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임상연구방법론에서 귀무가설과 대립가설, 귀류법에 대한 고찰과 한방이비인후과에서 베이지안 통계학의 활용
남승표,배재민,권강 대한한방안이비인후피부과학회 2019 한방안이비인후피부과학회지 Vol.32 No.4
Background : The current medical statistics used in clinical research are the results of Fisher's significance test and the Neyman-Pearson hypothesis test, which were combined by psychologists. Also, in the philosophical background, it is related to Popper's falsificationism based hypothesis-deductive method and reduction to absurdity. Objectives : This study was designed to find complementary and alternative methods of null hypothesis and alternative hypothesis used for the clinical research methodology of Korean medicine otolaryngology. Methods : The body of this paper was divided into seven part. These are historical background, hypothesis test, hypothesis test method used in the design of clinical study, falsificationism and reduction to absurdity, problem and alternative method of the Neyman-Pearson hypothesis test, diagnosis example of sinusitis differentiation syndromes by Bayesian statistics. Through this process, we found out problems of frequentist statistics and suggested alternative methods. Result & Conclusion : As a solution to the problems of the null hypothesis and the alternative hypothesis, there are effects size, confidence interval, Bayesian statistics and Lakatos methodology of scientific research programmes.
이지현,남승표,장영은,김은희,김희수,김진태 대한마취통증의학회 2020 Anesthesia and pain medicine Vol.15 No.2
Background: Ambu AuraGain and i-gel have different characteristics in design each other. However, few reports evaluate which device has more benefits for ventilation in children undergoing paralyzed general anesthesia. This prospective, randomized controlled trial compared the clinical performance AuraGain and i-gel in anesthetized children. Methods: Children aged between 1 month and 7 years undergoing elective surgery were randomly assigned to the AuraGain and i-gel groups. The primary outcome was initial oropharyngeal leak pressure (OLP). Secondary outcomes were OLP at 10 min post-insertion, first-attempt and total insertion success rates, number of attempts and ease of gastric suction catheter placement, peak inspiratory pressure, fiberoptic bronchoscopic view score, ventilation quality, requirement of additional manipulation post-insertion, and complications. Results: Data of 93 patients were analyzed. The initial OLPs of the AuraGain and i-gel were 27.5 ± 7.7 and 25.0 ± 8.0 cmH2O, respectively (P = 0.130). The OLP was significantly increased 10 min post-insertion in both groups. The initial success rates of the AuraGain and i-gel insertion were comparable. Suction catheter placement via the gastric port was easier (P = 0.018) and fiberoptic bronchoscopic view was better with the AuraGain (P < 0.001). The i-gel required additional manipulations post-insertion (P = 0.038). The incidence of complications during the emergence period was 10.8% for the i-gel and 2.2% for the AuraGain (P = 0.1). Conclusions: OLP is comparable between AuraGain and i-gel. The AuraGain would be more favorable than the i-gel for use in pediatric patients under general anesthesia considering other outcomes.