funding and policy. The implications of the nature of accepted evidence are becoming far reaching. The pursuit of the best available healthcare for each individual is the focus of EBP. However, the injudicious use of this system to direct health policy is fraught with biomedical bias and dominance. This issue raises the challenge to CAM to present high level evidence according to the rules of evidence, or face the annihilation of centuries of empirical knowledge.

한국과 미국의 의료건축 설계 연구의 특성 비교 - KIHA와 HERD의 연구경향 분석을 중심으로 (Comparative Analysis of Healthcare Architecture Design Research between Korea and the United States - Centered on the Analysis of Research Trends in KIHA and HERD)

  • 김덕수;권준범
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제30권2호
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    • pp.7-14
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    • 2024
  • Purpose: This study aims to examine the trends in healthcare architecture research by analyzing papers published in KIHA (Journal of the Korea Institute of Healthcare Architecture) and HERD (Health Environments Research and Design Journal) in the USA. The analysis categorizes these papers into Evidence-Based Design (EBD) and non-EBD research from a comparative perspective. Methods: A systematic literature review was conducted on 370 papers published in KIHA and 399 papers published in HERD from 2007 to 2022. The research trends were analyzed based on the researchers' fields of study, research focus, and research attributes. Results: The findings indicate that HERD involves researchers from 43 different fields, whereas KIHA involves researchers from 16 fields, indicating less diversity. HERD predominantly includes interdisciplinary and empirical studies, while KIHA primarily features theoretical and single-discipline studies. Papers in HERD generally demonstrate a higher level of evidence compared to those in KIHA. Implications: Direct comparisons should be approached with caution due to the differing contexts of healthcare architecture research in the two countries. The methodological efforts in HERD and the functional analysis results in KIHA provide valuable references for the future direction of healthcare architecture research. Expanding collaborative and interdisciplinary research involving various professionals is essential to advance the field.

A New Type of NPI Licensing Context: Evidence from French Subjunctive and NE Expletif

  • Choi, Yoon-Hee
    • 한국언어정보학회:학술대회논문집
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    • 한국언어정보학회 2007년도 정기학술대회
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    • pp.115-125
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    • 2007
  • The purpose of this paper is to propose a new type of NPI licensing context through French subjunctive and ne expletif. The distribution of NPIs on previous studies does not exactly correspond to negative function types. French subjunctive and ne expletif are good guidelines for reclassifying NPI licensing context. My classification is by a hierarchy of strength in negative force: overtly negative proposition > negative entailment > negative implicature. A new type of NPI licensing context is: (i) I-domain for negative implicature (ⅱ) E-domain for negative entailment and (ⅲ) overt negation.

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