{"id":85,"date":"2008-03-23T21:04:04","date_gmt":"2008-03-23T12:04:04","guid":{"rendered":"http:\/\/aihara.la.coocan.jp\/blog\/?p=85"},"modified":"2014-04-16T15:35:09","modified_gmt":"2014-04-16T06:35:09","slug":"grade%e3%82%b7%e3%82%b9%e3%83%86%e3%83%a0%e3%81%aeinconsistency","status":"publish","type":"post","link":"http:\/\/aihara.la.coocan.jp\/?p=85","title":{"rendered":"GRADE\u30b7\u30b9\u30c6\u30e0\u306einconsistency"},"content":{"rendered":"<div>\n<p>GRADE\u30b7\u30b9\u30c6\u30e0\u3067\u306e<a href=\"http:\/\/www.grade-jpn.com\/grade\/guideline\/limitations.html\"><b>Limitations<\/b><\/a>\u306f\u4ee5\u524d\u7d39\u4ecb\u3057\u307e\u3057\u305f\u304c\u3001<b>\u5404\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u306e\u7814\u7a76\u7d50\u679c\u306e\u4e00\u81f4\u6027 (consistency)<\/b>\u306e\u8a55\u4fa1\u304c\u91cd\u8981\u3067\u3059\u3002\u3059\u306a\u308f\u3061\u3001\u8907\u6570\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3042\u308b\u3044\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u5831\u544a\u304c\u3042\u308b\u306e\u3067\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u304c\u9ad8\u304f\uff08\u81e8\u5e8a\u533b\u306b\u3068\u3063\u3066\uff09\u4ecb\u5165\u306e\u63a8\u5968\u306e\u4fe1\u983c\u30fb\u78ba\u4fe1\u304c\u304a\u3051\u308b\u3068\u306f\u5b89\u6613\u306b\u5224\u65ad\u3059\u308b\u3053\u3068\u306f\u4e0d\u9069\u5207\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002\u5b9f\u969b\u306e\u81e8\u5e8a\u533b\u306b\u306f\u3001\u7814\u7a76\u9593\u306e<b>inconsistency (heterogeneity)<\/b>\u304c\u554f\u984c\u3068\u306a\u308b\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n<p><\/p>\n<p>\n<a href=\"http:\/\/www.grade-jpn.com\/grade\/guideline\/inconsistency.html\" target=\"_blank\"><b>Inconsistency(\u4e0d\u4e00\u81f4\uff09<\/b><\/a>\u306f\u3001\u7d50\u679c\u8aac\u660e\u304c\u3067\u304d\u306a\u3044\u7570\u8cea\u6027\u3068\u3044\u3046\u3053\u3068\u3067\u3042\u308a\u3001GRADE\u30b7\u30b9\u30c6\u30e0\u3067\u306erate-down \u56e0\u5b50\u306e\u3072\u3068\u3064\u3067\u3001\u91cd\u5927\u304b\u975e\u5e38\u306b\u91cd\u5927\u306a\u3082\u306e\u304b\u306b\u3088\u3063\u3066\u3001\uff11\uff5e\uff12\u6bb5\u968e\u7b49\u7d1a\u30c0\u30a6\u30f3\u306b\u3064\u306a\u304c\u308a\u307e\u3059\u3002\u901a\u5e38\u306finclusion criteria\u3068\u306e\u30ae\u30e3\u30c3\u30d7\u304b\u3089\u304f\u308b\u3053\u3068\u304c\u591a\u3044\u3082\u306e\u3067\u3059\u304c\u3001\u524d\u666f\u7591\u554f\u3068\u3057\u3066\u8003\u3048\u308b\u3068\u3001PICO\u306e\u3001Population\/patients\u306e\u90e8\u5206\u306e\u3053\u3068\u3082\u3001\u307e\u305fOutcome\u306e\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n<p><\/p>\n<p>\u3055\u3066\u3001<b>\u7570\u8cea\u6027 (heterogeneity)<\/b>\u3068\u3044\u3046\u6982\u5ff5\u304b\u3089\u3059\u308b\u3068\u3001\uff12\u3064\u306b\u5927\u5225\u3059\u308b\u5834\u5408\u3082\u3042\u308a\u307e\u3059\u3002<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<br \/>\n<b>(1) Clinical heterogeneity:<\/b> inconsistency about patients\/population<br \/>\n<b>(2) Statistical heterogeneity: <\/b>inconsistency about the results<br \/>\n&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;-<\/p>\n<p><\/p>\n<p>\u3067\u306f\u7570\u8cea\u6027\u304c\u9ad8\u3044\u3053\u3068\u304c\u306f\u305f\u3057\u3066\u81e8\u5e8a\u7684\u306b\u30c7\u30e1\u30ea\u30c3\u30c8\u306a\u306e\u304b\u3001\u3042\u308b\u3044\u306f\u91cd\u8981\u6027\u304c\u4f4e\u3044\u7814\u7a76\u3068\u5224\u65ad\u3059\u3079\u304d\u306a\u306e\u304b\u3068\u306a\u308b\u3068\u3001\u305d\u308c\u306f\u7591\u554f\u3067\u3059\u3002\u3059\u306a\u308f\u3061\u3001<\/p>\n<p>\nGreater the statistical heterogeneity, in general, the weaker the inferences about the estimates of effect overall. By contrast, the greater the clinical heterogeneity, in general, the greater the generalizability of the overall results.<\/p>\n<p><\/p>\n<p>\u3053\u306e\u3088\u3046\u306b\u3001\u7570\u8cea\u6027\u306e\u7a2e\u985e\u306b\u3088\u3063\u3066\u3001\u7cfb\u7d71\u7684\u30ec\u30d3\u30e5\u30fc\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3082\u305f\u3089\u3059\u5f71\u97ff\u306f\u7570\u306a\u308b\uff08Crowther MA, McMaster Univ. Hematology 2007: 493-497) \u3068\u3044\u3046\u3053\u3068\u3067\u3042\u308a\u3001\u7cfb\u7d71\u7684\u30ec\u30d3\u30e5\u30fc\u3042\u308b\u3044\u306f\u3001\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u8005\u306f\u3001\u7814\u7a76\u306e\u7570\u8cea\u6027\u3068\u91cd\u8981\u6027\u3068\u306f\u5225\u306b\u8003\u616e\u3059\u3079\u304d\u3067\u3059\u3002<\/p>\n<p><\/p>\n<p>\u307e\u305f\u3001heterogeneity\u306b\u3064\u3044\u3066\u306f\u3001\u5e38\u306b\u4e8b\u524d\u8a2d\u5b9a\u306e<a href=\"http:\/\/www.grade-jpn.com\/grade\/guideline\/subgroup_analysis.html\" target=\"_blank\"><b>\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790<\/b><\/a>\u306e\u8a55\u4fa1\u304c\u5fc5\u9808\u3067\u3059\u3002\u3053\u306e\u30b5\u30d6\u89e3\u6790\u304c\u4fe1\u983c\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306e\u5224\u5b9a\u306e\uff17\u9805\u76ee\u306e\u3072\u3068\u3064\u306e\u3001<b>&#8220;a priori\u304b&#8221;<\/b>\u304c\u91cd\u8981\u3067\u3001post hoc\u3067\u306f\u975e\u5e38\u306b\u4e0d\u9069\u5207\u306a\u89e3\u91c8\u306b\u3064\u306a\u304c\u308a\u307e\u3059\u3002<\/p>\n<p><\/p>\n<p><a href=\"http:\/\/www.grade-jpn.com\/grade\/guideline\/quality_Evid.html\"><b>GRADE\u30b7\u30b9\u30c6\u30e0:<br \/>\n\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u3068\u305d\u306e\u7b49\u7d1a\u3065\u3051<\/b><\/a>\u53c2\u7167\u3002<\/p>\n<p><\/p>\n<p>\n<a href=\"http:\/\/aihara.la.coocan.jp\/evid-4.php\" onclick=\"window.open('http:\/\/aihara.la.coocan.jp\/evid-4.php','popup','width=794,height=407,scrollbars=no,resizable=no,toolbar=no,directories=no,location=no,menubar=no,status=no,left=0,top=0'); return false\" onkeypress=\"window.open('http:\/\/aihara.la.coocan.jp\/evid-4.php','popup','width=794,height=407,scrollbars=no,resizable=no,toolbar=no,directories=no,location=no,menubar=no,status=no,left=0,top=0'); return false\"><img decoding=\"async\" loading=\"lazy\" src=\"http:\/\/aihara.la.coocan.jp\/evid-4-thumb.jpg\" width=\"250\" height=\"128\" alt=\"qoe\" \/><\/a>\n<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>GRADE\u30b7\u30b9\u30c6\u30e0\u3067\u306eLimitations\u306f\u4ee5\u524d\u7d39\u4ecb\u3057\u307e\u3057\u305f\u304c\u3001\u5404\u30a2\u30a6\u30c8\u30ab\u30e0\u306b\u3064\u3044\u3066\u306e\u7814\u7a76\u7d50\u679c\u306e\u4e00\u81f4\u6027 (consistency)\u306e\u8a55\u4fa1\u304c\u91cd\u8981\u3067\u3059\u3002\u3059\u306a\u308f\u3061\u3001\u8907\u6570\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u3042\u308b\u3044\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u5831\u544a\u304c\u3042\u308b\u306e [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[110],"tags":[111],"_links":{"self":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/85"}],"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=85"}],"version-history":[{"count":1,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/85\/revisions"}],"predecessor-version":[{"id":597,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/85\/revisions\/597"}],"wp:attachment":[{"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=85"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=85"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=85"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}