OBJECTIVE: The goal of this study is to compare the overall quality of film mammograms taken according to the Korean standards with the American College of Radiology (ACR) standard for clinical image evaluation and to identify means of improving mammography quality in Korea. MATERIALS AND METHODS: Four hundred and sixty eight sets of film mammograms were evaluated with respect to the Korean and ACR standards for clinical image evaluation. The pass and failure rates of mammograms were compared by medical facility types. Average scores in each category of the two standards were evaluated. Receiver operating characteristic curve analysis was used to identify an optimal Korean standard pass mark by taking the ACR standard as the reference standard. RESULTS: 93.6% (438/468) of mammograms passed the Korean standard, whereas only 80.1% (375/468) passed the ACR standard (p < 0.001). Non-radiologic private clinics had the lowest pass rate (88.1%: Korean standard, 71.8%: ACR standard) and the lowest total score (76.0) by the Korean standard. Average scores of positioning were lowest (19.3/29 by the Korean standard and 3.7/5 by the ACR standard). A cutoff score of 77.0 for the Korean standard was found to correspond to a pass level when the ACR standard was applied. CONCLUSION: We suggest that tighter regulations, such as, raising the Korean pass mark, subtracting more for severe deficiencies, or considering a very low scores in even a single category as failure, are needed to improve the quality of mammography in Korea.
Accreditation/*standards ; Female ; Humans ; Mammography/*standards ; *Quality Improvement ; ROC Curve ; Republic of Korea ; Retrospective Studies

ABSTRACT Clinical application of standards for reporting interventions in clinical trials of acupuncture (STRICTA) is introduced in this article, and improving opinions are proposed as well. STRICTA has already been extensively applied in designation of acupuncture clinical trials, composition of articles and quality assessment of acupuncture literature. According to the present version of STRICTA, it is suggested that items such as "standards and methods on acupoint selection and location", "angle and direction of needle insertion" and "whether the subjects ever have been acupunctured" should be further perfected. Individuated treat protocols which is highlighted on treatment according to differentiation of syndromes according to different opportunities and stages of diseases should be promoted so as to give better expression to the characteristics of Chinese medicine and enhance the clinical value of the relative literature.
Acupuncture Points ; Acupuncture Therapy ; methods ; standards ; Clinical Trials as Topic ; methods ; standards ; Humans ; Quality Improvement

OBJECTIVE: The purpose of this study was to evaluate any improvement in the quality of abdominal CTs after the utilization of the nationally based accreditation program. MATERIALS AND METHODS: Approval was obtained from the Institutional Review Board, and informed consent was waived. We retrospectively analyzed 1,011 outside abdominal CTs, from 2003 to 2007. We evaluated images using a fill-up sheet form of the national accreditation program, and subjectively by grading for the overall CT image quality. CT scans were divided into two categories according to time periods; before and after the implementation of the accreditation program. We compared CT scans between two periods according to parameters pertaining to the evaluation of images. We determined whether there was a correlation between the results of a subjective assessment of the image quality and the evaluation scores of the clinical image. RESULTS: The following parameters were significantly different after the implementation of the accreditation program: identifying data, display parameters, scan length, spatial and contrast resolution, window width and level, optimal contrast enhancement, slice thickness, and total score. The remaining parameters were not significantly different between scans obtained from the two different periods: scan parameters, film quality, and artifacts. CONCLUSION: After performing the CT accreditation program, the quality of the outside abdominal CTs show marked improvement, especially for the parameters related to the scanning protocol.
*Accreditation ; Humans ; *Quality Improvement ; Radiography, Abdominal/*standards ; Republic of Korea ; Retrospective Studies ; Tomography, X-Ray Computed/*standards

Hemolysis frequently causes preanalytical errors in laboratory measurements. We aimed to develop a quality improvement indicator for evaluating the extent of inappropriate procedures causing hemolysis in clinical samples collected in medical care units. We defined the threshold value of the hemolysis index (H index) causing significant interference with analyte measurement and analyzed the H index values of clinical samples in relation to the threshold. The H index threshold value causing a 10% bias in the measurement of lactate dehydrogenase was found to be 25. The monthly mean H index and monthly frequency of samples with an H index >25 were significantly different among the types of ward (P=0.001, respectively), and significantly decreased after replacement of a laboratory centrifuge lacking temperature control (20.6±0.58 vs 23.30±1.08, P=0.01; 23.4±1.69% vs 32.6±1.78%, P=0.01). The monthly mean H index and the monthly frequency of samples with an H index above a threshold value may be useful quality improvement indicators for detection of inappropriate procedures in the acquisition and handling of blood samples in medical care units.
Hemoglobins/analysis ; Hemolysis ; Humans ; L-Lactate Dehydrogenase/analysis ; Laboratories, Hospital/*standards ; Quality Improvement/*standards ; Specimen Handling

OBJECTIVETo evaluate the methodological qualities of clinical therapeutic research papers published in Chinese Journal of Pediatrics and find out the weaknesses and defects in the literature of clinical therapeutic research in China.

METHODSThe clinical therapeutic research articles from Chinese Journal of Pediatrics, which were published in the years 1999, 2000, 2001, 2009, 2010 and 2011, were analyzed manually, after dividing into randomized controlled trials (RCT) and non-randomized controlled trials. The methodological quality of RCT articles were evaluated by Consolidated Standards for Reporting of Trials (CONSORT) and Jadad scale, while non-RCT reports were assessed by specific evaluation standard criteria and analytical table. And the group A (1999 - 2001) and group B (2009 - 2011) of the quality documents were compared and analyzed.

RESULTSSeventeen RCTs were included. Based on the items in the CONSORT statement, the reporting quality of sample size determination, demographic baseline, random principle, blinding, lost to follow-up were all lower than 50%. Fourteen (82.4%) in the 17 RCTs mentioned 'eligibility criteria for participants', 11 (64.7%) RCTs mentioned 'details of the interventions', 15 (88.2%) RCTs mentioned 'adverse effects'. Compared with RCT reports in the year of 1999, 2000 and 2001, the methodological qualities of those in 2009, 2010 and 2011 were not improved. In the 17 RCTs, the total score achieved based on the Jadad scale, only 11.8% (2 out of 17) were high-quality trials (≥ 3 points). Analysis of the 28 non-RCTs, which were included and assessed by evaluation criteria and evaluation table, also showed some disadvantages on some key items.

CONCLUSIONSThe methodological quality of clinical therapeutic research reports should be consistent with the standards of international evaluation, pediatric clinicians should improve know ledge in clinical epidemiology, clinical trial methodology, and improve the quality of research reports.

China ; Humans ; Multivariate Analysis ; Pediatrics ; Periodicals as Topic ; standards ; Quality Control ; Quality Improvement ; Randomized Controlled Trials as Topic ; methods ; standards ; Research Design ; standards ; Research Report ; standards

Low quality clinical trials have a possibility to have errors in the process of deriving the results and therefore distort the study. Quality assessment of clinical trial is necessary in order to prevent any clinical application erroneous results is important. Randomized controlled trial (RCT) is a design for evaluate the effectiveness of medical procedure. This study was conducted by extracting the RCTs from the original articles published in the Journal of Korean Medical Science (JKMS) from 1986 to 2011 and conducting a qualitative analysis using three types of analysis tools: Jadad scale, van Tulder scale and Cochrane Collaboration risk of bias Tool. To compare the quality of articles of JKMS, quality analysis of the RCTs published in Yonsei Medical Journal (YMJ) and Korean Journal of Internal Medicine was also conducted. In the JKMS, YMJ and Korean Journal of Internal Medicine, the quantitative increase of RCT presented over time was observed but no qualitative improvement of RCT was observed over time. From the results of this study, it is required for the researchers to plan for and perform higher quality studies.
Humans ; Publishing ; *Quality Improvement ; Randomized Controlled Trials as Topic/*standards ; Research Design

PURPOSE: In April 2013, the journal metrics of the Korean Journal of Urology (KJU) were reported. That report showed tremendous improvement from the point of view of journal metrics. Two years later, the same metrics were reanalyzed to determine the present position of the KJU among the international journals in the Web of Science. MATERIALS AND METHODS: I analyzed journal metrics of the KJU such as impact factor, total citations, and h-index by use of the same methods as in the previous report. RESULTS: Total citations in the Web of Science were 332 in 2012, 439 in 2013, and 578 in 2014. Manually calculated impact factors from 2012 to 2014 were 0.770, 0.824, and 0.751, respectively. There was an increase in the h-index from 8 in 2012 to 11 in February 2015. Editorial board members were from 15 countries in 2014. Authors of KJU articles were from 21 countries in 2014. CONCLUSIONS: During 2 years, remarkable progress was made in KJU's citation indicators and in the diversity of the authors' and editorial board members' countries.
Bibliometrics ; Humans ; Journal Impact Factor ; Periodicals as Topic/standards ; Quality Improvement ; Republic of Korea ; *Urology

Biomedical Research ; Capacity Building ; Health Personnel ; education ; Humans ; Palliative Care ; standards ; Quality Improvement ; Singapore ; Terminal Care ; standards

The motivation for improving quality of gastrointestinal endoscopy begins with the desire to provide patients with the best possible care. Gastrointestinal endoscopy is an excellent area for quality improvement because of its high volume, significant associated risk and expense, and variability in its performance affecting outcomes. Therefore, the assurance that high-quality endoscopic procedures are performed has taken increased importance. The 'Korean Gastrointestinal Endoscopy Research Foundation' and 'Korean Society of Gastrointestinal Endoscopy', as ladders in promoting the highest quality patient care, formed endoscopy quality evaluation in 'National Cancer Screening Program' and 'Endoscopy Unit Accreditation' in Korea. However, both new systems have not settled down despite efforts of many years and support by the government. In this article, the past and present of quality improvement of gastrointestinal endoscopy will be reviewed, and the future of quality improvement of gastrointestinal endoscopy will be illuminated.
Early Detection of Cancer ; Endoscopy, Gastrointestinal/*standards ; Humans ; Neoplasms/diagnosis ; Quality Improvement ; Quality Indicators, Health Care ; Republic of Korea

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.
*National Health Programs ; Program Development ; Quality Improvement/*economics ; Quality of Health Care/economics ; Reimbursement, Incentive/*organization & administration/standards ; Republic of Korea