근거기반 의사결정을 위한 「근거문헌 활용 가이드라인」 고도화 연구

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근거기반 보건의료EBH근거문헌근거기반 의사결정Evidence Based HealthEvidence Based MedicineEvidence Based Decision making
The Health Insurance Review and Assessment Service (HIRA) is pivotal in shaping health policy, particulary through its committees responsible for the registration of insurance benefits and the establishment of standards. The key to these committee’s efficacy lies in making objective and rational decisions rooted in ‘reliable, high-quality information’. This process significantly impacts public health by influencing both medical providers and consumers.
Critical to these decisions is the reliance on evidence-based literature that ensures optimal use of healthcare interventions, drawing from valid clinical research results. In response to the need for a streamlined method that can generate scientific evidence data in a relatively short period of time, our institute has developed the Evidence Based Review Manual (EBRM). This methodology, applicable to our work, facilitates efficient decision-making. While literature is a cornerstone in all reimbursement decision-making processes, the methods of application vary across different medical practices and drugs committees, Since 2005, we have systematically incorporated the latest trends in the use of clinical research literature every 3-4 years.
This study reviewed domestic and international evidence-based decision-making guidelines and previous research, to introduce an updated decision-making methodology during the practical implementation of Evidence Based Health (EBH). We have collaborated with evidence-based medical experts to provide information that is not only easily comprehensible but also highly practical for practitioners. The collected methodologies were reviewed for their applicability to our company works.
Based on this research report, content that needs to be updated will be included in the 7th edition of EBRM. We anticipate that this study will serve as a readily accessible resource for departments which create evidence of pricing and reimbursement. Moreover, it suggests a progression and improvement in the existing guideline and aims to be invaluable for employees who highly utilize literature.
Alternative Title
Research to Advance Guidelines for Evidence-based Decision Making
Table Of Contents
제1장 서론 ······················································· 1
1. 연구 배경 및 목적 ·················································································· 1
가. 연구 배경 ·································································································· 1
나. 연구 목적 ·································································································· 2
2. 연구 내용 및 방법 ·················································································· 3
가. 연구 내용 ·································································································· 3
나. 연구 방법 ·································································································· 4

제2장 체계적 문헌 고찰 ······················································· 7
1. 개요 ······································································································ 7
2. 질 평가도구 ··························································································· 9
가. 무작위배정 연구(Randomized Controlled studies)의 질 평가도구 ··············· 12
나. 비무작위배정 연구(Non-Randomized studies)의 질 평가도구 ····················· 20
다. 체계적 문헌 고찰의 질 평가도구 ································································ 31
3. 반자동화 도구를 활용한 체계적 문헌 고찰 ·············································· 43
가. 반자동화 도구 소개 ·················································································· 43
나. 반자동화 도구 활용 사례 ··········································································· 54
4. 평가 결과 활용 ···················································································· 57
가. RevMan(Review Manager)을 이용한 결과 제시 ········································ 57
나. robvis를 이용한 결과 제시 ········································································ 59

제3장 근거기반 의사결정 ······················································· 63
1. 의사결정 방법론 ··················································································· 63
가. 의학적 필요성과 타당성 ············································································· 63
나. RAND/UCLA 적절성 평가 방법 ································································ 66
2. 의사결정 시 주요 결정 요인(근거) ·························································· 78
가. 문헌 선택 흐름도: PRISMA 2020 ····························································· 78
나. 임상진료지침 평가도구: AGREE Ⅱ ···························································· 87
다. 근거 수준 ································································································ 90

제4장 심사평가원의 회의 자료 작성 ······················································· 95
1. 회의 자료 양식 ···················································································· 95
2. 최종 선정 문헌의 일반적 특성표 ···························································· 96
3. 근거 요약표(제시) ·············································································· 97

제5장 결론 및 제언 ······················································· 103

◾ 참고 문헌 ····················································································· 106
◾ 부록 ··························································································· 109
◾ ABSTRACT ················································································ 121
박정미. (2024-01). 근거기반 의사결정을 위한 「근거문헌 활용 가이드라인」 고도화 연구.
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