{"id":5587,"date":"2017-05-16T18:24:43","date_gmt":"2017-05-16T09:24:43","guid":{"rendered":"http:\/\/aihara.la.coocan.jp\/?p=5587"},"modified":"2017-05-16T18:24:43","modified_gmt":"2017-05-16T09:24:43","slug":"grade-%ef%bd%83%ef%bd%90%ef%bd%87%e3%81%ae%e5%9f%ba%e6%9c%ac%e3%83%bc%ef%bc%94%ef%bc%8e%ef%bc%98%ef%bc%9acpg%e3%82%a8%e3%83%93%e3%83%87%e3%83%b3%e3%82%b9%e3%81%8b%e3%82%89%e6%8e%a8%e5%a5%a8%e3%81%b8","status":"publish","type":"post","link":"http:\/\/aihara.la.coocan.jp\/?p=5587","title":{"rendered":"GRADE \uff23\uff30\uff27\u306e\u57fa\u672c\u30fc\uff14\uff0e\uff18\uff1a[CPG]\u30a8\u30d3\u30c7\u30f3\u30b9\u304b\u3089\u63a8\u5968\u3078-\u2466\uff1a\u4fa1\u5024\u89b3\u306e\u8a55\u4fa1\u304c\u5fc5\u8981"},"content":{"rendered":"

GRADE\u30ef\u30fc\u30ad\u30f3\u30b0\u30b0\u30eb\u30fc\u30d7\u306f\u3001\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u597d\u307f\uff08value and preference\uff09<\/b>\u3092\u3001\u201d\u60a3\u8005\u304c\u4e3b\u8981\u306a\u5065\u5eb7\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u304a\u304f\u76f8\u5bfe\u7684\u91cd\u8981\u6027\u201d<\/b>\u3068\u3057\u3066\u5b9a\u7fa9\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u63a8\u5968\u4f5c\u6210\u306b\u304a\u3044\u3066\u3001\u95a2\u9023\u3059\u308b\u4fa1\u5024\u89b3\u3068\u597d\u307f\u3092\u691c\u8a0e\u3057\u306a\u304b\u3063\u305f\u5834\u5408\u3001\u7d76\u5bfe\u7684\u306a\u52b9\u679c\u63a8\u5b9a\u5024\u304b\u3089\u8aa4\u3063\u305f\u7d50\u8ad6\u304c\u5c0e\u304b\u308c\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u671b\u307e\u3057\u3044\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u671b\u307e\u3057\u304f\u306a\u3044\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u5927\u304d\u3055\u306e\u30d0\u30e9\u30f3\u30b9\u3092\u5224\u65ad\u3059\u308b\u306b\u306f\u3001\u3053\u308c\u3089\u306e\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u91cd\u307f\uff08\u91cd\u8981\u6027\uff09\u3092\u691c\u8a0e\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u3001\u305d\u306e\u91cd\u307f\u306f\u4fa1\u5024\u89b3\u3068\u597d\u307f(*)\u306b\u3088\u3063\u3066\u6c7a\u307e\u308b\u3068\u3044\u3046\u308f\u3051\u3067\u3059\u3002<\/p>\n

\n\n\n
\n

(*) Evidence to Decision framework\u306b\u304a\u3044\u3066\u3001\u3053\u306e\u201d\u8907\u6570\u306e\u91cd\u5927\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u305d\u308c\u305e\u308c\u306e\u91cd\u8981\u6027\u201d\u3092\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u201d\u4fa1\u5024\u89b3\u201d\uff08\u597d\u307f\u306e\u7528\u8a9e\u306f\u4f7f\u308f\u305a\u306b\uff09\u3068\u5b9a\u7fa9\u3059\u308bGRADE working member\u3082\u3044\u307e\u3059\u3002
\u3057\u304b\u3057\u3001EBM working group, GRADE working group, DECIDE group\u306e\u5168\u54e1\u304c\u305d\u306e\u65b9\u91dd\u306b\u540c\u610f\u3057\u3066\u3044\u308b\u308f\u3051\u3067\u306f\u306a\u3044\u3053\u3068\u304b\u3089\u3001\u672c\u89e3\u8aac\u30b7\u30ea\u30fc\u30ba\u3067\u306f\u3001\u3053\u308c\u307e\u3067\u306eJCE\u30b7\u30ea\u30fc\u30ba\u306b\u8a18\u8f09\u3055\u308c\u3066\u3044\u308b\u3088\u3046\u306b\u3001\u201d\u4fa1\u5024\u89b3\u3068\u597d\u307f\u201d\u3068\u3044\u3046\u7528\u8a9e\u3092\u4f7f\u7528\u3057\u307e\u3059\u3002<\/p>\n<\/td>\n<\/table>\n<\/div>\n

 <\/p>\n

\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30d1\u30cd\u30eb\u304c\u5178\u578b\u7684\u306a\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u597d\u307f\u306e\u63a8\u5b9a\u5024\u3092\u6c42\u3081\u308b\u306b\u306f\u3001\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u597d\u307f\u306b\u3064\u3044\u3066\u8abf\u3079\u305f\u7814\u7a76\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\uff08SR\uff09\u3092\u5b9f\u65bd\u3059\u308b\u304b\u3001\u3082\u3057\u304f\u306f\u95a2\u9023SR\u3092\u7279\u5b9a\u3059\u308b\u306e\u304c\u7406\u60f3\u7684\u3067\u3059\u3002\u3057\u304b\u3057\u3001\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u597d\u307f\u3092\u8abf\u3079\u305f\u5b9f\u8a3c\u7684\u7814\u7a76\u306f\u5c11\u306a\u304f\u3001\u5341\u5206\u306a\u60c5\u5831\u6e90\u3092\u6301\u3063\u3066\u3044\u308b\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30d1\u30cd\u30eb\u306f\u3001\u901a\u5e38\u3067\u3042\u308c\u3070\u3053\u308c\u3089\u306e\u7814\u7a76\u3092\u88dc\u5b8c\u3059\u308b\u305f\u3081\u306b\u500b\u3005\u306e\u60a3\u8005\u304a\u3088\u3073\u60a3\u8005\u96c6\u56e3\u3078\u306e\u805e\u304d\u53d6\u308a\u3092\u884c\u3046\u3053\u3068\u306b\u306a\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n

\u4fa1\u5024\u89b3\u3068\u597d\u307f\u306b\u3064\u3044\u3066\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u304c\u5165\u624b\u3067\u304d\u305a\u3001\u60a3\u8005\u304a\u3088\u3073\u60a3\u8005\u96c6\u56e3\u3078\u306e\u805e\u304d\u53d6\u308a\u3082\u884c\u3048\u306a\u3044\u3001\u5341\u5206\u306a\u60c5\u5831\u6e90\u3092\u6301\u305f\u306a\u3044\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u30d1\u30cd\u30eb\u306f\u3001\u5165\u624b\u53ef\u80fd\u306a\u6587\u732e\u306e\u975e\u7cfb\u7d71\u7684\u30ec\u30d3\u30e5\u30fc\u3068\u3001\u60a3\u8005\u3068\u306e\u3053\u308c\u307e\u3067\u306e\u3084\u308a\u53d6\u308a\u3067\u5f97\u305f\u7d4c\u9a13\u3092\u983c\u308a\u306b\u3057\u306a\u304f\u3066\u306f\u306a\u308a\u307e\u305b\u3093\u3002<\/p>\n

GRADE working group\u306b\u3088\u308b\u8ad6\u6587\u306b\u304a\u3044\u3066\u3001\u4fa1\u5024\u89b3\u3084\u597d\u307f\u306b\u95a2\u3059\u308b\u3044\u304f\u3064\u304b\u306e\u30a2\u30d7\u30ed\u30fc\u30c1\u3092\u77e5\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\u3002<\/p>\n

\u25a0BMJ 2016: 353\u8ad6\u6587<\/a>\uff08GRADE EtD frameworks\uff09\u3067\u306f\u3001\u4ee5\u4e0b\u306edisutility\u304c\u8a18\u8f09\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/b><\/p>\n

\"Disutility<\/a><\/p>\n

\u25a0AT9\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc<\/a><\/b>\uff08Patient Values and Preferences in Decision Making for Antithrombotic Therapy: A Systematic Review. Chest. 2012 Feb;141(2 Suppl):e1S-23S.\uff09
\n\u4f8b\u3001\u5178\u578b\u7684\u306a\u5fc3\u623f\u7d30\u52d5\u60a3\u8005\u3067\u3042\u308c\u3070\u3001\u6d88\u5316\u7ba1\u304b\u3089\u306e\u5927\u51fa\u8840\u56de\u907f\u3088\u308a\u306f\u3001\u8133\u5352\u4e2d\u56de\u907f\u306b\u304a\u304f\u4fa1\u5024\u89b3\u306f\u7d043\u500d\u3067\u3042\u308b\u3002<\/p>\n

<\/p>\n

\u25a0GRADE2\u7248\u306ep145\u811a\u6ce8\u306b\u3082\u3001\u611f\u60c5\u6e29\u5ea6\u8a08\u3092\u4f7f\u3063\u305f\u4fa1\u5024\u89b3\uff08=\u52b9\u7528\u5024 utility\uff09\u306e\u8a55\u4fa1\u3092\u8a18\u8f09\u3057\u3066\u3044\u307e\u3059\u3002<\/b>
\n\u305f\u3068\u3048\u3070\u3001\u3042\u308b\u4ecb\u5165\u304c\u8133\u5352\u4e2d\u306e\u5229\u76ca\u306b\u95a2\u3057\u3066NNT 83\u3001\u5927\u51fa\u8840\u306e\u5bb3\u306b\u95a2\u3057\u3066NNH 125\u306e\u52b9\u679c\u3068\u3059\u308b\u3068\u3001\u4ecb\u5165\u306b\u3088\u308a1.5\u500d\u306e\u52b9\u679c\u304c\u3042\u308a\u307e\u3059\u3002\u3057\u304b\u3057\u3001\u60a3\u8005\u304c\u30a2\u30a6\u30c8\u30ab\u30e0\u306e\u52b9\u679c\u3068\u5bb3\u306b\u304a\u304f\u4fa1\u5024\u89b3\uff08\u611f\u60c5\u6e29\u5ea6\u8a08<\/a>\u3092\u4f7f\u3063\u305fUtility\uff09\u3068\u3057\u3066\u3001\u8133\u5352\u4e2d\u306e\u3042\u308b\u751f\u6d3b\u30920.2\u3001\u5927\u51fa\u8840\u306e\u3042\u308b\u751f\u6d3b\u30920.8\u3068\u3059\u308b\u3068\uff08\u3064\u307e\u308a\u3001\u5f97\u3089\u308c\u308b\u5229\u76ca\u304c\u5bb3\u306e4\u500d\u3060\u3068\uff09\u3001\u4ecb\u5165\u306e\u5229\u76ca\u306e\u52b9\u679c\u306f\u5bb3\u306e6\u500d\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n

<\/p>\n

\u25a0Triple-X\u306e\u30b7\u30ca\u30ea\u30aa\u306b\u304a\u3044\u3066\u306f\u3001\u5404\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u304a\u304fdisutility\/\u4fa1\u5024\u89b3\u3092\u8abf\u67fb\u3057\u305f\u7d50\u679c\u3001\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u3082\u306e\u3060\u3063\u305f\u3068\u3057\u307e\u3059\u3002<\/b><\/p>\n\n\n\n\n\n\n\n\n
\n<\/td>\n\n\u30a2\u30a6\u30c8\u30ab\u30e0<\/b><\/td>\n\ndisutility<\/b><\/td>\n\nrelative value<\/b><\/td>\n<\/tr>\n
1<\/td>\n\u7dcf\u6b7b\u4ea1<\/b><\/td>\n1.00<\/td>\n3<\/td>\n<\/tr>\n
2<\/td>\n\u5fc3\u7b4b\u6897\u585e<\/b><\/td>\n0.33<\/td>\n1<\/td>\n<\/tr>\n
3<\/td>\n\u75c7\u5019\u6027VTE<\/b><\/td>\n0.33<\/td>\n1<\/td>\n<\/tr>\n
4<\/td>\n\u975e\u81f4\u6b7b\u6027\u8133\u5352\u4e2d<\/b><\/td>\n0.66<\/td>\n2<\/td>\n<\/tr>\n
5<\/td>\n\u5927\u51fa\u8840<\/b><\/td>\n0.33<\/td>\n1<\/td>\n<\/tr>\n
6<\/td>\n\u6cbb\u7642\u306e\u8ca0\u62c5\u3084\u30b3\u30b9\u30c8<\/td>\n0.01<\/td>\n0.03<\/td>\n<\/tr>\n<\/tr>\n<\/table>\n

<\/p>\n

\u3064\u307e\u308a\u3001\u4ed6\u306e\u91cd\u5927\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u3068\u6bd4\u8f03\u3057\u3066\u3001\u7dcf\u6b7b\u4ea1\u306b\u306f3\u500d\u3001\u8133\u5352\u4e2d\u306b\u306f2\u500d\u306e\u4fa1\u5024\u3092\u304a\u304f\u3068\u3057\u307e\u3059\u3002\u306a\u304a\u3001\u6cbb\u7642\u306e\u8ca0\u62c5\u306f\u8efd\u5fae\u3067\u3042\u308a\u3001\u63a8\u5968\u6c7a\u5b9a\u306e\u8a55\u4fa1\u30a2\u30a6\u30c8\u30ab\u30e0\u304b\u306f\u9664\u5916\u3057\u307e\u3059\u3002<\/p>\n

\u6ce8\u610f\uff1a
\n\uff11\uff0e\u5404\u4fa1\u5024\u89b3\u306f\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306e\u63a8\u5968\u4f5c\u6210\u306e\u76ee\u7684\u3084\u3001\u8996\u70b9\u306b\u3088\u3063\u3066\u3082\u7570\u306a\u308a\u307e\u3059\u3002
\n\uff12\uff0eGRADE working group\u306f\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u95a2\u3059\u308b\u4fa1\u5024\u89b3\u3092\u5e38\u306b\u5b9a\u91cf\u5316\u3057\u3066\u5bfe\u51e6\u3059\u3079\u304d\u3068\u63a8\u5968\u3057\u3066\u3044\u308b\u308f\u3051\u3067\u306f\u306a\u304f\u3001\u3042\u304f\u307e\u3067\u3082\u671b\u307e\u3057\u3044\u52b9\u679c\u3068\u671b\u307e\u3057\u304f\u306a\u3044\u52b9\u679c\u306e\u30d0\u30e9\u30f3\u30b9\uff08\u6b63\u5473\u306e\u52b9\u679c\uff09\u8a55\u4fa1\u306b\u304a\u3044\u3066\u53c2\u8003\u306b\u306a\u308b\u3060\u308d\u3046\u3068\u3044\u3046\u8003\u3048\u3067\u3059\u3002<\/p>\n

\n <\/p>\n","protected":false},"excerpt":{"rendered":"

GRADE\u30ef\u30fc\u30ad\u30f3\u30b0\u30b0\u30eb\u30fc\u30d7\u306f\u3001\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u597d\u307f\uff08value and preference\uff09\u3092\u3001\u201d\u60a3\u8005\u304c\u4e3b\u8981\u306a\u5065\u5eb7\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u304a\u304f\u76f8\u5bfe\u7684\u91cd\u8981\u6027\u201d\u3068\u3057\u3066\u5b9a\u7fa9\u3057\u3066\u3044\u307e\u3059\u3002 \u63a8\u5968\u4f5c\u6210\u306b\u304a\u3044\u3066\u3001\u95a2\u9023\u3059\u308b\u4fa1\u5024\u89b3\u3068\u597d\u307f\u3092\u691c\u8a0e\u3057\u306a\u304b […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[455,5],"tags":[],"_links":{"self":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/5587"}],"collection":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5587"}],"version-history":[{"count":64,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/5587\/revisions"}],"predecessor-version":[{"id":8810,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/5587\/revisions\/8810"}],"wp:attachment":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5587"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5587"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5587"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}