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Formulation of the Scope and Key Questions of the Guideline Recommendations for Immunosuppressive Treatment in Kidney Transplantation
Korean J Clin Pharm 2019;29(1):18-24
Published online March 31, 2019
© 2019 Korean College of Clinical Pharmacy.

Seungyeon Huh1, Nayoung Han1,2*, Minji Sohn1,2, Junghwa Ryu2, Jaeseok Yang2, and Jung Mi Oh1

1College of Pharmacy & Research Institute of Pharmaceutical Science, Seoul National University, Seoul, Republic of Korea
2Transplantation Center, Seoul National University Hospital, Seoul, Republic of Korea
Correspondence to: Nayoung Han, College of Pharmacy & Research Institute of Pharmaceutical Science, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
Tel: +82-2-740-8553, Fax: +82-2-766-9560, E-mail:
Received December 19, 2018; Revised February 27, 2019; Accepted March 6, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non- Commercial License ( which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Although a growing number of guidelines and clinical researches are available for immunosuppressive treatment of post-transplantation, there is no clinical practice guideline for the care of kidney transplant recipients in Korea. Selection of a researchable question is the most important step in conducting qualified guideline development. Thus, we aimed to formulate key questions for Korean guideline to aid clinical decision-making for immunosuppressive treatment. Methods: Based on previous published guidelines review, a first survey was constructed with 29 questions in the range of immunosuppressive treatments. The experts were asked to rate the clinical importance of the question using a 5-point Likert scale. The questions reached 60% or more from the first survey and additional new questions were included in the second survey. In analyzing the responses to items rated on the 9-point scale, consensus agreement on each question was defined as 75% or more of experts rating 7 to 9. Results: In the first survey, 50 experts were included. Among the 29 questions, 27 were derived to get 60% or more importance and 3 new questions were additionally identified. Through the second survey, 9 questions were selected that experts reached consensus on 75% and over of the options. Finally, we developed key questions using PICO (patient, intervention, comparison, and outcome) methodology. Conclusion: The experts reached a high level of consensus on many of key questions in the survey. Final key questions provide direction for developing clinical practice guideline in the immunosuppressive treatment of transplantation.
Keywords : Kidney transplantation, clinical guideline, evidence-based, key questions

March 2019, 29 (1)
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