The Present and Future of Clinical Practice Guidelines for Neuro-Traumatology in Korea

Clinical practice guidelines are defined as “statements that are systematically organized and written to assist clinicians and patients with decision-making in specific situations.”⁴⁾ Established clinical practice guidelines can serve as a guide in resolving uncertain clinical situations, help improve the quality of medical care, and improve the efficiency of medical services with limited medical resources.

In Korea, because of the characteristics of the national health insurance system, the participation and interest of domestic medical staff in the development of medical guidelines is low because there is a possibility that the medical guidelines may infringe on the autonomy of each medical staff.

However, as interest in and the importance of evidence-based medicine have been highlighted, the development of treatment guidelines has been revitalized. In the early 1990s, foreign countries began to establish policy support for medical guidelines, and in 2002, the Guidelines International Network was formed to promote international exchanges.

In Korea, the Korean Medical Guideline Information Center (KoMGi), started in 2008, has been established as a foundation for medical professionals to develop clinical care guidelines in Korea and is encouraging the development of clinical treatment guidelines through continuous education.²⁾ At the end of January 2022, the domestic medical guidelines listed in the KoMGi include nine guidelines developed by the Korean Academy of Medical Sciences, 32 guidelines approved by the Korean Academy of Medical Sciences, and 398 guidelines developed and registered in Korea.³⁾

Clinical practice guidelines for severe neurotrauma, such as severe traumatic brain injury, have already been developed by the Brain Trauma Foundation in 1995 (https://www.braintrauma.org/, USA), are widely known, and have been continuously revised.¹⁾ In Korea, the treatment guidelines for severe traumatic brain injury were produced by the Korean Neuro-Traumatology Society (KNTS) in 2004, but there have been no further updates since then. After that, neurotrauma-related clinical treatment guidelines have been partially covered by the trauma standard treatment guidelines developed by the Korean Society for Traumatology in 2018. However, these guidelines are insufficient to provide standard guidelines for various diseases caused by neurotrauma. Therefore, the KNTS expanded and reorganized the Neurotrauma Clinical Practice Guidelines Committee (NCPGC) to consider the de novo process or adaptation process for clinical treatment guidelines related to neurotrauma, and considered which diseases should be dealt with. Many diseases related to traumatic brain and spinal cord injuries remain; as a typical example, treatment guidelines for chronic subdural hematoma, which is often encountered in clinical settings and with increasing prevalence with the aging of society, have not yet been established.

Regarding content that will be dealt with later, the NCPGC in KNTS will summarize and report the evidence for key questions essential in the new development process and introduce newly developed medical guidelines. We hope that this will be of great help in treating patients in the clinical field in the future.