Korean Medical Research Articles

Fine-Tuned Bidirectional Encoder Representations From Transformers Versus ChatGPT for Text-Based Outpatient Department Recommendation: Comparative Study.

Patients often struggle with determining which outpatient specialist to consult based on their symptoms. Natural language processing models in health care offer the potential to assist patients in making these decisions before visiting a hospital. This study aimed to evaluate the performance of ChatGPT in recommending medical specialties for medical questions. We used a dataset of 31,482 medical questions, each answered by doctors and labeled with the appropriate medical specialty from the health consultation board of NAVER (NAVER Corp), a major Korean portal. This dataset includes 27 distinct medical specialty labels. We compared the performance of the fine-tuned Korean Medical bidirectional encoder representations from transformers (KM-BERT) and ChatGPT models by analyzing their ability to accurately recommend medical specialties. We categorized responses from ChatGPT into those matching the 27 predefined specialties and those that did not. Both models were evaluated using performance metrics of accuracy, precision, recall, and F1-score. ChatGPT demonstrated an answer avoidance rate of 6.2% but provided accurate medical specialty recommendations with explanations that elucidated the underlying pathophysiology of the patient's symptoms. It achieved an accuracy of 0.939, precision of 0.219, recall of 0.168, and an F1-score of 0.134. In contrast, the KM-BERT model, fine-tuned for the same task, outperformed ChatGPT with an accuracy of 0.977, precision of 0.570, recall of 0.652, and an F1-score of 0.587. Although ChatGPT did not surpass the fine-tuned KM-BERT model in recommending the correct medical specialties, it showcased notable advantages as a conversational artificial intelligence model. By providing detailed, contextually appropriate explanations, ChatGPT has the potential to significantly enhance patient comprehension of medical information, thereby improving the medical referral process.

Trends in South Korean Medical Device Development for Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder: Narrative Review.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are among the most prevalent mental disorders among school-aged youth in South Korea and may play a role in the increasing pressures on teachers and school-based special education programming. A lack of support for special education; tensions between teachers, students, and parents; and limited backup for teacher absences are common complaints among Korean educators. New innovations in technology to screen and treat ADHD and ASD may offer relief to students, parents, and teachers through earlier and efficient diagnosis; access to treatment options; and ultimately, better-managed care and expectations. This narrative literature review provides an account of medical device use and development in South Korea for the diagnosis and management of ADHD and ASD and highlights research gaps. A narrative review was conducted across 4 databases (PubMed, Korean National Assembly Library, Scopus, and PsycINFO). Journal articles, dissertations, and government research and development reports were included if they discussed medical devices for ADHD and ASD. Only Korean or English papers were included. Resources were excluded if they did not correspond to the research objective or did not discuss at least 1 topic about medical devices for ADHD and ASD. Journal articles were excluded if they were not peer reviewed. Resources were limited to publications between 2013 and July 22, 2024. A total of 1794 records about trends in Korean medical device development were categorized into 2 major groups: digital therapeutics and traditional therapy. Digital therapeutics resulted in 5 subgroups: virtual reality and artificial intelligence, machine learning and robot, gaming and visual contents, eye-feedback and movement intervention, and electroencephalography and neurofeedback. Traditional therapy resulted in 3 subgroups: cognitive behavioral therapy and working memory; diagnosis and rating scale; and musical, literary therapy, and mindfulness-based stress reduction. Digital therapeutics using artificial intelligence, machine learning, and electroencephalography technologies account for the biggest portions of development in South Korea, rather than traditional therapies. Most resources, 94.15% (1689/1794), were from the Korean National Assembly Library. Limitations include small sizes of populations to conclude findings in many articles, a lower number of articles discussing medical devices for ASD, and a majority of articles being dissertations. Emerging digital medical devices and those integrated with traditional therapies are important solutions to reducing the prevalence rates of ADHD and ASD in South Korea by promoting early diagnosis and intervention. Furthermore, their application will relieve pressures on teachers and school-based special education programming by providing direct supporting resources to students with ADHD or ASD. Future development of medical devices for ADHD and ASD is predicted to heavily rely on digital technologies, such as those that sense people's behaviors, eye movement, and brainwaves.

The legality and appropriateness of keeping Korean Medical Licensing Examination items confidential: a comparative analysis and review of court rulings.

This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees' abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

A Case of the 1st Metatarsal Bone Fracture in a Patient with Chronic Kidney Disease Treated by Acupuncture with Complex Korean Medical Treatment

A Case of the 1st Metatarsal Bone Fracture in a Patient with Chronic Kidney Disease Treated by Acupuncture with Complex Korean Medical Treatment

The Effectiveness and Safety of Yi Shen Juan Bi Pill on Rheumatoid Arthritis: a Protocol for Systematic Review and/or Meta-Analysis.

The Yi Shen Juan Bi (YSJB) pill has been used to treat rheumatoid arthritis (RA), with several studies reporting its anti-inflammatory effects and ability to prevent bone destruction. However, the lack of evidence regarding the effectiveness and toxicity of individual components of YSJB limits its widespread use. This protocol outlines a systematic review and/or meta-analysis to evaluate the effectiveness and safety of YSJB. We will search worldwide electronic databases, including MEDLINE, Cochrane Library, China National Knowledge Infrastructure, Wanfang, CiNii, J-STAGE, KoreaMed, Korean Medical Database, Korean Studies Information Service System, National Digital Science Library, Korea Institute of Science and Technology Information, and Oriental Medicine Advanced Searching Integrated System. In addition, we will conduct manual searches, and, if necessary, contact authors directly. The search will cover publications until June 2024. We will select randomized controlled trials (RCTs) that compare the use of YSJB for the treatment of RA against other treatments. Data from the selected RCTs will be extracted, including sample size, patient characteristics, intervention details, and outcome measures. We will perform a meta-analysis using Review Manager software. The primary outcome measures will include disease activity scores such as effective rate, swollen joint count, tender joint count, and morning stiffness. Secondary outcome measures will include blood test results and adverse events. The results will reveal the effectiveness and safety of YSJB for the treatment of RA. and Relevance: The findings will provide an evidence-based review of the use of YSJB for RA.S.

Scientific Publication Speed of Korean Medical Journals during the COVID-19 Era.

This study compared the scientific publication speeds of Korean medical journals before and during the coronavirus disease 2019 (COVID-19) era. We analyzed 2,064 papers from 43 international Korean medical journals, selecting 12 papers annually from 2019 to 2022. We assessed publication speed indicators, including the time from submission to revision and from submission to publication. Additionally, we examined variations in publication speed based on journal and paper characteristics, including whether the studies were related to COVID-19. Among the 43 journals analyzed, 39.5% disclosed the peer review duration from submission to the first decision, and 11.6% reported their acceptance rates. The average time from submission to acceptance was 127.0 days in 2019, 126.1 days in 2020, 124.6 days in 2021, and 126.4 days in 2022. For COVID-19-related studies, the average time from submission to revision was 61.4 days, compared to 105.1 days for non-COVID-19 studies; from submission to acceptance, it was 87.4 days for COVID-19-related studies and 127.1 days for non-COVID-19 studies. All indicators for COVID-19-related studies showed shorter durations than those for non-COVID-19 studies, and the proportion of studies accepted within 30 or 60 days was significantly higher for COVID-19-related studies. This study investigated the publication speed of Korean international medical journals before and during the COVID-19 pandemic. The pandemic influenced journals' review and publication processes, potentially impacting the quality of academic papers. These findings provide insights into publication speeds during the COVID-19 era, suggesting that journals should focus on maintaining the integrity of their publication and review processes.

A Case Report of Korean Medical Treatment for an Adult with Cyclic Vomiting Syndrome Analyzed by Electrogastrography and Subjective Evaluation Scale

Objectives: This case study reports the effectiveness of Korean medical treatment in a patient with cyclic vomiting syndrome.Methods: A 29-year-old female Korean patient with cyclic vomiting syndrome received acupuncture, electroacupuncture, herbal medicine, and moxibustion for 2 weeks in hospital. Changes in symptoms were evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), Visual Analog Scale (VAS), Index for Nausea, Vomiting, and Retching (INVR), Nausea Severity Scale (NSS), Nepean Dyspepsia Index-Korean version (NDI-K), quality of life using the Functional Dyspepsia Related Quality of Life questionnaire (FD-QoL), and gastric motility using electrogastrography (EGG).Results: Post-treatment, the patient showed high satisfaction and improvement in symptoms of nausea and vomiting. The following changes were observed in scores: GSRS: 23 to 19; VAS of nausea: 88 to 95; VAS of dyspepsia: 95 to 12; INVR: 13 to 1; NSS: 17 to 5; NDI-K: 107 to 78; and FD-QoL 84 to 27. We also found positive results in Channel 3 of EGG parameters, implying the improvement of gastric motility disorder.Conclusion: Korean medical treatment can be a therapeutic option for cyclic vomiting syndrome.

Interprofessional Education in Korean Medical Education: From Individual Efforts to Structural Collaboration

Interprofessional Education in Korean Medical Education: From Individual Efforts to Structural Collaboration

한의대생의 학업 성취도에 대한 영향 요인 연구

한의대생의 학업 성취도에 대한 영향 요인 연구

A Case Report of Complex Korean Medical Treatments, Including Shihogayonggolmoryo-tang, for Sleep Disorders Accompanied by a Herniated Intervertebral Disc

Objectives: We describe the clinical course in a 53-year-old female patient admitted to a Korean Medicine Hospital with insomnia disorder accompanied by a herniated intervertebral disc and managed with Korean medical treatments.Methods: The patient was treated with herbal medicines, including Shihogayonggolmoryo-tang, acupuncture, pharmacopuncture, and Chuna manual therapy for 33 days. The therapeutic effect was evaluated based on the Insomnia Severity Index, Numerical Rating Scale score, Oswestry Disability Index, and European Quality of Life 5 Dimensions Scale.Results: Post-treatment, the Insomnia Severity Index decreased from 21 to 6, the Numerical Rating Scale score decreased from 7 to 3, the Oswestry Disability Index decreased from 60 to 18, and the European Quality of Life 5 Dimensions Scale increased from 0.35 to 0.85.Conclusions: Korean medical treatments improved the symptoms of this patient with insomnia disorder accompanied by a herniated intervertebral disc. Further clinical research on patients with insomnia disorder is needed.

Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents: a systematic review and meta-analysis.

As childhood obesity escalates worldwide, the prevalence of nonalcoholic fatty liver disease (NAFLD) in pediatric and adolescent populations is also increasing. However, systematic studies and meta-analyses evaluating the prevalence of pediatric NAFLD remain limited. The MEDLINE, Korean Medical Database (KMBASE), Embase, Global Health, and Cochrane Library databases were searched from January 1997 to April 2023. Search terms included NAFLD or steatosis; nonalcoholic or steatohepatitis; child(ren), adolescent, or teenager; and prevalence, incidence, or epidemiology. A random-effects meta-analysis model was used to estimate the prevalence of pediatric NAFLD. A total of 2116 publications were found, of which 62 were included in the meta-analysis. Among them, 27 reported the prevalence in the general population and 39 in the obese population. The worldwide pooled prevalence of pediatric NAFLD was 13% [95% confidence interval (CI) 9-18%] in the general population and 47% (95% CI 41%-53%) in the obese population. Among 16 studies in the general population and 18 in the obese population, NAFLD prevalence varied by gender. In the general population, the prevalence of NAFLD was 15% (95% CI 8%-23%) in males and 10% (95% CI 6%-15%) in females. In the obese population, it was 54% (95% CI 46%-61%) in males and 39% (95% CI 30%-49%) in females. The global prevalence of pediatric NAFLD is rising in both the general and obese populations. Given the increasing rates of childhood obesity, epidemiological studies on the prevalence and incidence of NAFLD are needed.

Factors Related to Emotional Leadership in Nurses Manager: Systematic Review and Meta-Analysis

This study aimed to identify research trends related to emotional leadership among nurse managers by conducting a systematic literature review and meta-analysis. This study sought to derive insights that could contribute to improving emotional leadership in nursing practice. A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and Meta-Analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Web of Science, Research Information Sharing Service, Koreanstudies Information Service System, Korean Medical Database, KoreaMed, ScienceON, and DBpia were searched to obtain papers published in English and Korean. Literature searches and screenings were conducted for the period December 1, 2023 to December 17, 2023. The effect size correlation (ESr) was calculated for each variable and the meta-analysis was performed using the statistical software SPSS 29.0, R 4.3.1. Twenty-five (four personal, six job, and fifteen organizational) relevant variables were identified through the systematic review. The results of the meta-analysis showed that the total overall effect size was ESr = .33. Job satisfaction (ESr = .40) and leader-member exchange (ESr = .75) had the largest effect size among the job and organizational-related factors. Emotional leadership helps promote positive changes within organizations, improves organizational effectiveness, and increases member engagement and satisfaction. Therefore, it is considered an important strategic factor in improving organizational performance.

The Effect of Complex Korean Medical Treatment for Tibia, Fibula and Patellar Fractures in Patient with Sequelae of Poliomyelitis: A Case Report

The Effect of Complex Korean Medical Treatment for Tibia, Fibula and Patellar Fractures in Patient with Sequelae of Poliomyelitis: A Case Report

Quality evaluation of internet resources related to breast surgery in major search engines in Korea

Background With the increasing number of internet users, search engines have become a widely used source of health-related information. However, evaluating the quality of medical information obtained through search engines can be challenging. This study aimed to evaluate the quality of search results related to breast implants obtained from major domestic websites in Korea using systematic evaluation standards.Methods Two main primary search terms (“gaseum” [breast] implant and “yubang” [breast] implant), along with 15 adjunct search terms, were combined and searched in Google, Naver, and Daum. The top 20 websites were evaluated and classified according to their type and provider. They were scored using the Korean Medical Association’s Internet Health Information Certification Standards. The proportion of significant websites, their categorical distribution, and the quality of information scores were then compared.Results Google yielded the highest number of appropriate results, with statistical significance. Blogs (36.4%) and news (34.8%) were the most common types of search results, while healthcare provider groups (49.5%) constituted the most common provider subgroup. Only 1.9% of the search results were from public organizations. Google had a significantly higher average quality score (14.04) than Naver (13.22), and Daum (12.45) (P<0.05).Conclusions Although almost half of the search results were provided by medical personnel, their average quality score (13.16) was below the overall average (13.36) and far below the 21 points of the journal/abstract category. The findings highlight the need for healthcare providers to provide high-quality medical information, and for users to develop high-level digital health literacy.

The demographic analysis of women physicians in the leadership of medical societies in South Korea

Background: As female social participation increases, the importance of femininity in leadership also increases. In Korea in 2021, 26.8% of 132,013 doctors and 35.1% of 3,099 medical students were female. However, no research has been conducted on the gender demographics of medical leaders. This study aims to define Korean medical leadership, investigate the gender ratio, and determine whether the proportion of women leaders differs in the academic and non-academic worlds.Methods: Korean medical leaders were defined as those in director or higher-level positions in organizations affiliated with the Korean Medical Association, 34 organizing societies under the Korean Academy of Medical Sciences (KAMS), and those who held dean and vice dean positions in 40 medical schools. Academic societies comprised KAMS, KAMS-affiliated societies, and medical schools; the rest were classified as non-academic organizations. Data were collected through website, e-mail, or telephonic surveys. Differences in the number of women leaders between academics and non-academics were analyzed using the chi-square test.Results: In total, 1,863 medical leaders were evaluated, with females accounting for 12.6%. The difference in the ratio of female leaders between academic and non-academic societies was not statistically significant (13.1% academic vs. 11.8% non-academic; <i>P</i>=0.445).Conclusion: The proportion of women leaders in the Korean medical field is relatively low compared with that of female doctors and medical students. The number of women in leadership positions and their effect on medical society will be observed periodically.

A Message from the New Editor-in-Chief of the Korean Medical Education Review

A Message from the New Editor-in-Chief of the Korean Medical Education Review

Factors associated with academic performance among medical students at a medical school in South Korea: A retrospective cohort study.

Longitudinal research has provided systematic empirical data on the short- and long-term outcomes of admissions policies, curricular innovations, and complex decisions on students' academic progress. This study aimed to investigate the academic performance of medical students and related factors using cohort database collected from a medical school. The study participants included 134 medical students who graduated from Chonnam National University Medical School in 2022. The medical school's cohort database was used to collect data on demographics, admission, academic performance, extracurricular activities, and performance on the National Korean Medical Licensing Examination (KMLE). Participating in club activities had a significant association with medical students' academic advancement delay or leave of absence during the entire course of medical school (P = 0.007). Logistic regression analysis indicated that the nationwide clinical knowledge mock examination during the fourth year of medical school was significantly associated with passing the KMLE (adjusted odds ratio 1.12, 95% confidence interval 1.02-1.22; P = 0.014). Extracurricular school activities (a non-cognitive student attribute) and a wide range of cognitive student attributes captured from the cohort database were associated with medical students' academic performance. In conclusion, this study can reinforce a strong emphasis on the inclusion of cognitive and non-cognitive information in medical school curricula and assessments in order to improve medical education programs and future postgraduate performance.

Trends in Research on Patients With COVID-19 in Korean Medical Journals.

This study was conducted to systematically summarize trends in research concerning patients with coronavirus disease 2019 (COVID-19) as reported in Korean medical journals. We performed a literature search of KoreaMed from January 2020 to September 2022. We included only primary studies of patients with COVID-19. Two reviewers screened titles and abstracts, then performed full-text screening, both independently and in duplicate. We first identified the 5 journals with the greatest numbers of eligible publications, then extracted data pertaining to the general characteristics, study population attributes, and research features of papers published in these journals. Our analysis encompassed 142 primary studies. Of these, approximately 41.0% reported a funding source, while 3.5% disclosed a conflict of interest. In 2020, 42.9% of studies included fewer than 10 participants; however, by 2022, the proportion of studies with over 200 participants had increased to 40.6%. The most common design was the cohort study (48.6%), followed by case reports/series (35.2%). Only 3 randomized controlled trials were identified. Studies most frequently focused on prognosis (58.5%), followed by therapy/intervention (20.4%). Regarding the type of intervention/exposure, therapeutic clinical interventions comprised 26.1%, while studies of morbidity accounted for 13.4%. As for the outcomes measured, 50.7% of studies assessed symptoms/clinical status/improvement, and 14.1% evaluated mortality. Employing a systematic approach, we examined the characteristics of research involving patients with COVID-19 that was published in Korean medical journals from 2020 onward. Subsequent research should assess not only publication trends over a longer timeframe but also the quality of evidence provided.

Experiences of Patients With Breast Cancer Regarding Korean Medical Treatment Approaches: A Qualitative Study Protocol

The importance of a complementary medical approach for patients with breast cancer is being emphasized to improve their quality of life and manage treatment-related symptoms. Korean medical treatment methods such as acupuncture, moxibustion, and herbal medicine are widely used to treat the side effects and sequelae of cancer treatment, such as pain, lymphedema, gastrointestinal disorders, and psychological issues. However, qualitative research on the perceptions of Korean patients with breast cancer regarding Korean medical treatment is lacking. This study aims to explore the how patients with breast cancer choose Korean medicine as a treatment option, patient experience regarding various therapeutic interventions, and their perception of the advantages and disadvantages of Korean medicine. A qualitative research methodology will be employed and semi-structured, in-depth interviews will be conducted with around 15 patients with breast cancer aged 19–75 years who have undergone Korean medical treatment, and each interview will last approximately 60–120 min. If necessary, interviews will be conducted up to three times. Data will be analyzed using the grounded theory methodology. This study will investigate the benefits and limitations of Korean medical treatment as a remedy for the medical needs of patients with breast cancer. These outcomes could be used as foundational data for future quantitative cancer research and serve as a basis for the development of patient-centered Korean medicine healthcare systems.

Drawing Guideline for JKMS Manuscripts (06): Scatter Plot.

The appropriate plot effectively conveys the author's conclusions to the readers. Journal of Korean Medical Science is providing a series of guidelines to show you how to make consistent and excellent plots more easily. In this article, we introduce scatter plots and more.