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      National Priority Setting of Clinical Practice Guidelines Development for Chronic Disease Management

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          Abstract

          By November 2013, a total of 125 clinical practice guidelines (CPGs) have been developed in Korea. However, despite the high burden of diseases and the clinical importance of CPGs, most chronic diseases do not have available CPGs. Merely 83 CPGs are related to chronic diseases, and only 40 guidelines had been developed in the last 5 yr. Considering the rate of the production of new evidence in medicine and the worsening burden from chronic diseases, the need for developing CPGs for more chronic diseases is becoming increasingly pressing. Since 2011, the Korean Academy of Medical Sciences and the Korea Centers for Disease Control and Prevention have been jointly developing CPGs for chronic diseases. However, priorities have to be set and resources need to be allocated within the constraint of a limited funding. This study identifies the chronic diseases that should be prioritized for the development of CPGs in Korea. Through an objective assessment by using the analytic hierarchy process and a subjective assessment with a survey of expert opinion, high priorities were placed on ischemic heart disease, cerebrovascular diseases, Alzheimer's disease and other dementias, osteoarthritis, neck pain, chronic kidney disease, and cirrhosis of the liver.

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          Decision making with the analytic hierarchy process

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            GBD 2010: design, definitions, and metrics.

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              Raising the priority of preventing chronic diseases: a political process.

              Chronic diseases, especially cardiovascular diseases, diabetes, cancer, and chronic obstructive respiratory diseases,are neglected globally despite growing awareness of the serious burden that they cause. Global and national policies have failed to stop, and in many cases have contributed to, the chronic disease pandemic. Low-cost and highly effective solutions for the prevention of chronic diseases are readily available; the failure to respond is now a political, rather than a technical issue. We seek to understand this failure and to position chronic disease centrally on the global health and development agendas. To identify strategies for generation of increased political priority for chronic diseases and to further the involvement of development agencies, we use an adapted political process model. This model has previously been used to assess the success and failure of social movements. On the basis of this analysis,we recommend three strategies: reframe the debate to emphasise the societal determinants of disease and the interrelation between chronic disease, poverty, and development; mobilise resources through a cooperative and inclusive approach to development and by equitably distributing resources on the basis of avoidable mortality; and build one merging strategic and political opportunities, such as the World Health Assembly 2008–13 Action Plan and the high level meeting of the UN General Assembly in 2011 on chronic disease. Until the full set of threats—which include chronic disease—that trap poor households in cycles of debt and illness are addressed, progress towards equitable human development will remain inadequate.
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                Author and article information

                Journal
                J Korean Med Sci
                J. Korean Med. Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                December 2015
                30 November 2015
                : 30
                : 12
                : 1733-1742
                Affiliations
                [1 ]Department of Health Management and Policy, Kangwon National University School of Medicine, Chuncheon, Korea.
                [2 ]The Executive Committee for Clinical Practice Guidelines, The Korean Academy of Medical Sciences, Seoul, Korea.
                [3 ]Department of Radiology, Yonsei University Sevrance Hospital, Yonsei University College of Medicine, Seoul, Korea.
                [4 ]Department of Preventive Medicine, Kangwon National University Hospital, Chuncheon, Korea.
                Author notes
                Address for Correspondence: Moo-Kyung Oh, MD. Department of Preventive Medicine, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon 24289, Korea. Tel: +82.33-258-9031, Fax: +82.33-258-9294, somanghana@ 123456gmail.com
                Author information
                http://orcid.org/0000-0003-0245-3583
                http://orcid.org/0000-0001-7527-3829
                http://orcid.org/0000-0002-2011-5708
                Article
                10.3346/jkms.2015.30.12.1733
                4689816
                6b9ee703-5cc5-4466-9382-99e8d999fce6
                © 2015 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 June 2015
                : 18 August 2015
                Funding
                Funded by: Korea Health Promotion Foundation, CrossRef http://dx.doi.org/10.13039/501100003639;
                Funded by: Korea Centers for Disease Control & Prevention, CrossRef http://dx.doi.org/10.13039/501100003952;
                Award ID: 2013-84
                Categories
                Original Article
                Medicine General & Social Medicine

                Medicine
                clinical practice guideline,chronic disease,primary health care,health priorities,korea
                Medicine
                clinical practice guideline, chronic disease, primary health care, health priorities, korea

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