국내 상급종합병원과 종합병원에서의 정맥주입간호실무지침에 대한 태도와 확산정도

은영(Young Eun),구미옥(Mee Ok Gu),조용애(Young Ae Cho),김신미(Shin Mi Kim),정재심(Jae Shim Jeong),권정순(Jeong Soon Kwon),유정숙(Cheong Suk Yoo),정영선(Young Sun Jeong),정인숙(In Sook Jung),김경숙(Kyeong Sug Kim)이선희(Seon Heui Lee 한국근거기반간호학회 2014 근거와 간호 Vol.2 No.1

Purpose: This study was conducted to investigate the level of attitudes to and diffusion of Intravenous infusion nursing practice guideline in advanced general hospitals and general hospitals in Korea. Methods: The subjects were 41 nurses who were in charge of guideline diffusion in 41 advanced general hospitals and general hospitals. Data were collected between September 25 and November 2, 2014 by mail (return rates: 68.3 %). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 18.0. Results: The average attitude score of guideline among nurses in charge of guideline diffusion were 3.98±0.38 (range 1~5). The average guideline diffusion score and levels of diffusion was 2.26±1.39 (level of “persuasion of nursing knowledge”) for staff nurses, 3.05±0.86 (level of “use sometimes”) for nurses in charge of guideline diffusion, 2.87±0.78 (level of “use sometimes”) for nurse directors. 41.4 % of nursing divisions in 41 hospitals reviewed the intravenous infusion nursing practice guideline, educated the guideline to nurses, and implemented the guideline in clinical practice for guideline diffusion. Conclusion: Study findings indicate that nurses in charge of intravenous infusion nursing practice guideline in hospitals had positive attitude for guideline. The levels of guideline diffusion in hospitals was “persuasion of nursing knowledge” to “use sometimes”. Therefore, the strategies for promoting the diffusion and implementation of guideline in clinical practice in the level of nursing division is needed. Further study of outcome evaluation of guideline implementation will be needed.

법정형과 양형기준의 관계에 관한 고찰

김슬기(Kim, Seul-Ki) 한국형사법학회 2012 刑事法硏究 Vol.24 No.2

In 2007, the Republic of Korea founded its Sentencing Commission by amending the Court Organization Act. Since then, Korea has gradually established the Sentencing Guideline for major crimes to guarantee unity and objectivity of judicial power. In consequence, Korea, a country with substantive criminal law background in the civil law, has now ended up with two different kinds of standards, a ‘statutory penalty’ proposed by legislators and a ‘sentencing guideline’ proposed by the Sentencing Commission. In that sense, it is evident that establishing the normative relationship between these two standards is a prerequisite for drawing up a reasonable Sentencing Guideline. The Sentencing Guideline, which has a normative character, is not a sentence itself but a general standard prepared in advance to decree punishment. Thus, the relationship between statutory penalty and the Sentencing Guideline can be described as that of a general rule and a detailed rule regarding the choice of types and terms of punishment. Distribution of sentencing is definitely an important reference to the establishment of the Sentencing Guideline but it cannot be regarded as a decisive factor which justifies establishment of category ranges. A number of problems can be found when we examine the recently announced Sentencing Guidelines for violent crimes with respect to the relationship of these two standards. First of all, the Sentencing Guideline's classification of offence disregards the legislative decision, which has prescribed additional requirements separately. Secondly, with regard to the choice of sentencing factor, the Sentencing Guideline treats sentencing factors as an element in law and other sentencing factors equally. Thirdly, the Sentencing Guideline treats all sentencing factors equally, while it needs to be pointed out that statutory penalty evaluates the degree of aggravation and mitigation individually. Lastly, it arouses suspicion that the Sentencing Guideline ignores statutory penalty and even the least normative relationship. A case in point which shows this is the fact that the maximum punishment of the sentencing guideline is below the minimum punishment of statutory penalty in some offences. These problems should be resolved by statutory penalty reform by the legislature. The Sentencing Guideline should be carefully crafted in conformity with the civil law nature of and fulfill its role as the ‘statutory penalty’s detailed standard’.

양형기준 준수의미의 재고찰에 기초한 양형기준제도의 발전적 운영방안

김혜정 ( Hye-jeong Kim ) 법조협회 2018 法曹 Vol.67 No.5

양형기준제도는 “국민의 건전한 상식을 반영하고 국민이 신뢰할 수 있는 공정하고 객관적인 양형”을 실현하겠다는 목적으로 권고형량범위를 비롯하여 양형인자 등을 제시하여 법관의 양형재량을 합리화하려는 취지를 담고 있다. 법원조직법상 양형기준제도는 권고적 효력만을 갖고 있으나, 양형기준제도를 도입한 취지를 고려할 때, 양형기준제도 준수가 의미하는 바가 무엇인지 다시 생각해볼 필요가 있다. 특히 과거의 양형실무와 달리, 지금은 검사나 피고인(변호인)이 재판과정에서 자신의 입장에서 유리한 양형에 대한 주장과 입증을 펼치게 되고, 그 과정에서 검사와 피고인 사이에 양형의 요소에 대한 주장이 엇갈리고, 당해 양형 요소의 존재여부가 다투어지는 경우도 크게 늘었다고 한다. 이처럼 변화되는 양형실무에서 양형기준제도의 준수의미에 대한 재고찰을 바탕으로 양형기준제도의 발전적 운영방안을 모색해보는 것은 필요하고 또 중요하다. 양형기준제도의 준수라고 할 때, 권고형량의 범위 안에서 선고형을 도출하는 형식적인 준수뿐만 아니라 양형기준에서 제시하고 있는 양형인자에 대한 평가 등 모든 절차와 내용에 따라 판단하는 실질적인 준수를 포함하는 개념으로 이해해야 할 것이다. 이러한 양형기준의 실질적 준수여부를 판단하기 위해서는 판결문에 양형이유에 대한 명시적 기재가 중요하다. “양형기준의 명시적 기재”란 대상범죄유형, 양형인자의 존부 및 그에 대한 평가, 최초의 권고영역, 경합범에 해당한다면 다수범죄처리과정과 수정된 권고영역, 그리고 3년 이하의 선고형이 도출되었다면, 집행유예 참작사유의 존부 및 그에 대한 평가 등에 대한 구체적인 기재를 포함하는 것으로 이해되어야 할 것이다. 양형기준에 대한 준수를 실질적 준수로 재인식하는 경우, 양형기준이탈에 대한 인식의 전환도 필요하다. 양형기준의 발전적 운영을 위해서는 양형기준에 얽매여 형식적·기계적으로 판단하기 보다는 필요하다면 양형기준 이탈을 통해 양형의 개별화와 적정한 양형을 도출하는 것이 필요하다. 그러기 위해서는 양형기준 이탈에 대한 명확한 기준도 마련되어야 한다. 현행 양형기준은 제도도입 초기의 틀에서 크게 벗어나 있지 않다. 그러나 양형기준 도입초기 권고형량의 중첩문제, 양형인자의 불균형문제, 양형인자와 집행유예 참작사유의 이중평가문제, 다수범죄처리방식 등 양형기준에 대한 많은 문제가 제기되었다. 따라서 이러한 문제에 대해서도 그동안 축적된 통계자료를 바탕으로 개선방안에 대한 검토가 필요하다. 특히 양형심리를 충실하게 하기 위해서는 공판 절차 이원화에 대한 긍정적인 검토가 필요한 시점이다. The sentencing guideline system is intended to rationalize the sentencing of judges by presenting sentencing factors as well as a range of recommended sentences for the purpose of realizing a fair and objective sentence that reflects people's sound common sense and can be trusted by the public. Although the sentencing guideline system is only recommended, it is necessary to rethink what it means to adhere to the sentence guideline system, considering the introduction of the sentencing standards system. Unlike past sentencing practice, the prosecutor or defendant now has to argue and prove a favorable sentence in his or her position in the trial process. In the process, the assertion of the element of sentencing between the prosecutor and the defendant was divergent, and the cases in which the element of the sentence became contested also increased greatly. It is necessary to explore the development of the guideline system based on the reexamination of the implications of the guideline system in this changing sentence practice. It is a concept that includes compliance with the sentencing guideline system, including not only the formal adherence of the sentence within the scope of the recommendation sentence, but also the actual compliance with the judgment of all the procedures and contents such as the evaluation of the sentencing factors suggested by the sentencing guideline system. I have to understand. It is important to clearly state the reasons for the sentence in the sentence in order to judge whether the sentencing guideline are actually complied with. In the case of reaffirmation of compliance with the guideline as substantial compliance, it is also necessary to shift the perception of guideline deviations. For the developmental guideline to be developed, it is necessary to derive the individual sentence and proper sentence by departing from sentence guideline, if necessary, rather than judging formally and mechanically by sticking to sentencing guideline. In order to do so, clear guideline for departure from the guideline should be established. There were many problems with sentencing criteria such as overlapping sentence problems, imbalance of sentencing factors, dual evaluation of sentencing factors and probation reasons, and handling multiple crimes. Therefore, it is necessary to review the improvement plan based on the accumulated statistical data. In particular, in order to improve the sentencing hearing, it is necessary to positively review the process of trial procedure.

아동학대 범죄와 양형기준-최근의 개정 논의와 향후 전망을 중심으로

한상규 사법발전재단 2018 사법 Vol.1 No.45

Sentencing in criminal trials is as important as a decision of a defendant's conviction or acquittal. Impartial sentencing is the essence of criminal justice, the core of trust in criminal justice. There was a criticism in the past that punishments tend to be more lenient when it comes to “embezzlement of the chaebol (business tycoon)” and “white-collar crime”. There was not high confidence in criminal justice. The main criticism of sentencing is boiled down to compassionate sentencing and judicial subjectivity. To tackle these problems, the Sentencing Committee was established in April, 2007. With the purpose of enabling fair and objective sentencing, the Sentencing Committee set the sentencing guideline which could earn people's trust in criminal justice by reflecting sound common sense of the public. As of 2018, a total of 38 sentencing guidelines were set for 38 crime groups. Most of the prescribed sentencing guideline are in effect in criminal court practices with high compliance rates. In recent years, child abuse crimes have emerged as a serious problem of our society, which drove the introduction of the sentencing guideline as well as the enactment of the Act on Special Cases Concerning the Punishment, etc. of Child Abuse Crimes (hereinafter “Special Act on Child Abuse Crimes”). This article intends to identify (a) the impact of the Special Act on Child Abuse Crimes, enacted in 2014, on the establishment of the sentencing guideline; and (b) how the sentencing guideline on child abuse crimes are evaluated. This article will understand what child abuse is (II), examine the sentencing guideline related to child abuse crimes (III), and investigate the future prospects of sentencing guideline for child abuse (Ⅳ). The process would provide an opportunity to think about the significance, role and limitation, and the future of the sentencing guideline. Ten years have passed since the Sentencing Committee was inaugurated. It is time to investigate the appropriateness of the sentencing guideline, and whether there are errors or room for improvements in the sentencing factor described in the sentencing guideline. It is of critical importance to understand what constitutes child abuse crimes, as well as the current sentencing guideline and future agendas. Above all, it is utmost important to create sentencing guidelines that are trusted by the people. 형사재판에서 양형은 피고인에 대한 유·무죄를 결정하는 것만큼이나 중요하다. 합리적이고 공정한 양형은 형사재판의 본질이자 형사사법에 대한 신뢰의 핵심이다. 과거 ‘재벌의 횡령·배임죄’나 ‘화이트칼라 범죄’에 대해 상대적으로 관대한 형벌이 과해진다는 비난이 있었다. 형사사법에 대한 신뢰도 높지 않았다. 양형에 대한 주된 비판은 너무 온정적이라는 것 그리고 법관의 주관에 좌우된다는 것이었다. 이를 극복하고자 2007. 4. 양형위원회가 설치되었고 양형위원회는 양형 과정에 국민의 건전한 상식을 반영함으로써 국민이 신뢰할 수 있는 공정하고 객관적인 양형을 실현하는 것을 주된 목표로 양형기준을 설정하였다. 2018년 현재까지 모두 38개 범죄군에 대해 양형기준을 설정하였고, 설정된 양형기준은 대부분 형사재판 실무에서 높은 준수율을 보이면서 시행되고 있다. 근래 우리 사회의 심각한 문제 중 하나로 대두된 아동학대범죄에 대해서도 「아동학대범죄의 처벌에 관한 특례법」의 제정과 더불어 양형기준이 설정되었다. 2014년 제정된 「아동학대범죄의 처벌에 관한 특례법」은 양형기준 설정에 과연 어떤 영향을 주었고, 아동학대범죄의 양형기준은 어떤 평가를 받고 있는지 살펴보는 데 이 글의 주된 목적이 있다. 이 글은 아동학대범죄에 대한 이해를 통해(Ⅱ), 아동학대범죄의 양형기준을 살펴본 후(Ⅲ), 아동학대범죄 양형기준의 향후 전망(Ⅳ)에 대해 소개하고자 한다. 그 과정을 통해 양형기준의 의의와 역할 및 한계, 그리고 양형기준의 미래 등에 대해서도 생각해 볼 수 있을 것이다. 양형위원회가 출범한 지 10년이 넘었다. 이제는 설정된 양형기준이 적정한지, 양형기준에 기재된 양형인자들에 잘못이 있거나 개선점이 없는지 좀 더 살펴볼 시점이 되었다. 아동학대범죄와 현행 양형기준, 그리고 앞으로의 쟁점에 대해 이해하고, 무엇보다 국민에게 신뢰받는 양형기준이 만들어지도록 노력하여야 할 것이다

국내 상급종합병원과 종합병원 간호사의 정맥주입간호실무지침의 확산정도

은영(Young Eun),구미옥(Mee Ok Gu),조용애(Young Ae Cho),정재심(Jae Shim Jeong),권정순(Jeong Soon Kwon),유정숙(Cheong Suk Yoo5),정영선(Young Sun Jeong),정인숙(In Sook Jung),김경숙(Kyeong Sug Kim),이선희(Seon Heui Lee),서현주(Hyun Ju S 한국근거기반간호학회 2015 근거와 간호 Vol.3 No.1

Purpose: This study was conducted to investigate the extent of diffusion of Intravenous infusion nursing practice guideline among nurses in advanced general hospitals and general hospitals in Korea. Methods: The subjects were 234 nurses who practice the intravenous infusion in 24 advanced general hospitals and general hospitals. Data were collected between October 5 and November 2, 2015 by mail (return rates: 97.5 %). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/ WIN 21. Results: The average guideline diffusion score and levels of diffusion was 3.39±0.58 (level of “use sometimes”). 44 recommendations (46%) were in level of “use always” and 50 recommendations (53%) were in “use sometimes”. Extent of diffusion were significantly different according to present status (F=2.81, p=.040) and education (F=4.35, p=.014). The facilitating factors to use the guideline were education by department of nursing service, convenient composition of guideline and barrier factors were “no time to use the guideline”, “don’t know the guideline” and “there is no guideline at ward”. Conclusion: Extent of diffusion of Intravenous infusion nursing practice guideline among nurses was moderate level. The strategies for promoting the implementation of guideline in clinical practice is needed. Further study of outcome evaluation of guideline implementation will be needed.

Delphi방법을 이용한 일차의료 고혈압 진료지침 개발 및 적용

양윤준,홍명호 한국의료QA학회 1995 한국의료질향상학회지 Vol.2 No.1

background: Guideline for practice is useful because it can be the standard for assessment and way to improve quality. We need to take account of expert opinion and consensus as well as scientific evidences to develope practice guideline because it should be practical. Delphi method has been developed to gather opinions from experts fairly. This study was designed to develop practice guideline and apply it to practices as a method to improve quality in primary medical care. Methods: Hypertension(in adults over 18 years old) was selected as a target problem. Self questionnaires about management of hypertensive patients were developed by a researcher with advice of 11 experts. The questionnaires were designed to response as a 5 pont scale. The results of previous questionary were given to respondents in second and third questionnaires. If needed, the questionnaires were changed on the previous responses. The items with medium greater than or equal to 4 point in 1st and 2nd responses were accepted in guideline. The items with medium lesser than or equal to 3 point were questioned again about whether they can be excluded or not. The criteria for assessment was made with reference to guideline and applied to 85 hypertensive patients of 9 family practitioners. At 3 months after practice guideline had been given to family practitioners, performance of same practitioners was assessed with 36 new hypertensive patients. Results: 23 professors in family medicine, 22 family practitioners and 6 cardiologists. responded among 50, 50, 15 respectively. Practice guideline with 33 items was developed as a result of 3 times questionaires. The difference of responses between professors in family medicine, family practitioners and cardiologists was not significant. Performance of practice was improved in diagnosis, history taking about 6 fields, Jaboratory examination and decision making about time fo pharmaceutical prescription. It was not improved in physical examination, life style modification, method of pharmaceutical prescription, choice of initial antihypertensives and history taking about duration of disease and diet habit. It was decreased in history taking about psychosocial factors. The assessment scores were low in history taking, physical examination and life style modification before and after use of practice guideline. Conclusion: Practice guideline for hypertension could be developed by Delphi method. Performance of practice improved partially after use of guideline.

The Development of Evidence-Based Guideline for Diagnosis and Management of Headache in Korea

Sun Mi Kim,Young-Hoon Ko,Seoyoung Yoon,Won Sub Kang,Hye-Geum Kim,Hye Youn Park,Cheolmin Shin,Yoo Hyun Um,Soyoung Youn,Jae-Hon Lee,Seung-Ho Jang,Sang Won Jeon,Hong Jun Jeon,Seockhoon Chung,Jae-Won Choi 대한신경정신의학회 2019 PSYCHIATRY INVESTIGATION Vol.16 No.3

Objective: We aimed to develop the clinical guideline for headache by the systematic review and synthesis of existing evidence-based guidelines. The purpose of developing the guideline was to improve the appropriateness of diagnosis and treatment of headache disorder, and consequently, to improve patients’ pain control and quality of life. The guideline broadly covers the differential diagnosis and treatment of tension-type headache, migraine, cluster headache, and medication-overuse headache. Methods: This is a methodological study based on the ADAPTE methodology, including a systematic review of the literature, quality assessment of the guidelines using the Appraisal of Clinical Guidelines for REsearch & Evaluation II (AGREE II) Instrument, as well as an external review using a Delphi technique. The inclusion criteria for systematic search were as follows: topic-relevant, up-to-date guidelines including evidence from within 5 years, evidence-based guidelines, guidelines written in English or Korean, and guidelines issued by academic institutions or government agencies. Results: We selected five guidelines and conducted their quality assessment using the AGREE II Instrument. As a result, one guideline was found to be eligible for adaptation. For 13 key questions, a total of 39 recommendations were proposed with the grading system and revised using the nominal group technique. Conclusion: Recommendations should be applied to actual clinical sites to achieve the ultimate goal of this guideline; therefore, follow-up activities, such as monitoring of guideline usage and assessment of applicability of the recommendations, should be performed in the future. Further assessment of the effectiveness of the guideline in Korea is needed.

Differences in prevalence of hypertension subtypes according to the 2018 Korean Society of Hypertension and 2017 American College of Cardiology/American Heart Association guidelines: The Korean National Health and Nutrition Examination Survey, 2007–2017

조소미,이호규,김현창 대한고혈압학회 2020 Clinical Hypertension Vol.26 No.1

Background: The significance of high systolic and diastolic blood pressure remains controversial. We assessed the differences in prevalence of hypertension and its subtypes according to the different hypertension diagnostic criteria embodied by the 2017 American College of Cardiology/American Heart Association (2017 ACC/AHA) and 2018 Korean Society of Hypertension (2018 KSH) guidelines. Methods: We used the 2007–2017 Korea National Health and Nutrition Examination Survey (KNHANES) data to calculate guideline-specific hypertension prevalence among untreated, adult participants. By the 2017 ACC/AHA guideline, a mean SBP ≥130 mmHg, DBP ≥80 mmHg, or currently using antihypertensive medications were considered to have hypertension. Isolated diastolic hypertension (IDH) was defined as DBP ≥80 mmHg and SBP < 130 mmHg, isolated systolic hypertension (ISH) as SBP ≥130 mmHg and DBP <80 mmHg, and systolic diastolic hypertension (SDH) as SBP ≥130 mmHg and DBP ≥80 mmHg. In a similar manner, by the 2018 KSH guideline, all hypertension and its subtype prevalence were calculated using the 140/90 mmHg cutoff. The two versions of all hypertension and its corresponding subtype prevalence were calculated among all study participants and separately by sex and age then compared via analysis of variance. Results: The prevalence of all hypertension increased from 25.9% (95% confidence interval (CI) 25.4–26.5) defined by the 2018 KSH guideline to 46.3% (95% CI 45.6–46.9) classified by the 2017 ACC/AHA guideline. Such increase was primarily manifested through substantial increase in IDH prevalence, from 5.2% (95% CI 4.9–5.4) defined by the 2018 KSH guideline to 17.9% (95% CI 17.4–18.3) defined by the 2017 ACC/AHA guideline, and was most notably observed in young age groups, 30-49 years. ISH prevalence showed minimal differences. SDH prevalence moderately increased from 3.5% (95% CI 3.3–3.7) defined by the 2018 KSH guideline to 11.1% (95% CI 10.7–11.4) defined by the 2017 ACC/AHA guideline, achieved primarily among participants aged 50 years or above. Conclusions: Changes in each subtype prevalence made differential contribution to additionally classified hypertension cases by the 2017 ACC/AHA guideline. Future studies should investigate the diastolic-associated cardiovascular risks and benefits of its long-term primary prevention in the young population.

Revised Korean Antiviral Guideline Reduces the Hepatitis B-related Hepatocellular Carcinoma Risk in Cirrhotic Patients

Kim David Sooik,Park Soo Young,김범경,박준용,김도영,한광협,Lee Yu Rim,Tak Won Young,Kweon Young Oh,정인경,Han Minkyung,Kim Eun Hwa,안상훈,김승업 대한의학회 2021 Journal of Korean medical science Vol.36 No.16

Background: Since September 2015, the initiation of antiviral therapy (AVT) for patients with chronic hepatitis B (CHB)-related cirrhosis has been reimbursed according to the revised Korean Association for the Study of Liver (KASL) guideline, if the patient had hepatitis B virus DNA level ≥ 2,000 IU/L, regardless of aminotransferase or alanine aminotransferase levels. This study investigated whether the KASL guideline implementation reduced the risk of CHB-related hepatocellular carcinoma (HCC) in patients with cirrhosis in South Korea. Methods: A total of 429 patients with CHB-related cirrhosis who initiated AVT between 2014 and 2016 were recruited. The risk of HCC development was compared between patients who initiated AVT before and after September 2015 (pre-guideline [n = 196, 45.7%] vs. postguideline implementation [n = 233, 54.3%]). Results: Univariate analysis showed that AVT initiation before guideline implementation, older age, male gender, and diabetes significantly predicted increased risk of HCC development (all P < 0.05). Subsequent multivariate analysis showed that AVT initiation before guideline implementation (HR = 1.941), older age (HR = 5.762), male gender (HR = 2.555), and diabetes (HR = 1.568) independently predicted increased risk of HCC development (all P < 0.05). Additionally, multivariate analysis showed that AVT initiation before guideline implementation (HR = 2.309), male gender (HR = 3.058), and lower platelet count (HR = 0.989) independently predicted mortality (P < 0.05). The cumulative incidences of HCC and mortality were significantly higher in patients who initiated AVT before guideline implementation than in those who initiated AVT after guideline implementation (all P < 0.05, log-rank test). Conclusion: The prognosis of patients with CHB-related cirrhosis who initiated AVT improved after guideline implementation according to the revised KASL guideline.

무증상 성인에서 관상동맥 질환의 일차 예방 전략의 비교

조영진,윤연이,김지현,박준빈,박효은,이원재,최의근,전은주,최상일,최동주,장혁재 대한심장학회 2008 Korean Circulation Journal Vol.38 No.9

Background and Objectives: The National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III guideline has been widely accepted for the primary prevention of coronary heart disease (CHD). The coronary artery calcium score (CACS) has recently been recognized as an excellent predictor of CHD events, and a primary prevention strategy based on the CACS [the Screening for Heart Attack Prevention and Education (SHAPE) guideline] has been proposed. The purpose of this study was to explore how the guidelines function for asymptomatic South Korean individuals. Subjects and Methods: We consecutively enrolled 2,079 asymptomatic subjects (age range for men: 45-75 years, age range for women: 55-75 years) who underwent CACS and coronary CT angiography (CCTA) as a part of a health check-up. We analyzed the differences of the target population for CHD prevention according to the 2 guidelines and we compared them in terms of the presence of occult CHD. Results: Four-hundred eighteen (20%) individuals were recommended for pharmacotherapy according to the NCEP-ATP III and 371 (18%) were recommended for pharmacotherapy according to the SHAPE guideline (Cohen’s κ=0.36). According to the SHAPE guideline, more individuals with significant stenosis noted on the CCTA were categorized into the high or very high risk group (50% vs. 24%, respectively, p<0.001) and recommended for pharmacotherapy (53% vs. 28%, respectively, p<0.001). However, 57 (43%) individuals with significant stenosis on the CCTA were not suitable for pharmacotherapy according to either the NCEP-ATP III or the SHAPE guideline. Conclusion: Comparing the NCEP-ATP III and the SHAPE guidelines, there were considerable differences for primary prevention in the target population. Although SHAPE might provide more accurate stratification in terms of the presence of occult CHD, a more precise risk stratification algorithm needs to be implemented for this population. Background and Objectives: The National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III guideline has been widely accepted for the primary prevention of coronary heart disease (CHD). The coronary artery calcium score (CACS) has recently been recognized as an excellent predictor of CHD events, and a primary prevention strategy based on the CACS [the Screening for Heart Attack Prevention and Education (SHAPE) guideline] has been proposed. The purpose of this study was to explore how the guidelines function for asymptomatic South Korean individuals. Subjects and Methods: We consecutively enrolled 2,079 asymptomatic subjects (age range for men: 45-75 years, age range for women: 55-75 years) who underwent CACS and coronary CT angiography (CCTA) as a part of a health check-up. We analyzed the differences of the target population for CHD prevention according to the 2 guidelines and we compared them in terms of the presence of occult CHD. Results: Four-hundred eighteen (20%) individuals were recommended for pharmacotherapy according to the NCEP-ATP III and 371 (18%) were recommended for pharmacotherapy according to the SHAPE guideline (Cohen’s κ=0.36). According to the SHAPE guideline, more individuals with significant stenosis noted on the CCTA were categorized into the high or very high risk group (50% vs. 24%, respectively, p<0.001) and recommended for pharmacotherapy (53% vs. 28%, respectively, p<0.001). However, 57 (43%) individuals with significant stenosis on the CCTA were not suitable for pharmacotherapy according to either the NCEP-ATP III or the SHAPE guideline. Conclusion: Comparing the NCEP-ATP III and the SHAPE guidelines, there were considerable differences for primary prevention in the target population. Although SHAPE might provide more accurate stratification in terms of the presence of occult CHD, a more precise risk stratification algorithm needs to be implemented for this population.