{"id":1552,"date":"2015-05-28T20:54:15","date_gmt":"2015-05-28T11:54:15","guid":{"rendered":"http:\/\/aihara.la.coocan.jp\/?p=1552"},"modified":"2015-05-28T20:54:15","modified_gmt":"2015-05-28T11:54:15","slug":"nma%e3%82%a8%e3%83%93%e3%83%87%e3%83%b3%e3%82%b9%e3%81%aegrade%e8%a9%95%e4%be%a1-1","status":"publish","type":"post","link":"https:\/\/aihara.la.coocan.jp\/?p=1552","title":{"rendered":"NMA\u30a8\u30d3\u30c7\u30f3\u30b9\u306eGRADE\u8a55\u4fa1-(1)"},"content":{"rendered":"

\u524d\u56de\u3001\u524d\u3005\u56de\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9(NMA)\u306b\u3064\u3044\u3066\u3001GRADE\u3092\u4f7f\u3063\u3066\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u3092\u8a55\u4fa1\u3059\u308b\u3068\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u624b\u9806\u3068\u306a\u308b\u3002NMA\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u95a2\u3059\u308bGRADE\u30a2\u30d7\u30ed\u30fc\u30c1\u306e\u9069\u7528\uff08\uff14\u3064\u306e\u30b9\u30c6\u30c3\u30d7\uff09\u306b\u3064\u3044\u3066\u306f\u3001GRADE2\u7248<\/strong><\/a>\u3092\u53c2\u7167\u3057\u3066\u3044\u305f\u3060\u304d\u305f\u3044\u3002<\/p>\n

<\/p>\n

\"\u753b\u50cf\"<\/a><\/p>\n

\u25a0Step-1: \u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u5185\u306e\u5404\u6bd4\u8f03\u306b\u3064\u3044\u3066\u76f4\u63a5\u63a8\u5b9a\u5024\u3068\u9593\u63a5\u63a8\u5b9a\u5024\u3092\u793a\u3059<\/strong><\/p>\n\n\n
\n

Reamed(A) vs Unreamed(B)\u6bd4\u8f03\u306b\u304a\u3051\u308b\u3001\u76f4\u63a5\u63a8\u5b9a\u5024\uff084\u4ef6\u306eRCT\uff09\u306f0.74(0.45-1.24)\u3001\u9593\u63a5\u63a8\u5b9a\u5024\uff087\u4ef6\u306eRCT\uff09\u306f0.07(0.01-0.46)\u3067\u3042\u308b\u3002<\/p>\n<\/td>\n<\/tr>\n<\/table>\n

<\/p>\n

\u25a0Step-2\uff1a\u76f4\u63a5\u63a8\u5b9a\u5024\u3068\u9593\u63a5\u63a8\u5b9a\u5024\u306e\u8cea\u3092\u7b49\u7d1a\u3059\u308b<\/b><\/p>\n\n\n
\n

AvB\u306ehead-to-head\u3001\u3064\u307e\u308a\u76f4\u63a5\u63a8\u5b9a\u5024\u306erisk of bias\u306flow\u3067\u3042\u308b\u304c\u3001\u305d\u306e\u4fe1\u983c\u533a\u9593\u306f\u5e83\u304f\uff080.45-1.24\uff09\u3001\u201d\u52b9\u679c\u306a\u3057=1\u201d\u3092\u307e\u305f\u3044\u3067\u304a\u308a\u3001\u4e0d\u7cbe\u78ba\u3055\uff08imprecision\uff09\u306e\u305f\u3081\uff11\u6bb5\u968e\u30b0\u30ec\u30fc\u30c9\u30c0\u30a6\u30f3\u3068\u306a\u308b\u3002\uff08GRADE QoE: Moderate\uff09<\/p>\n

\u4e00\u65b9\u3001AvB\u306e\u9593\u63a5\u6bd4\u8f03\u306e\u63a8\u5b9a\u5024\u306f0.07(0.01-0.46)\u3068\u6709\u610f\u5dee\u304c\u3042\u308a\u3001\u30ea\u30fc\u30de\u4f7f\u7528\u306e\u91d8\u56fa\u5b9a\u3088\u308a\u306f\u30ea\u30fc\u30de\u4e0d\u4f7f\u7528\u306e\u91d8\u56fa\u5b9a\u306e\u65b9\u304c\u306f\u308b\u304b\u306b\u518d\u624b\u8853\u7387\u304c\u4f4e\u3044\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u308b\u3002\u3057\u304b\u3057\u3001\u63a1\u7528\u7814\u7a76\u304c\u5272\u308a\u4ed8\u3051\u306e\u96a0\u853d\u5316\u3084\u30d6\u30e9\u30a4\u30f3\u30c9\u5316\u306e\u6b20\u5982\u306e\u305f\u3081risk of bias\u304c\u9ad8\u3044\u3053\u3068\u304b\u3089\u300cmoderate quality\u300d\u306b\u30b0\u30ec\u30fc\u30c9\u30c0\u30a6\u30f3\u3001\u3055\u3089\u306b\u3001\u52b9\u679c\u4fee\u98fe\u306b\u5dee\u304c\u3042\u308b\uff08\u975e\u63a8\u79fb\u6027\uff1a\u6ce8\uff11\uff09\u306e\u7591\u3044\u306e\u8a66\u9a13\u306b\u3088\u308a\u69cb\u6210\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304b\u3089\u3001\u6700\u7d42\u7684\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u306flow\u306b\u30b0\u30ec\u30fc\u30c9\u30c0\u30a6\u30f3\u3068\u306a\u3063\u305f\uff08\u8ad6\u6587\u8457\u8005\u3089\u306e\u8a55\u4fa1\uff09\u3002<\/p>\n

\u6ce8\uff11\uff1a\u975e\u63a8\u79fb\u6027\uff1a\u305f\u3068\u3048\u3070\u3001\u5171\u901a\u306e\u6bd4\u8f03\u5bfe\u7167(B)\u3092\u4ecb\u3057\u3066\u3001\u61f8\u6848\u306e\u6bd4\u8f03\uff08\u305f\u3068\u3048\u3070A\u5bfeC\uff09\u306b\u95a2\u3059\u308b\u63a8\u8ad6\u3092\u7acb\u3066\u308b\u5834\u5408\u3001AvB\u8a66\u9a13\u3068BvC\u8a66\u9a13\u3068\u3067\u3001\u60a3\u8005\u3001\u4ecb\u5165\u3001\u30a2\u30a6\u30c8\u30ab\u30e0\u304c\u8457\u3057\u304f\u7570\u306a\u308b\u554f\u984c\u3092\u3001\u201d\u63a8\u79fb\u6027\u306e\u9055\u53cd\uff08violation of transitivity\uff09\u201d\u3082\u3057\u304f\u306f\u975e\u63a8\u79fb\u6027\uff08intransitivity\uff09\u3068\u3044\u3046\u3002<\/p>\n<\/td>\n<\/tr>\n<\/table>\n

<\/p>\n

\u25a0Step-3: NMA\u63a8\u5b9a\u5024\u3092\u793a\u3059<\/b><\/p>\n\n\n
\n

\u76f4\u63a5\u63a8\u5b9a\u5024\u3068\u9593\u63a5\u63a8\u5b9a\u5024\u306f\u3001\u305d\u308c\u305e\u308c\u3092\u53d6\u308a\u5dfb\u304f\u4fe1\u983c\u533a\u9593\u306e\u91cd\u306a\u308a\u306f\u307b\u3068\u3093\u3069\u306a\u304f\u3001\u4e21\u8005\u304c\u540c\u4e00\u3067\u3042\u308b\u3068\u3059\u308b\u5e30\u7121\u4eee\u8aac\u306e\uff50<\/em>\u5024\uff08\u6ce8\uff12\uff09\u306f0.0196\uff08\u8ad6\u6587\u306b\u306f0.02\u3068\u8a18\u8f09\u3055\u308c\u3066\u3044\u308b\uff09\u3067\u3042\u308a\u3001\u52b9\u679c\u304c\u540c\u3058\u3067\u306f\u306a\u3044\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\u3002
\nNMA\u63a8\u5b9a\u5024\u306f\u30010.62(0.37-1.03)\u3067\u3042\u308b\u3002<\/p>\n

\u6ce8\uff12\uff1ainteraction, \u6574\u5408\u6027\u691c\u5b9a
\n\uff08NMA\u306b\u95a2\u3059\u308b\u7279\u6b8a\u7528\u8a9e\u3068\u305d\u306e\u610f\u5473\u306f\u3001GRADE\uff12\u7248\u3092\u53c2\u7167\u306e\u3053\u3068\uff09<\/p>\n<\/td>\n<\/tr>\n<\/table>\n

<\/p>\n

\u25a0Step-4: NMA\u63a8\u5b9a\u5024\u3092\u7b49\u7d1a\u3059\u308b<\/b><\/p>\n\n\n
\n

\n\u76f4\u63a5\u63a8\u5b9a\u5024\u3068\u9593\u63a5\u63a8\u5b9a\u5024\u306b\u306f\u975e\u6574\u5408\u6027\u304c\u3042\u308a\u3001\u7406\u8ad6\u7684\u306b\u306f\u3053\u306e\u6574\u5408\u6027\u306f\u975e\u63a8\u79fb\u6027\u306b\u3088\u3063\u3066\u9593\u63a5\u6bd4\u8f03\u306b\u751f\u3058\u305f\u30d0\u30a4\u30a2\u30b9\u304c\u539f\u56e0\u3067\u751f\u3058\u308b\u3002\u975e\u6574\u5408\u6027\uff08incoherence\uff09\u306e\u305f\u3081\u306b\u3001\u672cNMA\u63a8\u5b9a\u5024\u306e\u78ba\u4fe1\u6027\u306f\u4f4e\u4e0b\u3057\u3001\u3055\u3089\u306b95%\u4fe1\u983c\u533a\u9593\u304b\u3089\u201d\u4e0d\u7cbe\u78ba\uff08imprecision\uff09\u201d\u3067\u3082\u3042\u308b\u3002\u3057\u305f\u304c\u3063\u3066\u3001NMA\u63a8\u5b9a\u5024\u306e\u6700\u7d42\u7684\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u306f\u3001high\u304b\u30892\u6bb5\u968e\u4f4e\u4e0b\u3057\u3001Low\u3068\u306a\u308b\u3002<\/p>\n<\/td>\n<\/tr>\n<\/table>\n

<\/p>\n

\u25a0\u30a8\u30d3\u30c7\u30f3\u30b9\u30c6\u30fc\u30d6\u30eb<\/strong><\/p>\n

\"nma_evidence_table-1\"<\/a><\/p>\n

\u3055\u3066\u3001\u6211\u3005\u306f\u3001Reamed vs Unreamed\u306e\u6bd4\u8f03\u306b\u95a2\u3057\u3066\u3001\u76f4\u63a5\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u9593\u63a5\u30a8\u30d3\u30c7\u30f3\u30b9\u3068NMA\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u3044\u305a\u308c\u3092\u4fe1\u7528\u3059\u3079\u304d\u3060\u308d\u3046\u304b<\/strong><\/span><\/p>\n

\u30fb\u30fb\u30fb\u7b54\u3048\u306f\u660e\u3089\u304b\u306b\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u304c\u201c\u4e2d(moderate)\u201d\u306e\u300c\u76f4\u63a5\u30a8\u30d3\u30c7\u30f3\u30b9\u300d<\/strong>\u3067\u3042\u308b\u3002
\n\u300c\u30ea\u30fc\u30de\u4e0d\u4f7f\u7528\u306e\u91d8\u56fa\u5b9a\u8853\u306f\u30ea\u30fc\u30de\u4f7f\u7528\u306e\u91d8\u56fa\u5b9a\u8853\u306b\u6bd4\u3079\u3066\u3001\u518d\u624b\u8853\u306e\u30aa\u30c3\u30ba\u6bd4\u309230\uff05\u6e1b\u5c11\u3059\u308b\u300d\u3068\u3044\u3048\u308b\u3002<\/p>\n

\u9593\u63a5\u6bd4\u8f03\u306b\u3088\u308b\u52b9\u679c\u306f\u975e\u5e38\u306b\u5927\u304d\u3044\u304c\u3001\u305d\u306e\u52b9\u679c\u63a8\u5b9a\u5024\u306b\u95a2\u3059\u308b\u78ba\u4fe1\u6027\u306f\u4f4e\u304f\u3001\u904e\u5927\u8a55\u4fa1\u3057\u3066\u3044\u308b\u306e\u3067\u3042\u308d\u3046\u3002\u307e\u305f\u3001\u6574\u5408\u6027\u304c\u306a\u3044\u76f4\u63a5\u63a8\u5b9a\u5024\u3068\u9593\u63a5\u63a8\u5b9a\u5024\u304b\u3089\u6df7\u5408\u63a8\u5b9a\u5024\u3092\u5f97\u308b\u3053\u3068\u304c\u9069\u5207\u3068\u306f\u601d\u3048\u306a\u3044\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

\u524d\u56de\u3001\u524d\u3005\u56de\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9(NMA)\u306b\u3064\u3044\u3066\u3001GRADE\u3092\u4f7f\u3063\u3066\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u3092\u8a55\u4fa1\u3059\u308b\u3068\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u624b\u9806\u3068\u306a\u308b\u3002NMA\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u95a2\u3059\u308bGRADE\u30a2\u30d7\u30ed\u30fc\u30c1\u306e\u9069\u7528\uff08\uff14\u3064\u306e\u30b9\u30c6\u30c3\u30d7\uff09\u306b\u3064\u3044\u3066\u306f\u3001GRADE2 […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,258],"tags":[],"_links":{"self":[{"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/1552"}],"collection":[{"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1552"}],"version-history":[{"count":64,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/1552\/revisions"}],"predecessor-version":[{"id":1642,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=\/wp\/v2\/posts\/1552\/revisions\/1642"}],"wp:attachment":[{"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1552"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1552"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/aihara.la.coocan.jp\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1552"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}