Publications by authors named "Miyoung Choi"

45 Publications

[SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID].

Korean J Gastroenterol 2021 08;78(2):117-128

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus, is threatening global health worldwide with unprecedented contagiousness and severity. The best strategy to overcome COVID-19 is a vaccine. Various vaccines are currently being developed, and mass vaccination is in progress. Despite the very encouraging clinical trial results of these vaccines, there is insufficient information on the safety and efficacy of vaccines for inflammatory bowel disease (IBD) patients facing various issues. After reviewing current evidence and international guidelines, the Korean Association for the Study of Intestinal Diseases (KASID) developed an expert consensus statement on COVID-19 vaccination issues for Korean IBD patients. This expert consensus statement emphasizes that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination be strongly recommended for IBD patients, and it is safe for IBD patients receiving immunomodulatory therapy.
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http://dx.doi.org/10.4166/kjg.2021.110DOI Listing
August 2021

[KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement].

Korean J Gastroenterol 2021 08;78(2):105-116

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

The coronavirus disease 2019 (COVID-19) pandemic has reduced the ability to prevent or control chronic disease due to the concerns about safety in accessing health care. Inflammatory bowel disease (IBD) is a chronic condition requiring long- term sustained treatment, which is difficult in the current panedemic situation. The Korean Association for the Study of Intestinal Diseases (KASID) has developed an expert consensus statement on the clinical practice management of adult inflammatory bowel disease during the COVID-19 pandemic. This expert consensus statement is based on guidelines and clinical reports from several countries around the world. It provides recommendations to deal with the risk of COVID-19 and medication use in IBD patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and emphasizes the importance of right treatment approach to avoid worsening of the disease condition in IBD patients.
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http://dx.doi.org/10.4166/kjg.2021.112DOI Listing
August 2021

Revised Korean Society of Infectious Diseases/National Evidence-based Healthcarea Collaborating Agency Guidelines on the Treatment of Patients with COVID-19.

Infect Chemother 2021 Mar;53(1):166-219

Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Despite the global effort to mitigate the spread, coronavirus disease 2019 (COVID-19) has become a pandemic that took more than 2 million lives. There are numerous ongoing clinical studies aiming to find treatment options and many are being published daily. Some effective treatment options, albeit of variable efficacy, have been discovered. Therefore, it is necessary to develop an evidence-based methodology, to continuously check for new evidence, and to update recommendations accordingly. Here we provide guidelines on pharmaceutical treatment for COVID-19 based on the latest evidence.
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http://dx.doi.org/10.3947/ic.2021.0303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032920PMC
March 2021

Systematic review and meta-analysis of diagnostic performance of CT imaging for assessing resectability of pancreatic ductal adenocarcinoma after neoadjuvant therapy: importance of CT criteria.

Abdom Radiol (NY) 2021 Jul 31. Epub 2021 Jul 31.

Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Purpose: To assess the CT diagnostic performance for evaluating resectability of pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy and identify the factor(s) that affect(s) diagnostic performance.

Methods: Databases were searched to identify studies published from January 1, 2000, to November 5, 2019 that evaluated the CT diagnostic performance for assessing resectability of post-neoadjuvant PDAC. Two reviewers independently extracted data and assessed the study quality. A meta-analysis was performed to obtain summary sensitivity and specificity values using a bivariate random-effects model, and heterogeneity across studies was assessed. Univariable meta-regression analysis was performed with eight variables, including the different CT criteria for resectability, conventional National Comprehensive Cancer Network (NCCN) criteria for upfront surgery, and modified criteria for post-neoadjuvant surgery.

Results: Ten studies were included and analyzed. The summary sensitivity and specificity for resectability were 78% (95% CI 68-86%) and 60% (95% CI 44-74%), respectively. No significant heterogeneity was identified (bivariate correlation coefficient ρ = - 1, p-value for hierarchical summary receiver operating characteristics model β = 0.667). The two different CT criteria showed different diagnostic performance (p < 0.01), with higher sensitivity (81% [95% CI 73-90%] vs. 28% [95% CI 15-42%], p < 0.01) and lower specificity (57% [95% CI 41-73%] vs. 90% [95% CI 80-100%], p < 0.01) for the modified criteria. No other variables affected the diagnostic performance.

Conclusion: CT criteria were the factors that affected the diagnostic performance. Modification of the conventional criteria improved sensitivity but lowered specificity. Further modifications are required to improve specificity and uniformity.
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http://dx.doi.org/10.1007/s00261-021-03198-2DOI Listing
July 2021

Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections.

Clin Endosc 2021 Jul 27;54(4):505-521. Epub 2021 Jul 27.

Division of Gastroenterology, Department of Internal Medicine, Cha University Bundang Medical Center, Seongnam, Korea.

Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.
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http://dx.doi.org/10.5946/ce.2021.185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8357592PMC
July 2021

Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections.

Gut Liver 2021 Sep;15(5):677-693

Division of Gastroenterology, Department of Internal Medicine, CHA University Bundang Medical Center, Seongnam, Korea.

Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy appointed a Task Force to develop medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.
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http://dx.doi.org/10.5009/gnl210001DOI Listing
September 2021

Korean Society of Infectious Diseases/National Evidence-based Healthcare Collaborating Agency Recommendations for Anti-SARS-CoV-2 Monoclonal Antibody Treatment of Patients with COVID-19.

Infect Chemother 2021 Jun;53(2):395-403

Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Neutralizing antibodies targeted at the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein have been developed and now under evaluation in clinical trials. The US Food and Drug Administration currently issued emergency use authorizations for neutralizing monoclonal antibodies in non-hospitalized patients with mild to moderate coronavirus disease 2019 (COVID-19) who are at high risk for progressing to severe disease and/or hospitalization. In terms of this situation, there is an urgent need to investigate the clinical aspects and to develop strategies to deploy them effectively in clinical practice. Here we provide guidance for the use of anti-SARS-CoV-2 monoclonal antibodies for the treatment of COVID-19 based on the latest evidence.
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http://dx.doi.org/10.3947/ic.2021.0304DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258293PMC
June 2021

Evidence based guidelines for the treatment of Helicobacter pylori infection in Korea 2020.

Korean J Intern Med 2021 07 8;36(4):807-838. Epub 2021 Jun 8.

Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

Helicobacter pylori infection is one of the most common infectious diseases worldwide. H. pylori is responsible for substantial gastrointestinal morbidity with a high disease burden. Since the revision of the H. pylori Clinical Practice Guidelines in 2013 in Korea, the eradication rate of H. pylori has gradually decreased with the use of a clarithromycin based triple therapy. According to a nationwide randomized controlled study by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance to clarithromycin. The clinical practice guidelines for treatment of H. pylori were updated based on evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines were designed to provide clinical evidence for the treatment of H. pylori to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards, and will be revised if more evidence emerges in the future.
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http://dx.doi.org/10.3904/kjim.2020.701DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8273819PMC
July 2021

2020 Imaging Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer: Korean Society of Thyroid Radiology.

Korean J Radiol 2021 05 9;22(5):840-860. Epub 2021 Feb 9.

Department of Radiology, Gangneung Asan Hospital, Ulsan University College of Medicine, Gangneung, Korea.

Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.
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http://dx.doi.org/10.3348/kjr.2020.0578DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8076832PMC
May 2021

Current Status of Clinical Practice Guidelines in Korea.

J Korean Med Sci 2021 Feb 8;36(6):e35. Epub 2021 Feb 8.

Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Background: The development process of clinical practice guidelines (CPGs) must adhere to development standards and must be supported and steered by a representative and consistent governing body. We aimed to investigate the current status of the most recent CPGs published in Korea through surveys of medical professional societies and literature searches.

Methods: We collected CPGs developed in Korea in the past 5 years through several electronic database searches (MEDLINE, Embase, and KoreaMed), hand searches, and surveys of medical society memberships from the Korean Academy Medical Societies. Three authors selected Korean CPGs according to our inclusion/exclusion criteria and extracted data from selected CPGs about general characteristics, characteristics of CPGs for setup, evidence evaluation, and the finalization phase.

Results: Out of 2,337 articles searched from various sources and 66 documents collected by survey, 129 guidelines (122 by database searching and 7 by survey) were selected. During the recent 5 years, the yearly numbers of CPGs developed were around 25. A single organization was the most frequent CPG development body (42, 32.6%). The most common development methodologies described in the CPGs included were de novo (53, 41.1%) followed by adaptation (48, 37.2%) and hybrid (4, 3.1%). Systematic literature searching was performed in most of the guidelines (79.8%). The evidence level was reported in 104 guidelines (80.6%). There were 77 guidelines (59.7%) that reported an update plan. Fifty guidelines were published in Korean (41.0%), and 46 guidelines were published in English only (37.7%).

Conclusion: Among CPGs developed in Korea in the last 5 years, the proportion adhering to CPG development standards has increased, but there is still room for improvement.
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http://dx.doi.org/10.3346/jkms.2021.36.e35DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7870424PMC
February 2021

Evidence-Based Guidelines for the Treatment of Infection in Korea 2020.

Gut Liver 2021 03;15(2):168-195

Division of Healthcare Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

infection is one of the most common infectious diseases worldwide. Although the prevalence of is gradually decreasing, approximately half of the world's population still becomes infected with this disease. is responsible for substantial gastrointestinal morbidity worldwide, with a high disease burden. It is the most common cause of gastric and duodenal ulcers and gastric cancer. Since the revision of the clinical practice guidelines in 2013 in Korea, the eradication rate of has gradually decreased with the use of a clarithromycin-based triple therapy for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was mostly due to increased antimicrobial resistance, especially from clarithromycin. The clinical practice guidelines for the treatment of were updated according to evidence-based medicine from a meta-analysis conducted on a target group receiving the latest level of eradication therapy. The draft recommendations developed based on the meta-analysis were finalized after an expert consensus on three recommendations regarding the indication for treatment and eight recommendations for the treatment itself. These guidelines were designed to provide clinical evidence for the treatment (including primary care treatment) of infection to patients, nurses, medical school students, policymakers, and clinicians. These may differ from current medical insurance standards and will be revised if more evidence emerges in the future.
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http://dx.doi.org/10.5009/gnl20288DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960974PMC
March 2021

[Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy].

Korean J Gastroenterol 2020 12;76(6):282-296

Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea.

Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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http://dx.doi.org/10.4166/kjg.2020.142DOI Listing
December 2020

Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy.

Clin Endosc 2020 Nov 26;53(6):663-677. Epub 2020 Nov 26.

Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea.

Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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http://dx.doi.org/10.5946/ce.2020.192DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7719428PMC
November 2020

2020 Clinical Practice Guideline for Percutaneous Transthoracic Needle Biopsy of Pulmonary Lesions: A Consensus Statement and Recommendations of the Korean Society of Thoracic Radiology.

Korean J Radiol 2021 02 19;22(2):263-280. Epub 2020 Nov 19.

Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
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http://dx.doi.org/10.3348/kjr.2020.0137DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817630PMC
February 2021

Impact of F-18 Fluorodeoxyglucose PET/CT and PET/MRI on Initial Staging and Changes in Management of Pancreatic Ductal Adenocarcinoma: A Systemic Review and Meta-Analysis.

Diagnostics (Basel) 2020 Nov 14;10(11). Epub 2020 Nov 14.

Samsung Medical Center, Department of Nuclear Medicine, Sungkyunkwan University School of Medicine, 81, Irwon-ro, Gangnam-gu, Seoul 06351, Korea.

A systemic review and meta-analysis were conducted to investigate the diagnostic ability for staging and impact on management of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and PET/magnetic resonance imaging (MRI) in patients with pancreatic ductal adenocarcinoma. A comprehensive search was performed in four databases to retrieve studies of pancreatic ductal adenocarcinoma patients that have reported the diagnostic ability of FDG PET/CT and PET/MRI for detecting metastasis and the proportion of patients whose management was changed by its results. The sensitivity and specificity for detecting metastasis and the proportion of patients with management changes were pooled using a random-effects model. A total of 10 studies were included. The pooled sensitivity and specificity for detecting lymph node metastasis were 0.55 and 0.94, respectively, while the pooled sensitivity and specificity for detecting distant metastasis were 0.80 and 1.00, respectively. The areas under the summarized receiver operating characteristic curves for detecting lymph node and distant metastasis were 0.88 and 0.92, respectively. The pooled proportion of patients with management changes was 19%. FDG PET/CT and PET/MRI showed high diagnostic accuracy for detecting lymph node and distant metastasis in pancreatic ductal adenocarcinoma patients, and the use of these imaging tools led to management changes in a significant portion of these patients.
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http://dx.doi.org/10.3390/diagnostics10110952DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7696716PMC
November 2020

Clinical practice guideline for endoscopic resection of early gastrointestinal cancer.

Intest Res 2021 Apr 13;19(2):127-157. Epub 2020 Oct 13.

Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea.

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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http://dx.doi.org/10.5217/ir.2020.00020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8100377PMC
April 2021

Clinical applications of Doppler ultrasonography for thyroid disease: consensus statement by the Korean Society of Thyroid Radiology.

Ultrasonography 2020 Oct 25;39(4):315-330. Epub 2020 Aug 25.

Department of Radiology, GangNeung Asan Hospital, Gangneung, Korea.

Doppler ultrasonography (US) is widely used for the differential diagnosis of thyroid nodules, metastatic cervical lymph nodes in patients with thyroid cancer, and diffuse parenchymal disease, as well as for guidance in various US-guided procedures, including biopsy and ablation. However, controversies remain regarding the appropriate use and interpretation of Doppler US. Therefore, the Korean Society of Thyroid Radiology organized a taskforce to develop a consensus statement on the clinical use of Doppler US for thyroid disease. The review and recommendations in this article are based on a comprehensive analysis of the current literature and the consensus of experts.
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http://dx.doi.org/10.14366/usg.20072DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7515666PMC
October 2020

Developing evidence-based clinical imaging guidelines of justification for radiographic examination after dental implant installation.

BMC Med Imaging 2020 08 31;20(1):102. Epub 2020 Aug 31.

Department of Oral and Maxillofacial Radiology, Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea.

Background: This study aimed to develop evidence-based clinical imaging guidelines to assess the proper implant location following implant surgery and identify potential complications during follow-up.

Methods: The guideline development process employed an adaptation methodology in accordance with the Korean clinical imaging guidelines (K-CIG). Core (Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, and Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched used to retrieve guidelines, and two reviewers analyzed the retrieved articles. The articles were included in this review using well-established inclusion criteria.

Results: Our online search identified 66 articles, of which 3 were selected for the development of the guidelines. Consequently, based on these three guidelines, we formulated distinct recommendations regarding the appropriate imaging modalities that should be used following implant placement.

Conclusions: Conventional imaging (e.g., periapical or panoramic radiography) should be the first choice for assessing the implant following its placement and osseointegration. The metal artifacts in Cone Beam Computed Tomography (CBCT) should be considered. However, CBCT is recommended for patients with sensory abnormalities following dental implant surgery to evaluate and identify the underlying cause of implant complications and to determine the appropriate treatment.
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http://dx.doi.org/10.1186/s12880-020-00501-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457348PMC
August 2020

Supervised Physical Rehabilitation in the Treatment of Patients with Advanced Cancer: a Systematic Review and Meta-analysis.

J Korean Med Sci 2020 Jul 27;35(29):e242. Epub 2020 Jul 27.

National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.

Background: As the survival rate of cancer patients increases, the clinical importance of rehabilitation provided by healthcare professionals also increases. However, the evidence supporting the relevance of rehabilitation programs is insufficient. This study aimed to review the literature on effectiveness in physical function, quality of life (QOL) or fatigue of supervised physical rehabilitation in patients with advanced cancer.

Methods: A systematic review and meta-analysis was conducted following the Cochrane guidelines. We narratively described the results when meta-analysis was not applicable or appropriate. Literature databases including Ovid-MEDLINE, Ovid-EMBASE, and the Cochrane Library, as well as several Korean domestic databases, were searched up to June 2017 for studies that investigated the effectiveness of supervised physical rehabilitation programs on physical function, QOL or fatigue in patients with advanced cancer. The quality of the selected studies was evaluated independently by paired reviewers.

Results: Eleven studies with 922 participants were finally selected among 2,459 articles. The meta-analysis revealed that after physical exercise, the physical activity level and strength of patients with advanced cancer increased significantly. The QOL showed a statistically significant improvement after physical rehabilitation according to the European Organization for Research and Treatment of Cancer version C30. Though some of measurements about cardiovascular endurance or strength in several studies were not able to be synthesized, each study reported that they were significantly improved after receiving rehabilitation.

Conclusion: Supervised physical rehabilitation for patients with advanced cancer is effective in improving physical activity, strength, and QOL. However, more trials are needed to prove the effectiveness of supervised exercise and to strengthen the evidence.
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http://dx.doi.org/10.3346/jkms.2020.35.e242DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7384905PMC
July 2020

[Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer].

Korean J Gastroenterol 2020 05;75(5):264-291

Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea.

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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http://dx.doi.org/10.4166/kjg.2020.75.5.264DOI Listing
May 2020

Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer.

Clin Endosc 2020 Mar 30;53(2):142-166. Epub 2020 Mar 30.

Department of Gastroenterology, Korea University Anam Hospital, Seoul, Korea.

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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http://dx.doi.org/10.5946/ce.2020.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137564PMC
March 2020

Development of an evidence-based clinical imaging diagnostic guideline for implant planning: Joint recommendations of the Korean Academy of Oral and Maxillofacial Radiology and National Evidence-based Healthcare Collaborating Agency.

Imaging Sci Dent 2020 Mar 17;50(1):45-52. Epub 2020 Mar 17.

Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.

Purpose: This study was conducted to develop an evidence-based clinical imaging diagnostic guideline for implant planning, taking into account efficacy, benefits, and risks.

Materials And Methods: The guideline development process employed the adaptation methodology used for Korean clinical imaging guidelines(K-CIG). Core databases(Ovid-Medline, Ovid-Embase, National Guideline Clearinghouse, Guideline International Network) and domestic databases (KoreaMed, KMbase, and KoMGI) were searched for guidelines. The retrieved articles were analyzed by 2 reviewers, and articles were selected using well-established inclusion criteria.

Results: The search identified 294 articles, of which 3 were selected as relevant guidelines. Based on those 3 guidelines, 3 recommendations for implant planning were derived.

Conclusion: We recommend radiography or cone-beam computed tomography (CBCT) scanning for individual patients judged to require a cross-sectional image after reading of a panoramic X-ray image and a conventional intraoral radiological image. Various steps should be taken to raise awareness of these recommendations among clinicians and the public, and K-CIG should be regularly reviewed and revised.
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http://dx.doi.org/10.5624/isd.2020.50.1.45DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7078410PMC
March 2020

Efficacy of glucocorticoids for the treatment of macrolide refractory mycoplasma pneumonia in children: meta-analysis of randomized controlled trials.

BMC Pulm Med 2019 Dec 18;19(1):251. Epub 2019 Dec 18.

Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, South Korea.

Background: Mycoplasma pneumoniae is one of the most common pathogens causing community acquired pneumonia in children. Although the rate of macrolide-refractory Mycoplasma pneumoniae (MRMP) has increased, systemic glucocorticoids as a treatment option has not been validated yet. The purpose of this study was to assess the efficacy of glucocorticoids add-on in the treatment of MRMP in children through systematic review and meta-analysis.

Methods: Data sources A systematic literature search was conducted using ten electronic bibliographic databases including English, Korean, Chinese and Japanese languages, up to March 8, 2018. Study selection The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and selected randomized control trials which compared the efficacy of glucocorticoids add-on to macrolide in the treatment of MRMP in children. Data extraction Two independent reviewers extracted: primary outcomes as hospital days, fever duration, and change in C-reactive protein (CRP) and main analysis was performed through meta-analysis with random effects model.

Results: Twenty-four unique randomized controlled trials met the inclusion criteria. The mean length of hospital stay in glucocorticoids treatment group was significantly shorter than that in conventional macrolide-treatment group (Weighted mean difference (WMD) = - 4.03 days). The mean length of fever duration was significantly shorter in the glucocorticoid treatment group in comparison with the conventional treatment group (WMD = -3.32 days). Level of CRP after treatment was significantly lower in the glucocorticoid treatment group than that in the conventional treatment group (WMD = -16.03). Sensitivity analysis and subgroup analysis showed no significant improvement in heterogeneity. As limitations of the study, most of the studies included were from a single country and we were unable to control for heterogeneity across interventions, lack of standardized measures, and different time points of assessments across studies.

Conclusions: Glucocorticoid add-on treatment for MRMP can significantly shorten the duration of fever and hospital stay and decrease the level of CRP. These results should be confirmed by adequately powered studies in the future.
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http://dx.doi.org/10.1186/s12890-019-0990-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6921474PMC
December 2019

The Mediating Effects of Academic Performance between Screen Time, Executive Function Difficulty and School Adjustment.

Compr Child Adolesc Nurs 2020 Dec 22;43(4):334-347. Epub 2019 Oct 22.

Department of Nursing, Kunsan National University , Gunsan-si, Republic of Korea.

The purpose of this study was to verify the mediating effects of academic performance on the relationship between screen time, executive function difficulty, and school adjustment. This study analyzed secondary data of the 8th Panel Survey on Korean Children. The 8th Panel Survey was the first measurement of children's academic performance, executive function difficulty, and school adjustment through large sampling. Accordingly, it is possible to provide a large amount of data that can verify the relationship between them. The respondents were parents and teachers of students. The total number was 1,031. Data were analyzed by descriptive, t-test, analysis of variance, Pearson correlation, and three-steps multiple regression statistics. As a result, screen time has a full mediating effect on school adjustment through academic performance. The executive function difficulty has a partial mediating effect on school adjustment through academic performance. The results of this study will contribute to the development of the school adjustment improvement program.
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http://dx.doi.org/10.1080/24694193.2019.1675805DOI Listing
December 2020

Validation of the resilience scale for nurses (RSN).

Arch Psychiatr Nurs 2019 08 4;33(4):434-439. Epub 2019 Jan 4.

Department of Nursing, Kunsan Medical Center, 29-1, Jigok-dong, Jeollabuk-do 54105, Republic of Korea.

Aim: The purpose of this study was to verify the validity and reliability of the resilience scale for nurses (RSN).

Methods: 27 preliminary items were extracted from previous research. The subjects were 339 nurses who worked at 2 hospitals in South Korea in 2016. Collected data were analyzed using explanatory factor analysis (EFA). EFA was performed with principal axis factoring with oblimin rotation and confirmatory factor analysis (CFA) with SPSS 25.0 and AMOS 25.0 version program. Also, data were examined by construct, discriminant, and convergent validity, and internal consistency reliability.

Results: Resilience scale for nurses showed CFA supported the four-factor structure (Philosophical pattern, Relational pattern, Dispositional pattern, and Situational pattern) of the measure. The 19 items for 4 factors identified that explained 67.329% of the total variance in RSN. A total the internal consistency reliability (Cronbach's α = 0.938) was stable.

Conclusion: Psychometric properties of RSN show that it is a useful and reliable scale to assess Resilience in Korean nurses. Based on these results, effective resilience intervention programs for nurses can be developed.
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http://dx.doi.org/10.1016/j.apnu.2018.12.004DOI Listing
August 2019

Primary Imaging Test for Suspected Traumatic Thoracolumbar Spine Injury: 2017 Guidelines by the Korean Society of Radiology and National Evidence-Based Healthcare Collaborating Agency.

Korean J Radiol 2019 06;20(6):909-915

Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea.

The Korean Society of Radiology and the National Evidence-based Healthcare Collaborating Agency developed a primary imaging test for suspected traumatic thoracolumbar spine injury. This guideline was developed using an adaptation process involving collaboration between the development committee and the working group. The development committee, consisting of research methodology experts, established the overall plan and provided support on research methodology. The working group, composed of radiologists with expertise in musculoskeletal imaging, wrote the recommendation. The guidelines recommend that thoracolumbar spine computed tomography without intravenous contrast enhancement be the first-line imaging modality for diagnosing traumatic thoracolumbar spine injury in adults.
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http://dx.doi.org/10.3348/kjr.2018.0792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6536791PMC
June 2019

Implementation of Korean Clinical Imaging Guidelines: A Mobile App-Based Decision Support System.

Korean J Radiol 2019 02;20(2):182-189

Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.

Objective: The aims of this study were to develop a mobile app-based clinical decision support system (CDSS) for implementation of Korean clinical imaging guidelines (K-CIGs) and to assess future developments therein.

Materials And Methods: K-CIGs were implemented in the form of a web-based application (http://cdss.or.kr/). The app containing K-CIGs consists of 53 information databases, including 10 medical subspecialties and 119 guidelines, developed by the Korean Society of Radiology (KSR) between 2015 and 2017. An email survey consisting of 18 questions on the implementation of K-CIGs and the mobile app-based CDSS was distributed to 43 members of the guideline working group (expert members of the KSR and Korean Academy of Oral and Maxillofacial Radiology) and 23 members of the consultant group (clinical experts belonging to related medical societies) to gauge opinion on the future developmental direction of K-CIGs.

Results: The web-based mobile app can be downloaded from the Google Play Store. Detailed information on the grade of recommendation, evidence level, and radiation dose for each imaging modality in the K-CIGs can be accessed via the home page and side menus. In total, 32 of the 66 experts contacted completed the survey (response rate, 45%). Twenty-four of the 32 respondents were from the working group and eight were from the consulting group. Most (93.8%) of the respondents agreed on the need for ongoing development and implementation of K-CIGs.

Conclusion: This study describes the mobile app-based CDSS designed for implementation of K-CIGs in Korea. The results will allow physicians to have easy access to the K-CIGs and encourage appropriate use of imaging modalities.
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http://dx.doi.org/10.3348/kjr.2018.0621DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342762PMC
February 2019

Evidence-Based Practice Guideline for Surgical Treatment of Gastroesophageal Reflux Disease 2018.

J Gastric Cancer 2018 Dec 27;18(4):313-327. Epub 2018 Dec 27.

Guideline Committee of Korean Anti-Reflux Surgery (KARS) Study Group.

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.
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http://dx.doi.org/10.5230/jgc.2018.18.e41DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310769PMC
December 2018

The mediating effects on the relationship between campus life adaptation and clinical competence.

Nurse Educ Today 2019 Jan 14;72:67-72. Epub 2018 Nov 14.

Department of Nursing, Kunsan National University, #406, Digital Information Center, 558, Daehak-ro, Gunsan-si, Jeonllabuk-do 54150, Republic of Korea.

Background: The solution to the shortage of nursing staff is to improve the quality of nursing education and training rather than to increase the admission capacity. It is necessary for the university to establish the current level of nursing education and find ways to improve it. The clinical competence of nursing college students is an ability to perform the desired nursing role to solve the nursing needs of the subjects in the clinical field, which is an important aspect of nursing students' practical training. Therefore, to improve the quality of practical training, it is necessary to improve the clinical competence of nursing students.

Objectives: The purpose of this study was to investigate the mediating effect of social support and resilience on the relationships of campus life adaptation and clinical competence.

Design: This study is of a cross-sectional, descriptive correlation design.

Methods: Characteristics of the respondents, campus life adaptation, social support, resilience, and clinical competence were collected, using self-reported questionnaires, from July 1 to September 10, 2017. Data were analyzed by frequency, percentage, mean, standard deviation, t-test and ANOVA with Scheffe post hoc, Pearson correlation coefficients, the 3-steps multiple regression statistics of Baron and Kenny.

Results: Social support and resilience had a partial mediating effect on the relationships of campus life adaptation and clinical competence. In addition, clinical competence increased as more male nursing students enrolled and more students adapted well to the nursing department.

Conclusions: The result of this study is expected to be used as evidence data for the development of a program to improve the clinical competence of nursing students.
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http://dx.doi.org/10.1016/j.nedt.2018.11.009DOI Listing
January 2019

2018 Korean Clinical Imaging Guideline for Hemoptysis.

Korean J Radiol 2018 Sep-Oct;19(5):866-871. Epub 2018 Aug 6.

Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.

In 2014, the American College of Radiology (ACR) announced the guideline for the appropriate diagnostic approach and treatment of patients according to the severity of hemoptysis and risk for lung cancer. However, the application of the ACR guideline in Korea may not be appropriate, because many patients in Korea have active tuberculosis or pulmonary fibrosis due to previous tuberculosis. The Korean Society of Radiology and Korean Society of Thoracic Radiology have proposed a new guideline suitable for Korean practice. This new guideline was prepared through the consensus of a development committee, working party, and an advisory committee. The guideline proposal process was based on an evidence-based clinical imaging guideline proposed by the development committee. Clinical imaging guideline for adult patients with hemoptysis is as follows: Chest radiography is an initial imaging modality to evaluate hemoptysis. Contrast-enhanced chest CT is recommended in patients with two risk factors for lung cancer (> 40 years old and > 30 pack-year smoking history), moderate hemoptysis (> 30 mL/24 hours) or recurrent hemoptysis. Contrast-enhanced chest CT is also recommended in patients with massive hemoptysis (> 400 mL/24 hours) without cardiopulmonary compromise.
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http://dx.doi.org/10.3348/kjr.2018.19.5.866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082761PMC
April 2019
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