PURPOSE: To estimate the impact of a health information exchange (HIE) pilot project on ophthalmology department care. METHODS: Study sites included 4 ophthalmic clinics in three regions participating in the HIE pilot project (group A), and 12 clinics with similar distances and numbers of patient referrals as group A but who were not participating in the HIE pilot project (group B). The mean wait time, total medical costs, and ophthalmic examinations of referral patients were analyzed. RESULTS: The mean wait times were 8.4 ± 8.0 days in group A, which included 83 patients, and 11.7 ± 15.4 days in group B, which included 417 patients. The wait time was significantly shorter in group A (p = 0.005). Sensitivity analyses also indicated shorter wait times in group A. In 247 patients in group B who were referred to tertiary referral hospitals automatically through the conventional clinical cooperation center with group A, the wait times were 8.4 ± 8.0 and 7.7 ± 8.8 days, respectively, and the total cost of medical care was 260.6 ± 271.4 and 257.0 ± 251.7 thousand Won, respectively. No differences in these factors were found between the groups (p = 0.503, 0.913, respectively). There were no significant differences in participation in the HIE pilot project regarding ophthalmic examinations conducted within 2 weeks since patient referral (p > 0.050 for all). CONCLUSIONS: The HIE is advantageous because it results in shorter wait times to see an ophthalmologist, due to the automatic referral method based on medical records. However, there are no benefits in reducing total costs of medical care or the number of clinical examinations.
Health Communication ; Health Information Exchange ; Humans ; Medical Records ; Methods ; Ophthalmology ; Pilot Projects ; Referral and Consultation ; Tertiary Care Centers ; Tertiary Healthcare

PURPOSE: A systematic review and meta-analysis was conducted to evaluate the effects of smartphone-based mobile learning for nurses and nursing students. METHODS: Electronic literature search of PubMed, Cochrane Library, Embase, SCOPUS, Web of Science, ProQuest Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Educational Resource Information Center (ERIC) was conducted. Two authors independently reviewed empirical studies for inclusion and extracted the design, sample size, intervention method, outcome variables, and statistical values of them. Methodological quality was assessed using Cochrane collaboration risk of bias tool. To estimate the effect size, meta-analysis was performed using R meta program. RESULTS: Authors identified 11 randomized or nonrandomized controlled trials of a total of 3,419 studies. Overall effect sizes by random-effects model was large [Hedges'g (g) = 1.12, 95% confidence interval (CI) 0.72−1.52], with learning attitude (g = 1.69), skills (g = 1.41), knowledge (g = 1.47), and confidence in performance (g = 1.54). For heterogeneity, subgroup analyses using meta-analysis of variance were performed, but no significant difference was found. Finally, a funnel plot and Egger's regression test along with trim-and-fill analysis and fail-safe N were conducted to check for publication bias, but no significant bias was detected. CONCLUSION: Smartphone-based mobile learning had significantly positive influence on nursing students' knowledge, skills, confidence in performance, and learning attitude. Smartphone-based mobile learning may be an alternative or supportive method for better education in nursing fields.
Bias (Epidemiology) ; Cooperative Behavior ; Education ; Education, Nursing ; Humans ; Information Centers ; Learning ; Methods ; Nursing ; Population Characteristics ; Publication Bias ; Sample Size ; Smartphone ; Students, Nursing

OBJECTIVES: In the Republic of Korea (ROK), the notified incidence of tuberculosis in foreign-born individuals (NITFBI) has increased recently, as has the rate of multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis in foreigners staying in the ROK. As Jeju Province in ROK has a no-visa entry policy, control programs for NITFBI should be consolidated. The aim was to evaluate the status of NITFBI, with a focus on the distribution of MDR/RR tuberculosis by nationality. METHODS: Data on tuberculosis incidence in individuals born in Jeju Province and in foreign-born individuals were extracted from the Korean Statistical Information Service of Statistics Korea, and the Infectious Disease Surveillance Web Statistics of the Korea Centers for Disease Control and Prevention, respectively. RESULTS: Among all notified incident cases of tuberculosis, the proportion of NITFBI increased from 1.46% in 2011 to 6.84% in 2017. China- and Vietnam-born individuals accounted for the greatest proportion of the 95 cases of NITFBI. Seven cases of MDR/RR tuberculosis were found, all involving patients born in China. CONCLUSIONS: In Jeju Province, ROK, NITFBI might become more common in the near future. Countermeasures for controlling active tuberculosis in immigrants born in high-risk nations for tuberculosis should be prepared in Jeju Province, since it is a popular tourist destination.
Antitubercular Agents ; Centers for Disease Control and Prevention (U.S.) ; China ; Communicable Diseases ; Disease Management ; Drug Resistance ; Emigrants and Immigrants ; Ethnic Groups ; Humans ; Incidence ; Information Services ; Internationality ; Korea ; Mycobacterium tuberculosis ; Republic of Korea ; Tuberculosis

Archives ; Breast Neoplasms ; Breast ; Clone Cells ; Drug Therapy ; Ectopic Gene Expression ; Gene Expression ; Humans ; Microarray Analysis ; Neoplasm Metastasis ; Neoplastic Stem Cells ; Oligonucleotide Array Sequence Analysis ; Prognosis ; Survival Rate

The clinical practice guidelines (CPGs) is made step by step. The evidences that have been published were searched and a group of experts make a consensus based in the evidences. The CPGs in the medical field, where utilizations and interests are increasing, must be confirmed in the management of quality. The Korean Appraisal of Guidelines for Research & Evaluation II (K-AGREE II) tool that helps to manage the quality of CPGs and to develop CPGs was translated by the Steering Committee for Clinical Practice Guideline. It is divided into 6 domains and each domains are independent. It is consisted of 23 items as detail and 2 items for the overall evaluation. Only fifteen CPGs are successfully certified using the K-AGREE II tool in the Korean Medical Guideline Information Center from 2013 and 3 CPGs made by the Korea Urological Association and the associated societies are certified successfully. With the level of certification of CPGs is higher, the Korea Urological Association and the associated societies are also try to develop CPGs that meet their level of certification. The Korean clinical practice guideline for the treatment of prostate cancer developed recently is the evidence of effort.
Certification ; Consensus ; Information Centers ; Korea ; Prostatic Neoplasms ; Quality Improvement ; Urology

Medical Subject Headings (MeSH), a medical thesaurus created by the National Library of Medicine (NLM), is a useful resource for natural language processing (NLP). In this article, the current status of the Japanese version of Medical Subject Headings (MeSH) is reviewed. Online investigation found that Japanese-English dictionaries, which assign MeSH information to applicable terms, but use them for NLP, were found to be difficult to access, due to license restrictions. Here, we investigate an open-source Japanese-English glossary as an alternative method for assigning MeSH IDs to Japanese terms, to obtain preliminary data for NLP proof-of-concept.
Asian Continental Ancestry Group ; Humans ; Licensure ; Medical Subject Headings ; Methods ; National Library of Medicine (U.S.) ; Natural Language Processing ; Vocabulary, Controlled

Korea is undergoing a rapid environmental change in health and welfare. Therefore, the law mandates the establishment and implementation of plans in accordance with the changes. A total of 49 long-term plans related to health and welfare were specified by the National Law Information Center, the Korean representative legal information website managed by the Korea Ministry of Government Legislation. Of the 49 long-term plans, 10 plans (20.4%) were not yet fully constructed. Eight out of 10 non-constructive plans have been put into force for more than a year, but these plans still require further systematic planning and development. The complete construction of long-term plans is substantial to account for the changes in South Korean health and welfare. In addition, a systematic plan with solidarity and continuity between the mutual plans should be established in planning.
Information Centers ; Jurisprudence ; Korea ; Social Welfare

OBJECTIVES: This study aimed to determine the prevalence of odontogenic cysts, tumors, and other lesions among reports in the archives of the Department of Oral and Maxillofacial Surgery at the Faculty of Dentistry affiliated with Kocaeli University collected over a four-year period.MATERIALS AND METHODS: In this retrospective study, patient records from the archive of the Department of Oral and Maxillofacial Surgery from 2014 to 2018 were reviewed. Patient demographic information (age and sex) and lesion location were recorded and analyzed.RESULTS: From a total of 475 files reviewed, odontogenic cyst was confirmed in 340 cases (71.6%), and odontogenic tumor was confirmed in 52 cases (10.9%). Regarding odontogenic cyst type, the most common was radicular cyst (216 cases), followed by dentigerous cyst (77 cases) and odontogenic keratocyst (23 cases). Among odontogenic tumors, the most frequent was odontoma (19 cases), followed by ossifying fibroma (18 cases) and ameloblastoma (9 cases). Giant cell granuloma was also reported in 35 cases.CONCLUSION: The distribution pattern of odontogenic cysts and tumors in our retrospective study is relatively similar to that reported in the literature. Complete clinical reports for final diagnosis of these lesions and routine follow-up examinations are very important for treatment.
Ameloblastoma ; Archives ; Biopsy ; Dentigerous Cyst ; Dentistry ; Diagnosis ; Fibroma, Ossifying ; Follow-Up Studies ; Granuloma, Giant Cell ; Humans ; Jaw Neoplasms ; Odontogenic Cysts ; Odontogenic Tumors ; Odontoma ; Prevalence ; Radicular Cyst ; Retrospective Studies ; Surgery, Oral

OBJECTIVE: To compare the diagnostic accuracy of dynamic computed tomography (CT) and gadoxetate-enhanced magnetic resonance imaging (MRI) for characterization of hepatic lesions by using the Liver Imaging Reporting and Data System (LI-RADS) in a multicenter, off-site evaluation.MATERIALS AND METHODS: In this retrospective multicenter study, we evaluated 231 hepatic lesions (114 hepatocellular carcinomas [HCCs], 58 non-HCC malignancies, and 59 benign lesions) confirmed histologically in 217 patients with chronic liver disease who underwent both gadoxetate-enhanced MRI and dynamic CT at one of five tertiary hospitals. Four radiologists at different institutes independently reviewed all MR images first and the CT images 4 weeks later. They evaluated the major and ancillary imaging features and categorized each hepatic lesion according to the LI-RADS v2014. Diagnostic performance was calculated and compared using generalized estimating equations.RESULTS: MRI showed higher sensitivity and accuracy than CT for diagnosing hepatic malignancies; the pooled sensitivities, specificities, and accuracies for categorizing LR-5/5V/M were 59.0% vs. 72.4% (CT vs. MRI; p < 0.001), 83.5% vs. 83.9% (p = 0.906), and 65.3% vs. 75.3% (p < 0.001), respectively. CT and MRI showed comparable capabilities for differentiating between HCC and other malignancies, with pooled accuracies of 79.9% and 82.4% for categorizing LR-M, respectively (p = 0.139).CONCLUSION: Gadoxetate-enhanced MRI showed superior accuracy for categorizing LR-5/5V/M in hepatic malignancies in comparison with dynamic CT. Both modalities had comparable accuracies for distinguishing other malignancies from HCC.
Academies and Institutes ; Carcinoma, Hepatocellular ; Contrast Media ; Humans ; Information Systems ; Liver ; Liver Diseases ; Magnetic Resonance Imaging ; Retrospective Studies ; Tertiary Care Centers

BACKGROUND: The medical service delivery system in Korea works inefficiently and patients tend to visit tertiary hospitals by means of the emergency department (ED). Overcrowding of the ED threatens the health and life of emergency patients as a result of the inability to effectively distribute emergency medical resources in the community. To solve this problem, improvement in the medical delivery system and dispersion of patients by strengthening primary care may be helpful. In order to make policy decisions for this, it is necessary to estimate the scale of patients who can be distributed to primary care.METHODS: From January 1 to December 31, 2016, we analyzed the National Emergency Department Information System (NEDIS) data of patients who visited a tertiary ED to examine the proportion of patients eligible for primary medical care. The inclusion and exclusion criteria for primary care were made through the consensus of three physicians.RESULTS: A total of 65,061 NEDIS records were analyzed. Among them, by inclusion criteria, 29,818 cases were Korean Triage and Acuity Scale level 4 and 5, and 11,791 patients visited the ED during the day. After considering the exclusion criteria, there were 6,468 cases who may be suitable for primary medical care.CONCLUSION: Of the patients who visited the ED of tertiary hospitals, approximately 10% of them may be suitable for primary care. There should be a discussion and social consensus to reduce overcrowding in EDs and deliver better medical services.
Consensus ; Emergencies ; Emergency Service, Hospital ; Humans ; Information Systems ; Korea ; Primary Health Care ; Tertiary Care Centers ; Tertiary Healthcare ; Triage