1.Development of Quality Management Systems for Clinical Practice Guidelines in Korea.
Heui Sug JO ; Dong Ik KIM ; Sung Goo CHANG ; Ein Soon SHIN ; Moo Kyung OH
Journal of Korean Medical Science 2015;30(11):1553-1557
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.
Guideline Adherence/*standards
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*Models, Organizational
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Practice Guidelines as Topic/*standards
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Quality Assurance, Health Care/*standards
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Republic of Korea
2.Osteoporosis Risk Prediction for Bone Mineral Density Assessment of Postmenopausal Women Using Machine Learning.
Tae Keun YOO ; Sung Kean KIM ; Deok Won KIM ; Joon Yul CHOI ; Wan Hyung LEE ; Ein OH ; Eun Cheol PARK
Yonsei Medical Journal 2013;54(6):1321-1330
PURPOSE: A number of clinical decision tools for osteoporosis risk assessment have been developed to select postmenopausal women for the measurement of bone mineral density. We developed and validated machine learning models with the aim of more accurately identifying the risk of osteoporosis in postmenopausal women compared to the ability of conventional clinical decision tools. MATERIALS AND METHODS: We collected medical records from Korean postmenopausal women based on the Korea National Health and Nutrition Examination Surveys. The training data set was used to construct models based on popular machine learning algorithms such as support vector machines (SVM), random forests, artificial neural networks (ANN), and logistic regression (LR) based on simple surveys. The machine learning models were compared to four conventional clinical decision tools: osteoporosis self-assessment tool (OST), osteoporosis risk assessment instrument (ORAI), simple calculated osteoporosis risk estimation (SCORE), and osteoporosis index of risk (OSIRIS). RESULTS: SVM had significantly better area under the curve (AUC) of the receiver operating characteristic than ANN, LR, OST, ORAI, SCORE, and OSIRIS for the training set. SVM predicted osteoporosis risk with an AUC of 0.827, accuracy of 76.7%, sensitivity of 77.8%, and specificity of 76.0% at total hip, femoral neck, or lumbar spine for the testing set. The significant factors selected by SVM were age, height, weight, body mass index, duration of menopause, duration of breast feeding, estrogen therapy, hyperlipidemia, hypertension, osteoarthritis, and diabetes mellitus. CONCLUSION: Considering various predictors associated with low bone density, the machine learning methods may be effective tools for identifying postmenopausal women at high risk for osteoporosis.
Aged
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*Artificial Intelligence
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Bone Density/*physiology
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Female
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Humans
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Middle Aged
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Osteoporosis, Postmenopausal
3.Guidelines for Safe Drug Use
Su Hyun KIM ; Hye-Kyung JUNG ; Ein-Soon SHIN ; Jin Seo LEE ; Yon Ju RYU ; Kyoung Sup HONG ; Soo Mee BANG ; Yoon-Seok CHANG ; Chan Kyu KIM ; Byung Wan LEE ; Seung-Jae HONG ; Chang Oh KIM ;
Korean Journal of Medicine 2021;96(3):225-235
Background/Aims:
In Korea, medications are available by prescription from a physician, or can be purchased over-the-counter (OTC) without a prescription. Education regarding both prescribed and OTC drugs is important to minimize side effects and avoid drug abuse. The risk of side effects due to polypharmacy is increasing due to the growing number of elderly patients with comorbidities.
Methods:
There are various clinical guidelines for physicians, but it is difficult for patients and their caregivers to find published guidelines regarding drug use. In this regard, experts from nine subspecialties of internal medicine, geriatric medicine, and guideline development methodology formed a working group to develop guidelines for safe drug use under the Clinical Practice Guidelines Committee of the Korean Association of Internal Medicine.
Results:
The main contents of this guideline are 1) safe and effective drug administration, 2) the proper use of analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs), 3) the proper use of tranquilizers and sleeping pills to prevent drug abuse, 4) points to be aware of when taking multiple medications.
Conclusions
The guidelines were developed for patients and their caregivers to understand the general principles and precautions for drug use, including commonly used painkillers, mood stabilizers, sleeping pills, and polypharmacy. These guidelines could also be used as educational materials for physicians, nurses, and healthcare workers to educate patients and their caregivers.
4.Guidelines for Safe Drug Use
Su Hyun KIM ; Hye-Kyung JUNG ; Ein-Soon SHIN ; Jin Seo LEE ; Yon Ju RYU ; Kyoung Sup HONG ; Soo Mee BANG ; Yoon-Seok CHANG ; Chan Kyu KIM ; Byung Wan LEE ; Seung-Jae HONG ; Chang Oh KIM ;
Korean Journal of Medicine 2021;96(3):225-235
Background/Aims:
In Korea, medications are available by prescription from a physician, or can be purchased over-the-counter (OTC) without a prescription. Education regarding both prescribed and OTC drugs is important to minimize side effects and avoid drug abuse. The risk of side effects due to polypharmacy is increasing due to the growing number of elderly patients with comorbidities.
Methods:
There are various clinical guidelines for physicians, but it is difficult for patients and their caregivers to find published guidelines regarding drug use. In this regard, experts from nine subspecialties of internal medicine, geriatric medicine, and guideline development methodology formed a working group to develop guidelines for safe drug use under the Clinical Practice Guidelines Committee of the Korean Association of Internal Medicine.
Results:
The main contents of this guideline are 1) safe and effective drug administration, 2) the proper use of analgesics (acetaminophen and nonsteroidal anti-inflammatory drugs), 3) the proper use of tranquilizers and sleeping pills to prevent drug abuse, 4) points to be aware of when taking multiple medications.
Conclusions
The guidelines were developed for patients and their caregivers to understand the general principles and precautions for drug use, including commonly used painkillers, mood stabilizers, sleeping pills, and polypharmacy. These guidelines could also be used as educational materials for physicians, nurses, and healthcare workers to educate patients and their caregivers.