1.Medical accident compensation systems in obstetrics: a comparison among Korea, Japan, and Taiwan, with suggestions for Korea
Kyong-No LEE ; Sang Hyun KIM ; Se Jin LEE ; Wook JANG ; Sunghun NA ; So Yun KIM
Journal of the Korean Medical Association 2025;68(3):148-156
Korea’s medical accident compensation system is a vital national initiative designed to create a stable environment for both mothers and healthcare professionals. This article examines how Korea's neighboring countries, Taiwan and Japan, operate their obstetric compensation systems to draw lessons and implications for Korea's approach.Current Concepts: Korea's medical malpractice compensation system is fully funded by the government, and the amount is determined by the Compensation Review Committee, which considers the type of accident and, in cases of cerebral palsy, the degree of impairment, with awards reaching up to 30 million won. Japan experienced severe declines in birth rates, a shortage of obstetricians, and the closure of maternity hospitals due to increasing medical litigation. In response, the government ,in 2009, introduced a no-fault obstetric compensation system that covers cerebral palsy cases regardless of negligence. Taiwan faced a surge in medical disputes, particularly in obstetrics and gynecology, with maternal lawsuits comprising 14% of all cases. In 2016, the government introduced the Childbirth Accident Emergency Relief Act, achieving a 93.9% compensation approval rate Discussion and Conclusion: Observing these challenges, young doctors are increasingly dissuaded from pursuing careers in obstetrics and gynecology doctor, thereby accelerating the decline of maternity care services. To maintain a stable medical environment, compensation amounts should be adjusted to reflect actual medical costs, and reimbursement rates for obstetric procedures should be re-evaluated. Drawing on the successful implementations in Japan and Taiwan, South Korea must establish a sustainable and protective obstetric care system at the national level.
2.Medical accident compensation systems in obstetrics: a comparison among Korea, Japan, and Taiwan, with suggestions for Korea
Kyong-No LEE ; Sang Hyun KIM ; Se Jin LEE ; Wook JANG ; Sunghun NA ; So Yun KIM
Journal of the Korean Medical Association 2025;68(3):148-156
Korea’s medical accident compensation system is a vital national initiative designed to create a stable environment for both mothers and healthcare professionals. This article examines how Korea's neighboring countries, Taiwan and Japan, operate their obstetric compensation systems to draw lessons and implications for Korea's approach.Current Concepts: Korea's medical malpractice compensation system is fully funded by the government, and the amount is determined by the Compensation Review Committee, which considers the type of accident and, in cases of cerebral palsy, the degree of impairment, with awards reaching up to 30 million won. Japan experienced severe declines in birth rates, a shortage of obstetricians, and the closure of maternity hospitals due to increasing medical litigation. In response, the government ,in 2009, introduced a no-fault obstetric compensation system that covers cerebral palsy cases regardless of negligence. Taiwan faced a surge in medical disputes, particularly in obstetrics and gynecology, with maternal lawsuits comprising 14% of all cases. In 2016, the government introduced the Childbirth Accident Emergency Relief Act, achieving a 93.9% compensation approval rate Discussion and Conclusion: Observing these challenges, young doctors are increasingly dissuaded from pursuing careers in obstetrics and gynecology doctor, thereby accelerating the decline of maternity care services. To maintain a stable medical environment, compensation amounts should be adjusted to reflect actual medical costs, and reimbursement rates for obstetric procedures should be re-evaluated. Drawing on the successful implementations in Japan and Taiwan, South Korea must establish a sustainable and protective obstetric care system at the national level.
3.Medical accident compensation systems in obstetrics: a comparison among Korea, Japan, and Taiwan, with suggestions for Korea
Kyong-No LEE ; Sang Hyun KIM ; Se Jin LEE ; Wook JANG ; Sunghun NA ; So Yun KIM
Journal of the Korean Medical Association 2025;68(3):148-156
Korea’s medical accident compensation system is a vital national initiative designed to create a stable environment for both mothers and healthcare professionals. This article examines how Korea's neighboring countries, Taiwan and Japan, operate their obstetric compensation systems to draw lessons and implications for Korea's approach.Current Concepts: Korea's medical malpractice compensation system is fully funded by the government, and the amount is determined by the Compensation Review Committee, which considers the type of accident and, in cases of cerebral palsy, the degree of impairment, with awards reaching up to 30 million won. Japan experienced severe declines in birth rates, a shortage of obstetricians, and the closure of maternity hospitals due to increasing medical litigation. In response, the government ,in 2009, introduced a no-fault obstetric compensation system that covers cerebral palsy cases regardless of negligence. Taiwan faced a surge in medical disputes, particularly in obstetrics and gynecology, with maternal lawsuits comprising 14% of all cases. In 2016, the government introduced the Childbirth Accident Emergency Relief Act, achieving a 93.9% compensation approval rate Discussion and Conclusion: Observing these challenges, young doctors are increasingly dissuaded from pursuing careers in obstetrics and gynecology doctor, thereby accelerating the decline of maternity care services. To maintain a stable medical environment, compensation amounts should be adjusted to reflect actual medical costs, and reimbursement rates for obstetric procedures should be re-evaluated. Drawing on the successful implementations in Japan and Taiwan, South Korea must establish a sustainable and protective obstetric care system at the national level.
4.Consensus-Based Guidelines for the Treatment of Atopic Dermatitis in Korea (Part II): Biologics and JAK inhibitors
Hyun-Chang KO ; Yu Ri WOO ; Joo Yeon KO ; Hye One KIM ; Chan Ho NA ; Youin BAE ; Young-Joon SEO ; Min Kyung SHIN ; Jiyoung AHN ; Bark-Lynn LEW ; Dong Hun LEE ; Sang Eun LEE ; Sul Hee LEE ; Yang Won LEE ; Ji Hyun LEE ; Yong Hyun JANG ; Jiehyun JEON ; Sun Young CHOI ; Ju Hee HAN ; Tae Young HAN ; Sang Wook SON ; Sang Hyun CHO
Annals of Dermatology 2025;37(4):216-227
Background:
Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed.
Objective:
This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based recommendations.
Methods:
The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved.
Results:
This guideline provides treatment guidance on advanced systemic treatment modalities for AD. In particular, the guideline offers up-to-date treatment recommendations for biologics and Janus-kinase inhibitors used in the treatment of patients with moderate to severe AD.It also provides guidance on other therapies for AD, along with tailored recommendations for children, adolescents, the elderly, and pregnant or breastfeeding women.
Conclusion
KADA’s updated AD treatment guidelines incorporate the latest evidence and expert opinion to provide a comprehensive approach to AD treatment. The guidelines will help clinicians optimize patient-specific therapies.
5.Consensus-Based Guidelines for the Treatment of Atopic Dermatitis in Korea (Part I): Basic Therapy, Topical Therapy, and Conventional Systemic Therapy
Hyun-Chang KO ; Yu Ri WOO ; Joo Yeon KO ; Hye One KIM ; Chan Ho NA ; Youin BAE ; Young-Joon SEO ; Min Kyung SHIN ; Jiyoung AHN ; Bark-Lynn LEW ; Dong Hun LEE ; Sang Eun LEE ; Sul Hee LEE ; Yang Won LEE ; Ji Hyun LEE ; Yong Hyun JANG ; Jiehyun JEON ; Sun Young CHOI ; Ju Hee HAN ; Tae Young HAN ; Sang Wook SON ; Sang Hyun CHO
Annals of Dermatology 2025;37(4):201-215
Background:
Atopic dermatitis (AD) is a common skin disease with a wide range of symptoms. Due to the rapidly changing treatment landscape, regular updates to clinical guidelines are needed.
Objective:
This study aimed to update the guidelines for the treatment of AD to reflect recent therapeutic advances and evidence-based practices.
Methods:
The Patient characteristics, type of Intervention, Control, and Outcome framework was used to determine 48 questions related to AD management. Evidence was graded, recommendations were determined, and, after 2 voting rounds among the Korean Atopic Dermatitis Association (KADA) council members, consensus was achieved.
Results:
The guidelines provide detailed recommendations on foundational therapies, including the use of moisturizers, cleansing and bathing practices, allergen avoidance, and patient education. Guidance on topical therapies, such as topical corticosteroids and calcineurin inhibitors, is also provided to help manage inflammation and maintain skin barrier function in patients with AD. Additionally, recommendations on conventional systemic therapies, including corticosteroids, cyclosporine, and methotrexate, are provided for managing moderate to severe AD.
Conclusion
KADA’s updated AD guidelines offer clinicians evidence-based strategies focused on basic therapies, topical therapies, and conventional systemic therapies, equipping them to enhance quality of care and improve patient outcomes in AD management.
6.2023 Consensus Korean Diagnostic Criteria for Atopic Dermatitis
Ji Hyun LEE ; Sul Hee LEE ; Youin BAE ; Young Bok LEE ; Yong Hyun JANG ; Jiyoung AHN ; Joo Yeon KO ; Hyun-Chang KO ; Hye One KIM ; Chan Ho NA ; Young-Joon SEO ; Min Kyung SHIN ; Yu Ri WOO ; Bark Lyn LEW ; Dong Hun LEE ; Sang Eun LEE ; Jiehyun JEON ; Sun Young CHOI ; Tae Young HAN ; Yang Won LEE ; Sang Wook SON ; Young Lip PARK
Annals of Dermatology 2025;37(1):12-21
Background:
In 2006, the Korean Atopic Dermatitis Association (KADA) working group released the diagnostic criteria for Korean atopic dermatitis (AD). Recently, more simplified, and practical AD diagnostic criteria have been proposed. Objective: Based on updated criteria and experience, we studied to develop and share a consensus on diagnostic criteria for AD in Koreans.
Materials and Methods:
For the diagnostic criteria, a questionnaire was constructed by searching the English-language literature in MEDLINE and the Cochrane Database of Systematic Reviews. A modified Delphi method composed of 3 rounds of email questionnaires was adopted for the consensus process. Fifty-four KADA council members participated in the 3 rounds of votes and expert consensus recommendations were established.
Results:
Diagnostic criteria for AD include pruritus, eczema with age-specific pattern, and chronic or relapsing history. Diagnostic aids for AD encompass xerosis, immunoglobulin E reactivity, hand–foot eczema, periorbital changes, periauricular changes, perioral changes, nipple eczema, perifollicular accentuation, and personal or family history of atopy.
Conclusion
This study streamlined and updated the diagnostic criteria for AD in Korea, making them more practicable for use in real-world clinical field.
7.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 1. Preoperative Imaging and Diagnostic Evaluation in Thyroid Cancer 2024
Ji Ye LEE ; Kwanhoon JO ; Ho-Cheol KANG ; Sun Wook KIM ; Young Joo PARK ; Ji-In BANG ; Young Shin SONG ; Min Kyoung LEE ; Eun Kyung LEE ; Dong-Jun LIM ; Yun Jae CHUNG ; Sang-Woo LEE ; Dong Gyu NA ;
International Journal of Thyroidology 2024;17(1):21-29
The selected treatment for a nodule that is diagnosed as thyroid cancer is surgery. Imaging and blood tests are performed prior to surgery to determine the extent of the surgery. An Ultrasound (US) of the thyroid and neck should be performed to evaluate the size of the cancer, whether it is multifocal and has invaded surrounding tissues, and the status of the cervical lymph nodes (LNs). In addition to US, contrast-enhanced computed tomography may help detect cervical LN metastasis and evaluate patients suspected with invasive thyroid cancer.Generally, routine preoperative measurement of serum thyroglobulin and thyroglobulin antibody concentrations is not recommended. Integrated 18F-fluorodeoxyglucose positron-emission/computed tomography may be helpful either in patients with suspected lateral cervical LNs or distant metastasis or in patients with aggressive histology.
8.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part III. Management of Advanced Differentiated Thyroid Cancers - Chapter 5.Treatment of Metastatic Lesions in Advanced Differentiated Thyroid Carcinoma 2024
Kyong Yeun JUNG ; Youngduk SEO ; Ho-Cheol KANG ; Sun Wook KIM ; Dong Gyu NA ; Young Joo PARK ; Young Shin SONG ; Dong Yeob SHIN ; Sang-Woo LEE ; Eun Kyung LEE ; Dong-Jun LIM ; Yun Jae CHUNG ; Won Gu KIM ;
International Journal of Thyroidology 2024;17(1):182-187
Only a small percentage of patients (2-5%) with differentiated thyroid cancer (DTC) exhibit distant metastasis at the initial diagnosis or during the disease course. The most common metastatic sites of DTC are the lungs, followed by the bones. Radioactive iodine (RAI) therapy is considered the primary treatment for RAI-avid distant metastatic DTC. Depending on the characteristics of metastatic lesions, local treatment such as surgical resection, radiofrequency ablation, and external beam radiation therapy may be considered for some patients with metastatic DTC. Slowly growing and asymptomatic metastases can be monitored with follow-up while receiving thyroid-stimulating hormone (TSH) suppression therapy. In patients with a limited number of lung metastases and good performance status, surgical removal of the metastatic lesions may be considered. Systemic therapy should be considered for patients with progressive RAI refractory DTC. In this clinical guideline, we aim to outline the treatment principles for patients with lung, bone, and brain metastases of DTC.
9.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part I. Initial Management of Differentiated Thyroid Cancers - Chapter 6. Radioactive Iodine Treatment after Thyroidectomy 2024
Sohyun PARK ; Ari CHONG ; Ho-Cheol KANG ; Keunyoung KIM ; Sun Wook KIM ; Dong Gyu NA ; Young Joo PARK ; Ji-In BANG ; Youngduk SEO ; Young Shin SONG ; So Won OH ; Eun Kyung LEE ; Dong-Jun LIM ; Yun Jae CHUNG ; Chae Moon HONG ; Sang-Woo LEE ;
International Journal of Thyroidology 2024;17(1):97-110
The initial treatment for differentiated thyroid cancer includes appropriate surgery and radioactive iodine (RAI) therapy, followed by thyroid-stimulating hormone (TSH) suppression therapy as long-term management to prevent recurrence. RAI therapy following thyroidectomy has the three main purposes: remnant ablation, adjuvant therapy, and therapy for known disease. To optimize the goals and targets of RAI therapy, postoperative disease assessment, determination of recurrence risk, and consideration of various individual factors are necessary. The objectives of RAI therapy are determined based on the individual’s recurrence risk, and the administered activity of RAI is then determined according to these treatment objectives. Adequate stimulation of serum TSH is necessary before RAI therapy, and recombinant human TSH is widely used because of its advantage in reducing the risk of exacerbation of comorbidities associated with levothyroxine discontinuation and improving patients’ quality of life. Additionally, reducing iodine intake through appropriate low-iodine diet is necessary. Whole-body scans are conducted to assess the disease status after RAI therapy. If planar whole-body scans are inconclusive, additional single-photon emission computed tomography (SPECT)/CT imaging is recommended. Over the past decade, prospective randomized or retrospective clinical studies on the selection of candidates for RAI therapy, administered activity, methods of TSH stimulation, and advantages of SPECT/CT have been published. Based on these latest clinical research findings and recommendations from relevant overseas medical societies, this clinical practice guideline presents the indications and methods for administering RAI therapy after thyroidectomy.
10.Korean Thyroid Association Guidelines on the Management of Differentiated Thyroid Cancers; Part II. Follow-up Surveillance after Initial Treatment 2024
Mijin KIM ; Ji-In BANG ; Ho-Cheol KANG ; Sun Wook KIM ; Dong Gyu NA ; Young Joo PARK ; Youngduk SEO ; Young Shin SONG ; So Won OH ; Sang-Woo LEE ; Eun Kyung LEE ; Ji Ye LEE ; Dong-Jun LIM ; Ari CHONG ; Yun Jae CHUNG ; Chae Moon HONG ; Min Kyoung LEE ; Bo Hyun KIM ;
International Journal of Thyroidology 2024;17(1):115-146
Based on the clinical, histopathological, and perioperative data of a patient with differentiated thyroid cancer (DTC), risk stratification based on their initial recurrence risk is a crucial follow-up (FU) strategy during the first 1–2 years after initial therapy. However, restratifiying the recurrence risk on the basis of current clinical data that becomes available after considering the response to treatment (ongoing risk stratification, ORS) provides a more accurate prediction of the status at the final FU and a more tailored management approach. Since the 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and DTC, the latest guidelines that include the National Comprehensive Cancer Network clinical practice and European Association for Medical Oncology guidelines have been updated to reflect several recent evidence in ORS and thyroid-stimulating hormone (TSH) suppression of DTC. The current clinical practice guideline was developed by extracting FU surveillance after the initial treatment section from the previous version of guidelines and updating it to reflect recent evidence. The current revised guideline includes recommendations for recent ORS, TSH target level based on risk stratification, FU tools for detection of recurrence and assessment of disease status, and long-term FU strategy for consideration of the disease status. These evidence-based recommendations are expected to avoid overtreatment and intensive FU of the majority of patients who will have a very good prognosis after the initial treatment of DTC patients, thereby ensuring that patients receive the most appropriate and effective treatment and FU options.

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