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선천결손된 상악 측절치와 수복 불가능한 대구치들의 심미수복을 위한 다학제 진료
박철완,Park, Chul-Wan 대한심미치과학회 2017 Journal of the Korean Academy of Esthetic Dentistr Vol.26 No.2
성공적인 심미치과치료를 위해서는 종종 교정과, 치주과, 보철과의사의 협진치료가 필요하다. 상실된 치아를 수복하는 경우, 특히 심미가 중요시되는 전치부의 상실치 수복시 임상가는 여러가지 치료방법의 장단점을 고려하여 치료법을 선택해야 한다. 이 글에서는 선천결손된 상악측절치와 발치가 필요한 구치를 가진 환자를 치아교정과 임플란트 수술 그리고 임플란트 보철의 다학제간 진료로 치료한 증례를 보여드리고자 한다. Successful treatment outcome of esthetic dentistry often requires team approach including orthodontist, surgeon and restorative dentist. Clinician should consider various treatment options to restore missing teeth, especially in anterior region. In this article, interdisciplinary treatment of restoring congenitally missing lateral incisor and unrestorable molars will be presented.
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정명진,전병율 대한의사협회 2021 대한의사협회지 Vol.64 No.10
Background: Cancer has been the leading cause of death in Korea for more than 40 years. As the aging population in the country increases, this trend is expected to continue. Cancer care is also being subdivided into specialties according to the development of medical technology. This division of care has made it difficult for a single physician to set up a complete cancer treatment plan. As a result, the call for multidisciplinary care has risen. Multidisciplinary cancer care allows physicians to share opinions and choose optimal patient treatment plans across multiple specialties. In August 2014, the Ministry of Health and Welfare designated a set number of approved multidisciplinary treatments and has included them under its health insurance coverage. As a result, multidisciplinary care is rapidly increasing. Current Concepts: An analysis on cancer care was conducted from 2014 to 2018, which examined the average medical expenses, hospitalization costs, and surgery costs per person according to therapeutic modality. Findings showed that multidisciplinary care decreased the overall cost of medical care in cancer patients compared to segmented care provided by single specialty physicians. Discussion and Conclusion: This study predicted that multidisciplinary care would be effective in reducing medical expenses. Cancer patients do not need to be treated by individual subspecialty physicians when personalized care treatment plans through a multidisciplinary approach is possible. The results of this study show that the Korean government should expand health insurance premium support and coverage for multidisciplinary cancer care
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김주훈,안중배 대한의사협회 2016 대한의사협회지 Vol.59 No.2
Cancer care can be complex with increased specialization within disciplines and more-sophisticated treatment techniques. Multidisciplinary care (MDC) is an integrated team approach to bring together a group of health professionals with appropriate skills to consider patient's treatment and care options. MDC are now conducted worldwide and is recommended as best practice for the management of patients with cancer. There is increasing evidence that MDC improves quality of care, treatment outcomes of patient with cancer and. other clinical outcomes, but concerns are raised over the paucity of good-quality evidence on their overall impact. In this review, we described available evidence on the impact of cancer MDC, and also reviewed focused on cancer MDC strategy depending on countries.
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Concordance Between Artificial Intelligence and Multidisciplinary Tumor Board for Lung Cancer
김민석,박하영,고보건,박철규,오인재,김영철,김석,윤주식,송상윤,나국주,정재욱,윤선미,안성자,유수웅,권성영,범희승,김인영,최유덕 대한결핵 및 호흡기학회 2018 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.126 No.0
Background: IBM Watson for Oncology (WFO) is a cognitive computing system which helps physicians quickly identify key information in a patient’s medical record, surface relevant evidence and explore treatment options. We evaluated the level of agreement between WFO and multidisciplinary tumor board (MDT) for lung cancer. Methods: From January to April 2018, newly diagnosed lung cancer cases in Chonnam National University Hwasun Hospital were retrospectively examined using WFO version 18.4 according to four treatment categories [surgery, radiotherapy, concurrent chemoradiotherapy (CCRT), and palliative setting]. Concordance between MDT and WFO was analyzed by Cohen's kappa value. Results: Total 132 cases were enrolled in this study. The concordance rate occurred in 92.4% (k=0.881, p<0.001) for the all cases. The strength of agreement was very good in stage 1 (92.4%, k=0.855), stage 4 NSCLC (100%, k=1.000) and extensive disease SCLC (100%, k=1.000). In stage 3 NSCLC, the strength of agreement was good (80.8%, k=0.622). And the concordance was moderate in stage 2 NSCLC (83.3%, k=0.556) and limited disease SCLC (84.6%, k=0.435). There were discordant cases in surgery (4/29, 13.8%) and CCRT (5/33, 15.2%), but discordance was not occurred in radiotherapy and palliative care. Conclusion: Treatment recommendations made by WFO and MDT were highly concordant for lung cancer cases especially in stage 1 NSCLC and metastatic stage. However, WFO was just an assisting tool in stage 2-3 NSCLC and limited disease SCLC, so shared decision making may be more important in this stage.
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