1
|
Oh C, Lim J, Jung YS, Kim Y, Jung K, Hong S, Won Y. Decreasing trends in thyroid cancer incidence in South Korea: What happened in South Korea? Cancer Med 2021; 10:4087-4096. [PMID: 33979040 PMCID: PMC8209587 DOI: 10.1002/cam4.3926] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 03/22/2021] [Accepted: 04/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND South Korea has the highest incidence of thyroid cancer in the world. Our study examined the trends in thyroid cancer incidence by the histologic type, cancer stage, and age group and explored possible factors that affected thyroid cancer trends. METHODS We conducted a descriptive epidemiological study using the national cancer registry data and cause of death data from 1999 to 2016 in South Korea. Age-standardized rates were calculated using Segi's world standard population. Joinpoint regression analysis was applied to determine the changing point of thyroid cancer trends according to histologic type; Surveillance, Epidemiology, and End Results (SEER) summary stage; and age groups by sex. RESULTS The age-standardized incidence of thyroid cancer in both men and women increased from 6.3 per 100,000 people in 1999 to 63.4 per 100,000 in 2012 but declined from 2012 to 2016, before the debates for over diagnosis of thyroid cancer began in 2014. The age-standardized mortality rate of thyroid cancer, incidence of distant thyroid cancer, and incidence of regional and localized thyroid cancer started to decline since early 2000, 2010, and 2012, respectively. In addition, thyroid cancer prevalence in thyroid nodules showed decreasing trends from 1999-2000 to 2013-2014. CONCLUSIONS The incidence of thyroid cancer began declining from 2012, before the debates for over diagnosis of thyroid cancer began in 2014. Changes in guidelines for thyroid nodule examinations may have affected this inflection point. Moreover, the debates for over diagnosis of thyroid cancer may have accelerated the decline in thyroid cancer.
Collapse
Affiliation(s)
- Chang‐Mo Oh
- Department of Preventive MedicineSchool of MedicineKyung Hee UniversitySeoulSouth Korea
| | - Jiwon Lim
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Yuh Seog Jung
- Department of Otolaryngology‐Head and Neck SurgeryHead & Neck Oncology ClinicCenter for Thyroid CancerNational Cancer Center HospitalGoyangSouth Korea
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
| | - Yeol Kim
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
- Division of Cancer Management & PolicyNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Kyu‐Won Jung
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Seri Hong
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
| | - Young‐Joo Won
- Division of Cancer Registration and SurveillanceNational Cancer Control InstituteNational Cancer CenterGoyangSouth Korea
- Department of Cancer Control and Population HealthNational Cancer Center Graduate School of Cancer Science and PolicyNational Cancer CenterGoyangSouth Korea
| |
Collapse
|
2
|
Yang Y, Huo H, Jiang J, Sun X, Guan Y, Guo X, Wan X, Liu S. Clinical decision-making framework against over-testing based on modeling implicit evaluation criteria. J Biomed Inform 2021; 119:103823. [PMID: 34044155 DOI: 10.1016/j.jbi.2021.103823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 12/25/2022]
Abstract
Different statistical methods include various subjective criteria that can prevent over-testing. However, no unified framework that defines generalized objective criteria for various diseases is available to determine the appropriateness of diagnostic tests recommended by doctors. We present the clinical decision-making framework against over-testing based on modeling the implicit evaluation criteria (CDFO-MIEC). The CDFO-MIEC quantifies the subjective evaluation process using statistics-based methods to identify over-testing. Furthermore, it determines the test's appropriateness with extracted entities obtained via named entity recognition and entity alignment. More specifically, implicit evaluation criteria are defined-namely, the correlation among the diagnostic tests, symptoms, and diseases, confirmation function, and exclusion function. Additionally, four evaluation strategies are implemented by applying statistical methods, including the multi-label k-nearest neighbor and the conditional probability algorithms, to model the implicit evaluation criteria. Finally, they are combined into a classification and regression tree to make the final decision. The CDFO-MIEC also provides interpretability by decision conditions for supporting each clinical decision of over-testing. We tested the CDFO-MIEC on 2,860 clinical texts obtained from a single respiratory medicine department in China with the appropriate confirmation by physicians. The dataset was supplemented with random inappropriate tests. The proposed framework excelled against the best competing text classification methods with a Mean_F1 of 0.9167. This determined whether the appropriate and inappropriate tests were properly classified. The four evaluation strategies captured the features effectively, and they were imperative. Therefore, the proposed CDFO-MIEC is feasible because it exhibits high performance and can prevent over-testing.
Collapse
Affiliation(s)
- Yang Yang
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin 150001, China
| | - Hongxing Huo
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin 150001, China
| | - Jingchi Jiang
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin 150001, China
| | - Xuemei Sun
- Hospital of Harbin Institute of Technology, Harbin 150003, China
| | - Yi Guan
- School of Computer Science and Technology, Harbin Institute of Technology, Harbin 150001, China.
| | - Xitong Guo
- School of Management, Harbin Institute of Technology, Harbin 150001, China
| | - Xiang Wan
- Shenzhen Research Institute of Big Data, Shenzhen 518000, China
| | - Shengping Liu
- Unisound AI Technology Co., Ltd, Beijing 100083, China
| |
Collapse
|
3
|
Choi TY, Yeom SR, Choi J, Lee JA, Jun JH, Kang BK, Lee MS. Provision of a clinical practice guidelines leaflet improves levels of satisfaction for patients suffering from shoulder pain: A randomized crossover trial. Eur J Integr Med 2021. [DOI: 10.1016/j.eujim.2021.101321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
4
|
Abstract
BACKGROUND The development process of clinical practice guidelines (CPGs) must adhere to development standards and must be supported and steered by a representative and consistent governing body. We aimed to investigate the current status of the most recent CPGs published in Korea through surveys of medical professional societies and literature searches. METHODS We collected CPGs developed in Korea in the past 5 years through several electronic database searches (MEDLINE, Embase, and KoreaMed), hand searches, and surveys of medical society memberships from the Korean Academy Medical Societies. Three authors selected Korean CPGs according to our inclusion/exclusion criteria and extracted data from selected CPGs about general characteristics, characteristics of CPGs for setup, evidence evaluation, and the finalization phase. RESULTS Out of 2,337 articles searched from various sources and 66 documents collected by survey, 129 guidelines (122 by database searching and 7 by survey) were selected. During the recent 5 years, the yearly numbers of CPGs developed were around 25. A single organization was the most frequent CPG development body (42, 32.6%). The most common development methodologies described in the CPGs included were de novo (53, 41.1%) followed by adaptation (48, 37.2%) and hybrid (4, 3.1%). Systematic literature searching was performed in most of the guidelines (79.8%). The evidence level was reported in 104 guidelines (80.6%). There were 77 guidelines (59.7%) that reported an update plan. Fifty guidelines were published in Korean (41.0%), and 46 guidelines were published in English only (37.7%). CONCLUSION Among CPGs developed in Korea in the last 5 years, the proportion adhering to CPG development standards has increased, but there is still room for improvement.
Collapse
Affiliation(s)
- Miyoung Choi
- National Evidence-based Healthcare Collaborating Agency, Seoul, Korea
| | - Soo Young Kim
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
| | - You Kyung Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | | |
Collapse
|
5
|
Park YR, Koo H, Yoon YK, Park S, Lim YS, Baek S, Kim HR, Kim TW. Expedited Safety Reporting to Sponsors Through the Implementation of an Alert System for Clinical Trial Management at an Academic Medical Center: Retrospective Design Study. JMIR Med Inform 2020; 8:e14379. [PMID: 32130175 PMCID: PMC7068534 DOI: 10.2196/14379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 09/09/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022] Open
Abstract
Background Early detection or notification of adverse event (AE) occurrences during clinical trials is essential to ensure patient safety. Clinical trials take advantage of innovative strategies, clinical designs, and state-of-the-art technologies to evaluate efficacy and safety, however, early awareness of AE occurrences by investigators still needs to be systematically improved. Objective This study aimed to build a system to promptly inform investigators when clinical trial participants make unscheduled visits to the emergency room or other departments within the hospital. Methods We developed the Adverse Event Awareness System (AEAS), which promptly informs investigators and study coordinators of AE occurrences by automatically sending text messages when study participants make unscheduled visits to the emergency department or other clinics at our center. We established the AEAS in July 2015 in the clinical trial management system. We compared the AE reporting timeline data of 305 AE occurrences from 74 clinical trials between the preinitiative period (December 2014-June 2015) and the postinitiative period (July 2015-June 2016) in terms of three AE awareness performance indicators: onset to awareness, awareness to reporting, and onset to reporting. Results A total of 305 initial AE reports from 74 clinical trials were included. All three AE awareness performance indicators were significantly lower in the postinitiative period. Specifically, the onset-to-reporting times were significantly shorter in the postinitiative period (median 1 day [IQR 0-1], mean rank 140.04 [SD 75.35]) than in the preinitiative period (median 1 day [IQR 0-4], mean rank 173.82 [SD 91.07], P≤.001). In the phase subgroup analysis, the awareness-to-reporting and onset-to-reporting indicators of phase 1 studies were significantly lower in the postinitiative than in the preinitiative period (preinitiative: median 1 day, mean rank of awareness to reporting 47.94, vs postinitiative: median 0 days, mean rank of awareness to reporting 35.75, P=.01; and preinitiative: median 1 day, mean rank of onset to reporting 47.4, vs postinitiative: median 1 day, mean rank of onset to reporting 35.99, P=.03). The risk-level subgroup analysis found that the onset-to-reporting time for low- and high-risk studies significantly decreased postinitiative (preinitiative: median 4 days, mean rank of low-risk studies 18.73, vs postinitiative: median 1 day, mean rank of low-risk studies 11.76, P=.02; and preinitiative: median 1 day, mean rank of high-risk studies 117.36, vs postinitiative: median 1 day, mean rank of high-risk studies 97.27, P=.01). In particular, onset to reporting was reduced more in the low-risk trial than in the high-risk trial (low-risk: median 4-0 days, vs high-risk: median 1-1 day). Conclusions We demonstrated that a real-time automatic alert system can effectively improve safety reporting timelines. The improvements were prominent in phase 1 and in low- and high-risk clinical trials. These findings suggest that an information technology-driven automatic alert system effectively improves safety reporting timelines, which may enhance patient safety.
Collapse
Affiliation(s)
- Yu Rang Park
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - HaYeong Koo
- Clinical Research Center, Asan Institute of Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Young-Kwang Yoon
- Clinical Research Center, Asan Institute of Life Sciences, Asan Medical Center, Seoul, Republic of Korea
| | - Sumi Park
- Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea
| | - Young-Suk Lim
- Clinical Trial Center, Asan Medical Center, Seoul, Republic of Korea.,Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seunghee Baek
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hae Reong Kim
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Tae Won Kim
- Clinical Research Center, Asan Institute of Life Sciences, Asan Medical Center, Seoul, Republic of Korea.,Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
6
|
Memaryan N, Ghaempanah Z, Aghababaei N, Koenig HG. Integration of Spiritual Care in Hospital Care System in Iran. JOURNAL OF RELIGION AND HEALTH 2020; 59:82-95. [PMID: 31227979 DOI: 10.1007/s10943-019-00864-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
There is a growing body of evidence on the positive effects of religion and spirituality on recovery from cancer and the ability to cope with it. Most spiritual interventions carried out in Iranian research are based on care and support models that have been developed in the West. With the unique cultural and religious features of the Iranian context, a more refined look at spiritual care in the hospital care system of Iran is called for. This paper examines how to implement the spiritual care of cancer patients in hospitals and oncology wards in Iran. A consensus panel of experts was used to develop guidelines for spiritually integrated care consisting of 18 primary areas, which are described in detail in this report. Health care policy makers and managers of health care in Iran and possibly other areas of the Middle East should consider implementing these guidelines. Using indigenous models and programs specific to the religion and the cultural of a region should be considered when providing spiritual care for cancer patients.
Collapse
Affiliation(s)
- Nadereh Memaryan
- Spiritual Health Research Center, Mental Health Department, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Ghaempanah
- Spiritual Health Research Center, Iran University of Medical Sciences, Shahid Mansouri Street, Niyayesh Street, Satarkhan Avenue, Tehran, 1445613111, Iran.
- Office of Islamic Studies in Mental Health, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran.
| | - Naser Aghababaei
- Department of Behavioral Sciences, The Institute for Research and Development in the Humanities (SAMT), Tehran, Iran
| | - Harold G Koenig
- Center for Spirituality, Theology and Health Duke University Medical Center, Durham, NC, USA
- Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Ningxia Medical University, Yinchuan, People's Republic of China
| |
Collapse
|
7
|
Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU. Crit Care Med 2019; 46:e825-e873. [PMID: 30113379 DOI: 10.1097/ccm.0000000000003299] [Citation(s) in RCA: 1834] [Impact Index Per Article: 366.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To update and expand the 2013 Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the ICU. DESIGN Thirty-two international experts, four methodologists, and four critical illness survivors met virtually at least monthly. All section groups gathered face-to-face at annual Society of Critical Care Medicine congresses; virtual connections included those unable to attend. A formal conflict of interest policy was developed a priori and enforced throughout the process. Teleconferences and electronic discussions among subgroups and whole panel were part of the guidelines' development. A general content review was completed face-to-face by all panel members in January 2017. METHODS Content experts, methodologists, and ICU survivors were represented in each of the five sections of the guidelines: Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption). Each section created Population, Intervention, Comparison, and Outcome, and nonactionable, descriptive questions based on perceived clinical relevance. The guideline group then voted their ranking, and patients prioritized their importance. For each Population, Intervention, Comparison, and Outcome question, sections searched the best available evidence, determined its quality, and formulated recommendations as "strong," "conditional," or "good" practice statements based on Grading of Recommendations Assessment, Development and Evaluation principles. In addition, evidence gaps and clinical caveats were explicitly identified. RESULTS The Pain, Agitation/Sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) panel issued 37 recommendations (three strong and 34 conditional), two good practice statements, and 32 ungraded, nonactionable statements. Three questions from the patient-centered prioritized question list remained without recommendation. CONCLUSIONS We found substantial agreement among a large, interdisciplinary cohort of international experts regarding evidence supporting recommendations, and the remaining literature gaps in the assessment, prevention, and treatment of Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) in critically ill adults. Highlighting this evidence and the research needs will improve Pain, Agitation/sedation, Delirium, Immobility (mobilization/rehabilitation), and Sleep (disruption) management and provide the foundation for improved outcomes and science in this vulnerable population.
Collapse
|
8
|
Preferred Reporting Items for the Development of Evidence-based Clinical Practice Guidelines in Traditional Medicine (PRIDE-CPG-TM): Explanation and elaboration. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.07.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
9
|
Lee JA, Choi J, Choi TY, Jun JH, Lee D, Roh SS, Lee MS. Clinical practice guidelines of Korean medicine on acupuncture and herbal medicine for atopic dermatitis: A GRADE approach. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.07.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
10
|
Chang SG, Kim DI, Shin ES, Jang JE, Yeon JY, Lee YS. Methodological Quality Appraisal of 27 Korean Guidelines Using a Scoring Guide Based on the AGREE II Instrument and a Web-based Evaluation. J Korean Med Sci 2016; 31:682-7. [PMID: 27134487 PMCID: PMC4835591 DOI: 10.3346/jkms.2016.31.5.682] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 01/27/2016] [Indexed: 11/26/2022] Open
Abstract
This study evaluated the methodological quality of CPGs using the Korean AGREE II scoring guide and a web-based appraisal system and was conducted by qualified appraisers. A total of 27 Korean CPGs were assessed under 6 domains and 23 items on the AGREE II instrument using the Korean scoring guide. The domain scores of the 27 guidelines were as following: the mean domain score was 82.7% (median 84.7%, ranging from 55.6% to 97.2%) for domain 1 (scope and purpose); 53.4% (median 56.9%, ranging from 11.1% to 95.8%) for domain 2 (stakeholder involvement); 63.0% (median 71.4%, ranging from 13.5% to 90.6%) for domain 3 (rigor of development); 88.9% (median 91.7%, ranging from 58.3% to 100.0%) for domain 4 (clarity of presentation); 30.1% (median 27.1%, ranging from 3.1% to 67.7%) for domain 5 (applicability); and 50.2% (median 58.3%, ranging from 0.0% to 93.8%) for domain 6 (editorial independence). Three domains including scope and purpose, rigor of development, and clarity of presentation were rated at more than 60% of the scaled domain score. Three domains including stakeholder involvement, applicability, and editorial independence were rated at less than 60% of the scaled domain score. Finally, of the 27 guidelines, 18 (66.7%) were rated at more than 60% of the scaled domain score for rigor of development and were categorized as high-quality guidelines.
Collapse
Affiliation(s)
- Sung-Goo Chang
- Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dong-Ik Kim
- Department of Radiology, CHA Bundang Medical Center, CHA University, Seoul, Korea
| | - Ein-Soon Shin
- Research Agency for Clinical Practice Guidelines, Research Center, Korean Academy of Medical Sciences, Seoul, Korea
| | - Ji-Eun Jang
- Research Agency for Clinical Practice Guidelines, Research Center, Korean Academy of Medical Sciences, Seoul, Korea
| | - Ji-Yun Yeon
- Research Agency for Clinical Practice Guidelines, Research Center, Korean Academy of Medical Sciences, Seoul, Korea
| | - Yoon-Seong Lee
- Department of Forensic Medicine, Seoul National University College of Medicine, Seoul, Korea
| |
Collapse
|
11
|
An SY, Kim HJ, Kim S, Kim J, Seo KS, Lee DW, Hwang KG. Study on the trends in Korean clinical practice guidelines development. J Dent Anesth Pain Med 2016; 16:31-37. [PMID: 28879293 PMCID: PMC5564116 DOI: 10.17245/jdapm.2016.16.1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 01/28/2016] [Accepted: 03/09/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The definition of evidence-based clinical practice guidelines (CPGs) is "statements that are systematically developed to assist in the doctors' and patients' decision-making in certain situations." This study aims to establish the concept of evidence-based CPGs and investigate the development status to seek measures to apply evidence-based methods to CPG development for dental sedation in Korea. METHODS The study conducted systematic searching methods based on evidence-based CPGs. Articles published between 1995 to 2015 were searched on a Korean database and the international database PubMed. The search was based on keywords related to four subjects (dentistry, clinical practice, guideline, recommendation). Two authors independently reviewed the searched articles to determine their analysis inclusion and the convergence stages, and to arrive at a conclusion through discussion. RESULTS A total of 65 Korean CPGs were included. There were 51 medical guidelines, of which seven were dental and seven were Oriental medicine. CONCLUSIONS As a basic direction for the development of evidence-based CPGs, this work suggests the following: increased awareness; consensus on the need to supply evidence-based development methods; education, computerization, and systematic observation of evidence-based CPG development methods; continuous research development and distribution of CPGs; and creation of a database for Korean clinical dentistry practice outcomes.
Collapse
Affiliation(s)
- So-Youn An
- Department of Pediatric dentistry, College of Dentistry, Wonkwang University, Daejeon, Korea
| | - Hyun Jeong Kim
- Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Seungoh Kim
- Department of Dental Anesthesiology, School of Dentistry, Dankook University, Cheonan, Korea
| | - Jongbin Kim
- Department of Pediatric Dentistry, School of Dentistry, Dankook University, Cheonan, Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Deok-Won Lee
- Department of Oral and Maxillofacial Surgery, Kyung Hee University Dental Hospital at Gangdong, Kyung Hee University, Seoul, Korea
| | - Kyung-Gyun Hwang
- Department of Dentistry/Oral & Maxillofacial Surgery, College of Medicine, Hanyang University, Seoul, Korea
| |
Collapse
|
12
|
Jo HS, Kim DI, Oh MK. National Priority Setting of Clinical Practice Guidelines Development for Chronic Disease Management. J Korean Med Sci 2015; 30:1733-42. [PMID: 26713047 PMCID: PMC4689816 DOI: 10.3346/jkms.2015.30.12.1733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 08/18/2015] [Indexed: 11/21/2022] Open
Abstract
By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.
Collapse
Affiliation(s)
- Heui-Sug Jo
- Department of Health Management and Policy, Kangwon National University School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guidelines, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Dong Ik Kim
- Department of Radiology, Yonsei University Sevrance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| |
Collapse
|
13
|
Jo HS, Kim DI, Chang SG, Shin ES, Oh MK. Development of Quality Management Systems for Clinical Practice Guidelines in Korea. J Korean Med Sci 2015; 30:1553-7. [PMID: 26538997 PMCID: PMC4630469 DOI: 10.3346/jkms.2015.30.11.1553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 08/05/2015] [Indexed: 11/20/2022] Open
Abstract
This study introduces the Clinical practice guidelines (CPGs) appraisal system by the Korean Academy of Medical Sciences (KAMS). Quality management policies for CPGs vary among different countries, which have their own cultures and health care systems. However, supporting developers in guideline development and appraisals using standardized tools are common practices. KAMS, an organization representing the various medical societies of Korea, has been striving to establish a quality management system for CPGs, and has established a CPGs quality management system that reflects the characteristics of the Korean healthcare environment and the needs of its users. KAMS created a foundation for the development of CPGs, set up an independent appraisal organization, enacted regulations related to the appraisals, and trained appraisers. These efforts could enhance the ability of each individual medical society to develop CPGs, to increase the quality of the CPGs, and to ultimately improve the quality of the information available to decision-makers.
Collapse
Affiliation(s)
- Heui-Sug Jo
- Department of Health Management and Policy, Kangwon National University, School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Dong Ik Kim
- Department of Radiology, Yonsei University Sevrance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-Goo Chang
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Department of Urology, Kyung Hee University Medical Center, School of Medicine Kyung-Hee University, Seoul, Korea
| | - Ein-Soon Shin
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Research Agency for Clinical Practice Guidelines, KAMS Research Center, The Korean Academy of Medical Sciences, Seoul, Korea
| | - Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| |
Collapse
|
14
|
Choi TY, Choi J, Lee JA, Jun JH, Park B, Lee MS. The quality of clinical practice guidelines in traditional medicine in Korea: appraisal using the AGREE II instrument. Implement Sci 2015; 10:104. [PMID: 26216349 PMCID: PMC4515911 DOI: 10.1186/s13012-015-0294-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 07/15/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the quality of the current clinical practice guidelines (CPGs) in traditional medicine (TM) in South Korea using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument to further enhance the CPG development. METHODS A search was performed for guidelines in Korea from inception until March 2014 in the major Korean guideline websites [the Korean Medical Guideline Information Centre (KoMGI), the Korean Guideline Clearing House (KGC)], PubMed and seven Korean electronic databases; the Association of Korean Oriental Medicine (AKOM) was also consulted. Five independent assessors rated the quality of each CPG using the AGREE II instrument and calculated the mean score of each AGREE item. The overall agreement amongst reviewers was evaluated using the intra-class correlation coefficient (ICC). RESULTS Initially, 17 CPGs were examined for TM in Korea, and only 8 CPGs satisfied the inclusion criteria. The mean scores for each AGREE II domain were as follows: (1) scope and purpose, 60.0 % (CIs, 45.05-74.94 %); (2) stakeholder involvement, 56.11 % (41.28-70.94 %); (3) rigour of development, 42.7 % (23.48-61.92 %); (4) clarity and presentation, 62.50 % (50.89-74.10 %); (5) applicability, 20.31 % (13.96-26.66 %); and (6) editorial independence, 44.58 % (10.78-78.38 %). All of the CPGs were rated as "recommended with provisos or modifications". The ICC values for CPG appraisal using the AGREE II ranged from 0.230 to 0.993. CONCLUSIONS To improve clinical practice and health outcomes, well-developed CPGs are needed. The quality of CPGs for TM in Korea has remained suboptimal according to the AGREE II instrument evaluation. Therefore, guideline developers in Korea should make more of an effort to ensure high-quality CPGs.
Collapse
Affiliation(s)
- Tae-Young Choi
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
| | - Jiae Choi
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
| | - Ju Ah Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
| | - Ji Hee Jun
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
| | - Bongki Park
- Liver and Immunology Research Center, Daejeon Oriental Hospital of Daejeon University, Daejeon, South Korea.
| | - Myeong Soo Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, 305-811, South Korea.
| |
Collapse
|
15
|
Oh MK, Jo H, Lee YK. Improving the reliability of clinical practice guideline appraisals: effects of the Korean AGREE II scoring guide. J Korean Med Sci 2014; 29:771-5. [PMID: 24932076 PMCID: PMC4055808 DOI: 10.3346/jkms.2014.29.6.771] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Accepted: 03/28/2014] [Indexed: 11/20/2022] Open
Abstract
The Korean translated Appraisal of Guidelines for Research and Evaluation II (Korean AGREE II) instrument was distributed into Korean medical societies in 2011. However, inter-rater disagreement issues still exist. The Korean AGREE II scoring guide was therefore developed to reduce inter-rater differences. This study examines the effects of the Korean AGREE II scoring guide to reduce inter-rater differences. Appraisers were randomly assigned to two groups (Scoring Guide group and Non-Scoring Guide group). The Korean AGREE II instrument was provided to both groups. However, the scoring guide was offered to Scoring Guide group only. Total 14 appraisers were participated and each guideline was assessed by 8 appraisers. To evaluate the reliability of the Korean AGREE II scoring guide, correlation of scores among appraisers and domain-specific intra-class correlation (ICC) were compared. Most scores of two groups were comparable. Scoring Guide group showed higher reliability at all guidelines. They showed higher correlation among appraisers and higher ICC values at almost all domains. The scoring guide reduces the inter-rater disagreement and improves the overall reliability of the Korean-AGREE II instrument.
Collapse
Affiliation(s)
- Moo-Kyung Oh
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Heuisug Jo
- Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea
- Department of Health Management and Policy, Kangwon National University School of Medicine, Chuncheon, Korea
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
| | - You Kyoung Lee
- The Executive Committee for Clinical Practice Guideline, The Korean Academy of Medical Sciences, Seoul, Korea
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
- Department of Laboratory Medicine and Genetics, Soonchunhyang University College of Medicine, Cheonan, Korea
| |
Collapse
|
16
|
Choi J, Choi TY, Lee JA, Yun KJ, Lim HJ, Lee MS. Perceptions on developing clinical practice guidelines for traditional medicine in Korea: Results of a web-based survey. Eur J Integr Med 2014. [DOI: 10.1016/j.eujim.2013.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Lee YK, Shin ES, Shim JY, Min KJ, Kim JM, Lee SH. Developing a scoring guide for the Appraisal of Guidelines for Research and Evaluation II instrument in Korea: a modified Delphi consensus process. J Korean Med Sci 2013; 28:190-4. [PMID: 23400114 PMCID: PMC3565128 DOI: 10.3346/jkms.2013.28.2.190] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2012] [Accepted: 12/07/2012] [Indexed: 11/20/2022] Open
Abstract
Korea has a relatively short history in the development and use of clinical practice guidelines (CPGs). Additionally, it has been difficult to employ the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument due to the lack of consensus and the presence of differences in Korean medical settings and in the Korean socio-cultural environment. An AGREE II scoring guide was therefore developed to reduce differences among evaluators using the same tool. In consideration of the importance of using a quantitative measure of satisfaction with the elements described in the AGREE II manual, a final draft was developed through a Delphi consensus process. Ninety-two draft scoring guides for anchor points 1, 3, 5, and 7 (full score) in 23 items were developed. Consensus was defined as agreement among at least 70% of the raters. Agreement on 88 draft scoring guidelines was reached in the first Delphi round, and agreement for the remaining four was achieved in the second round. The development of an AGREE II scoring guide in this study is expected to contribute to improving the CPG environment.
Collapse
Affiliation(s)
- You Kyoung Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Ein Soon Shin
- Department of Preventive Medicine & Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Jae-Yong Shim
- Department of Family Medicine, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Kyung Joon Min
- Department of Psychiatry, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jun-Mo Kim
- Department of Urology, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Hee Lee
- Department of Preventive Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | | | | |
Collapse
|