Genomics ; Government Agencies ; Laboratories ; United States

OBJECTIVE: We aimed to develop the clinical guideline for headache by the systematic review and synthesis of existing evidence-based guidelines. The purpose of developing the guideline was to improve the appropriateness of diagnosis and treatment of headache disorder, and consequently, to improve patients’ pain control and quality of life. The guideline broadly covers the differential diagnosis and treatment of tension-type headache, migraine, cluster headache, and medication-overuse headache. METHODS: This is a methodological study based on the ADAPTE methodology, including a systematic review of the literature, quality assessment of the guidelines using the Appraisal of Clinical Guidelines for REsearch & Evaluation II (AGREE II) Instrument, as well as an external review using a Delphi technique. The inclusion criteria for systematic search were as follows: topic-relevant, up-to-date guidelines including evidence from within 5 years, evidence-based guidelines, guidelines written in English or Korean, and guidelines issued by academic institutions or government agencies. RESULTS: We selected five guidelines and conducted their quality assessment using the AGREE II Instrument. As a result, one guideline was found to be eligible for adaptation. For 13 key questions, a total of 39 recommendations were proposed with the grading system and revised using the nominal group technique. CONCLUSION: Recommendations should be applied to actual clinical sites to achieve the ultimate goal of this guideline; therefore, follow-up activities, such as monitoring of guideline usage and assessment of applicability of the recommendations, should be performed in the future. Further assessment of the effectiveness of the guideline in Korea is needed.
Cluster Headache ; Delphi Technique ; Diagnosis ; Diagnosis, Differential ; Follow-Up Studies ; Government Agencies ; Headache Disorders ; Headache ; Korea ; Methods ; Migraine Disorders ; Quality of Life ; Tension-Type Headache

Recently, digital health has gained the attention of physicians, patients, and healthcare industries. Digital health, a broad umbrella term, can be defined as an emerging health area that uses brand new digital or medical technologies involving genomics, big data, wearables, mobile applications, and artificial intelligence. Digital health has been highlighted as a way of realizing precision medicine, and in addition is expected to become synonymous with health itself with the rapid digitization of all health-related data. In this article, we first define digital health by reviewing the diverse range of definitions among academia and government agencies. Based on these definitions, we then review the current status of digital health, mainly in Korea, suggest points that are missing from the discussion or ought to be added, and provide future directions of digital health in clinical practice by pointing out certain key points.
Artificial Intelligence ; Genomics ; Government Agencies ; Government Regulation ; Health Care Sector ; Humans ; Korea ; Mobile Applications ; Precision Medicine ; Telemedicine

OBJECTIVES: We analyzed Korea's data privacy regime in the context of protecting and utilizing health and medical big data and tried to draw policy implications from the analyses. METHODS: We conducted comparative analyses of the legal and regulatory environments governing health and medical big data with a view to drawing policy implications for Korea. The legal and regulatory regimes considered include the following: the European Union, the United Kingdom, France, the United States, and Japan. We reviewed relevant statutory materials as well as various non-statutory materials and guidelines issued by public authorities. Where available, we also examined policy measures implemented by government agencies. RESULTS: In this study, we investigated how various jurisdictions deal with legal and regulatory issues that may arise from the use of health and medical information with regard to the protection of data subjects' rights and the protection of personal information. We compared and analyzed various forms of legislation in various jurisdictions and also considered technical methods, such as de-identification. The main findings include the following: there is a need to streamline the relationship between the general data privacy regime and the regulatory regime governing health and medical big data; the regulatory and institutional structure for data governance should be more clearly delineated; and regulation should encourage the development of suitable methodologies for the de-identification of data and, in doing so, a principle-based and risk-based approach should be taken. CONCLUSIONS: Following our comparative legal analyses, implications were drawn. The main conclusion is that the relationship between the legal requirements imposed for purposes of personal information protection and the regulatory requirements governing the use of health and medical data is complicated and multi-faceted and, as such, their relationship should be more clearly streamlined and delineated.
Computer Security ; European Union ; France ; Government Agencies ; Great Britain ; Humans ; Japan ; Korea ; Privacy ; United States

Health insurance big data not only provide real-world evidence of unmet needs in actual clinical practice but also of breakthroughs in the medical industry which will shape the future of health care. Big data are also expected to transform the existing medical paradigm and provide a truly personalized medical age. However, questions about research through the collection and utilization of various big data in various fields have also been raised because quality limitations cannot be overlooked. Therefore, many challenges remain to be overcome in the use of big data research as a basis for changing medical practice. Intervention and interpretation by clinical medical experts are required in judging the scientific trustworthiness of the big data analysis process and the validity of the results. Therefore, healthcare big data research cannot achieve its goal by the efforts of researchers alone. Teams of data analysis scientists, epidemiologists, statistics experts, and clinical researchers are required to collaborate closely with team members, from the design phase to expert consultation, through regular meetings. In addition, it is necessary, in the creation of a healthier community, to cooperate with government agencies that provide data based on the whole nation or the world's population, as well as interest groups representing the people, and policy-making organizations. In this paper, we describe the knowledge, practical clinical applications, and future research directions and prospects for the next phase of health care, from the design of clinical research using health insurance big data to report writing.
Delivery of Health Care ; Government Agencies ; Humans ; Insurance, Health ; Public Opinion ; Statistics as Topic ; Writing

PURPOSE: This study aimed to examine the process from occurrence of a hospital nurse's suicide to workers' compensation approval, responses of the parties involved, issues debated during approval deliberations, and significant policy changes resulting from the incident.METHODS: We conducted in-depth interviews with involved parties and collected various documents, including newspaper articles, forum proceedings, and the agency report on determination of workers' compensation. Content analysis was performed on the collected data.RESULTS: A Joint Task Force continuously reported its progress and findings through mass media such as newspaper, radio, and TV. These activities exerted pressure on a government agency to conduct an occupational disease review and significantly impacted the workers' compensation approval. The agency recognized associations between the hospital's inadequate nurse training and the suicide but did not confirm the excessive overtime and workplace harassment experienced by the nurse as causes of the suicide. This case's media coverage and impact resulted in a law prohibiting workplace harassment and a hospital system dedicating at least one nurse to training activities.CONCLUSION: This incident had a significant social impact as the first case of workers' compensation approval for a hospital nurse's suicide. However, the case produced no structural changes in nurses' working conditions such as heavy workloads.
Advisory Committees ; Government Agencies ; Joints ; Jurisprudence ; Mass Media ; Occupational Diseases ; Occupational Health ; Social Change ; Suicide ; Teaching ; Workers' Compensation

BACKGROUND/OBJECTIVES: Obesity is a serious concern worldwide, for which the restaurant industry holds partial responsibility. This study was conducted to estimate restaurant consumers' intention to select healthy menu items and to examine the relationships among behavioral beliefs, past behaviors, attitudes and behavioral intentions, which are known to be major determinants of consumer behaviors. SUBJECTS/METHODS: An online, self-administered survey was distributed for data collection. The study sample consisted of customers who reported having visited casual dining restaurants in the last three months at the time of the survey. Structural equation modeling was used to verify the fit of the proposed research model. RESULTS: Structural equation modeling revealed that the proposed model supports the sequential, mediated (indirect) relationships among behavioral beliefs, past behaviors, attitudes and behavioral intentions toward healthy menu selection. CONCLUSION: This study contributes to the available literature regarding obesity by adding past behaviors, one of the most influential variables involved in prediction of future behaviors of consumers, to the TPB model, enabling a better understanding of restaurant consumers' rational decision process regarding healthy menu choices. The results of this study provide practical implications for restaurant practitioners and government agencies regarding ways to promote healthy menus.
Consumer Behavior ; Data Collection ; Government Agencies ; Intention* ; Obesity ; Restaurants

A duodenoscope is complex instrument with an elevator and an elevator wire channel which are difficult to access and not readily amenable to cleaning and disinfection. Lapses in endoscope reprocessing have been regarded as a major cause of duodenoscope-associated transmission of infection. However, recent outbreaks of carbapenem-resistant Enterobacteriaceae or other multidrug-resistant organisms have emerged in spite of proper adherence to the manufacturer's reprocessing instructions. It is the time to reestablish reprocessing protocol appropriate for duodenoscope and revise a new design of duodenoscope that makes reprocessing easier in order to prevent cross-transmission of infection by duodenoscope. This manuscript reviews current state of duodenoscope-associated infections, recent measures from the United States government agencies and its limitations, and future strategies to prevent duodenoscope-associated infections.
Disease Outbreaks ; Disinfection ; Duodenoscopes ; Elevators and Escalators ; Endoscopes ; Enterobacteriaceae ; United States Government Agencies

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
Administrative Personnel ; Adult* ; Family Characteristics ; Government Agencies ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys ; Smoke* ; Smoking* ; Sociological Factors ; Tobacco*

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.
Administrative Personnel ; Adult* ; Family Characteristics ; Government Agencies ; Humans ; Korea* ; Logistic Models ; Nutrition Surveys ; Smoke* ; Smoking* ; Sociological Factors ; Tobacco*