{"id":3648,"date":"2015-01-27T12:00:39","date_gmt":"2015-01-27T03:00:39","guid":{"rendered":"https:\/\/www.ishamachi.com\/?p=3648"},"modified":"2018-03-12T12:01:44","modified_gmt":"2018-03-12T03:01:44","slug":"%e3%81%9d%e3%81%ae%e5%81%a5%e5%ba%b7%e7%9f%a5%e8%ad%98%e3%80%81%e6%9c%ac%e5%bd%93%e3%81%ab%e3%81%82%e3%81%a3%e3%81%a6%e3%81%be%e3%81%99%e3%81%8b%ef%bc%9f%e3%80%80%ef%bc%8d%e5%8c%bb%e5%ad%a6%e3%81%ae","status":"publish","type":"post","link":"https:\/\/www.ishamachi.com\/?p=3648","title":{"rendered":"\u305d\u306e\u5065\u5eb7\u77e5\u8b58\u3001\u672c\u5f53\u306b\u3042\u3063\u3066\u307e\u3059\u304b\uff1f\u3000\uff0d\u533b\u5b66\u306e\u6b63\u3057\u3055\u3092\u793a\u3059\u300c\u30a8\u30d3\u30c7\u30f3\u30b9\u300d\u3068\u306f\u2015"},"content":{"rendered":"

\u203b\u3053\u306e\u8a18\u4e8b\u306f\u3001\u57f7\u7b46\u8005\u304c\u7814\u4fee\u533b\u306e\u6642\u306b\u4f5c\u6210\u3057\u305f\u8a18\u4e8b\u3067\u3059\u3002<\/p>\n

\u533b\u5b66\u306b\u306f\u6839\u62e0\u304c\u5fc5\u8981<\/h2>\n

\u6628\u4eca\u3067\u306f\u3001\u5065\u5eb7\u306b\u307e\u3064\u308f\u308b\u3042\u3089\u3086\u308b\u60c5\u5831\u304c\u98db\u3073\u4ea4\u3063\u3066\u3044\u307e\u3059\u3002<\/p>\n

\u30c6\u30ec\u30d3\u3084\u30a4\u30f3\u30bf\u30fc\u30cd\u30c3\u30c8\u3067\u8a71\u984c\u306b\u306a\u308b\u5065\u5eb7\u77e5\u8b58\u306f\u3001\u3057\u304b\u3057\u3001\u6b63\u3057\u3044\u3053\u3068\u3082\u3042\u308c\u3070\u898b\u5f53\u306f\u305a\u308c\u306a\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u305f\u3068\u3048\u3070\u300c\u8840\u5727\u3092\u4e0b\u3052\u308b\u305f\u3081\u306b\u306f\u5869\u5206\u3092\u63a7\u3048\u308b\u300d\u3068\u3044\u3063\u305f\u533b\u5b66\u754c\u3067\u306f\u65e2\u306b\u5e38\u8b58\u3068\u306a\u3063\u3066\u3044\u308b\u3082\u306e\u3082\u3042\u308c\u3070\u3001\u70ad\u6c34\u5316\u7269\u5236\u9650\u306e\u3088\u3046\u306b\u4eca\u307e\u3055\u306b\u8b70\u8ad6\u304c\u306a\u3055\u308c\u3066\u3044\u308b\u3082\u306e\u3001\u306f\u305f\u307e\u305f\u300c\u30b3\u30fc\u30e9\u3092\u98f2\u3080\u3068\u9aa8\u304c\u6eb6\u3051\u308b\u300d\u300c\u25cb\u25cb\u3060\u3051\u98df\u3079\u3066\u3044\u308c\u3070\u3084\u305b\u308b\u300d\u3068\u3044\u3063\u305f\u533b\u5b66\u7684\u306b\u307e\u3063\u305f\u304f\u6839\u62e0\u304c\u306a\u3044\u8ff7\u4fe1\u307e\u3067\u3055\u307e\u3056\u307e\u3067\u3059\u3002<\/p>\n

\u533b\u5b66\u306b\u306a\u3058\u307f\u306e\u306a\u3044\u65b9\u304c\u3053\u3046\u3057\u305f\u60c5\u5831\u306e\u6b63\u3057\u3055\u3092\u898b\u6975\u3081\u308b\u3068\u304d\u3001\u3044\u3063\u305f\u3044\u4f55\u3092\u76ee\u5b89\u306b\u3059\u308c\u3070\u3088\u3044\u306e\u3067\u3057\u3087\u3046\u304b\uff1f<\/p>\n

\u6211\u3005\u533b\u7642\u8005\u304c\u3053\u3046\u3057\u305f\u533b\u5b66\u7684\u77e5\u8b58\u3092\u8a55\u4fa1\u3059\u308b\u3068\u304d\u306b\u306f\u3001\u305d\u3053\u306b\u300c\u30a8\u30d3\u30c7\u30f3\u30b9\u300d<\/strong>\u304c\u3042\u308b\u304b\u3069\u3046\u304b\u306b\u6ce8\u76ee\u3057\u307e\u3059\u3002<\/p>\n

\u300c\u30a8\u30d3\u30c7\u30f3\u30b9\u300d\u306f\u3001\u76f4\u8a33\u3059\u308b\u3068\u300c\u8a3c\u8a00\u300d\u3068\u304b\u300c\u8a3c\u62e0\u300d\u3068\u3044\u3063\u305f\u3088\u3046\u306a\u610f\u5473\u306e\u8a00\u8449\u3067\u3059\u3002<\/p>\n

\u30d3\u30b8\u30cd\u30b9\u306e\u4e16\u754c\u3067\u306f\u3001\u30af\u30e9\u30a4\u30a2\u30f3\u30c8\u3068\u306e\u3084\u308a\u53d6\u308a\u3092\u30e1\u30fc\u30eb\u3084\u66f8\u985e\u306e\u5f62\u3067\u6b8b\u3059\u306a\u3069\u3001\u3042\u3068\u3067\u30c8\u30e9\u30d6\u30eb\u306e\u306a\u3044\u3088\u3046\u306b\u3068\u3063\u3066\u304a\u304f\u8a3c\u62e0\u306e\u3053\u3068\u3092\u8a00\u3046\u3053\u3068\u304c\u3042\u308b\u3088\u3046\u3067\u3059\u304c\u3001\u533b\u7642\u696d\u754c\u3067\u306f\u3082\u3046\u5c11\u3057\u53b3\u5bc6\u306a\u4f7f\u3044\u65b9\u3092\u3057\u307e\u3059\u3002<\/p>\n

\u533b\u7642\u306b\u304a\u3051\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u306f\u3001\u3042\u308b\u8a3a\u65ad\u3084\u6cbb\u7642\u306b\u3064\u3044\u3066\u300c\u3053\u306e\u65b9\u6cd5\u3067\u6b63\u78ba\u306a\u8a3a\u65ad\u304c\u3064\u304f\u300d\u300c\u3053\u306e\u6cbb\u7642\u3067\u3088\u304f\u306a\u308b\u300d\u3068\u8a00\u3048\u308b\u6839\u62e0\u306e\u3053\u3068<\/strong>\u3067\u3059\u3002<\/p>\n

\u6211\u3005\u533b\u7642\u8005\u306f\u3001\u6839\u62e0\u306e\u306a\u3044\u8a3a\u65ad\u3084\u6cbb\u7642\u3092\u884c\u3046\u3053\u3068\u306f\u3067\u304d\u307e\u305b\u3093\u3002\u8a3a\u7642\u3092\u3067\u304d\u308b\u3060\u3051\u610f\u5473\u306e\u3042\u308b\u3082\u306e\u306b\u3059\u308b\u305f\u3081\u306b\u3001\u591a\u304f\u306e\u7814\u7a76\u304c\u884c\u308f\u308c\u3001\u691c\u67fb\u3084\u85ac\u306e\u52b9\u679c\u3001\u610f\u7fa9\u304c\u691c\u8a3c\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u666e\u6bb5\u75c5\u9662\u3067\u4f55\u6c17\u306a\u304f\u3082\u3089\u3063\u3066\u3044\u308b\u85ac\u3082\u3001\u80cc\u666f\u306b\u306f\u305d\u306e\u6839\u62e0\u3092\u88cf\u4ed8\u3051\u308b\u5927\u898f\u6a21\u306a\u7814\u7a76\u306e\u7d50\u679c\u304c\u3042\u308b\u306e\u3067\u3059\u3002<\/p>\n

\u3053\u3046\u3057\u305f\u6839\u62e0\u306b\u57fa\u3065\u304d\u3001\u7d71\u8a08\u5b66\u7684\u306b\u3082\u3063\u3068\u3082\u59a5\u5f53\u306a\u8a3a\u7642\u3092\u3059\u308b\u3053\u3068\u3092\u201cEvidence-based-medicine<\/strong>\u201d\u3001\u65e5\u672c\u8a9e\u3067\u300c\u6839\u62e0\u306e\u3042\u308b\u6cbb\u7642\u300d\u3068\u547c\u3073\u307e\u3059\u3002<\/strong><\/p>\n

Evidence-based-medicine\u306f\u3082\u3068\u3082\u3068\u30a2\u30e1\u30ea\u30ab\u3067\u4e3b\u6d41\u3068\u306a\u3063\u3066\u3044\u305f\u8003\u3048\u65b9\u3067\u3059\u3002\u3053\u308c\u306b\u5bfe\u3057\u3066\u3001\u65e5\u672c\u306e\u533b\u5b66\u306f\u30c9\u30a4\u30c4\u3092\u304a\u624b\u672c\u3068\u3057\u3066\u767a\u5c55\u3057\u3066\u304d\u305f\u7d4c\u7def\u304c\u3042\u308a\u3001\u30c9\u30a4\u30c4\u306b\u306a\u3089\u3063\u3066\u7d14\u7c8b\u306b\u79d1\u5b66\u3068\u3057\u3066\u306e\u7406\u8ad6\u306b\u91cd\u304d\u3092\u7f6e\u304f\u98a8\u6f6e\u304c\u3042\u308a\u307e\u3057\u305f\u3002<\/p>\n

\u3057\u304b\u3057\u4eca\u65e5\u3067\u306f\u65e5\u672c\u306e\u533b\u7642\u3082\u3001\u3088\u308a\u7d71\u8a08\u5b66\u7684\u306b\u7d50\u679c\u3092\u8ffd\u6c42\u3059\u308bEvidence-based-medicine\u306e\u8003\u3048\u65b9\u306b\u30b7\u30d5\u30c8\u3057\u3064\u3064\u3042\u308a\u307e\u3059\u3002<\/p>\n

\u30a8\u30d3\u30c7\u30f3\u30b9\u3082\u30d4\u30f3\u304b\u3089\u30ad\u30ea\u307e\u3067<\/h2>\n\"\u533b\u5e2b\uff12\"<\/a>\n

\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u306f\u3044\u304f\u3064\u304b\u306e\u30ec\u30d9\u30eb\u304c\u3042\u308a\u3001\u3069\u306e\u3088\u3046\u306b\u3057\u3066\u5f97\u3089\u308c\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u306a\u306e\u304b\u306b\u3088\u3063\u3066\u4fe1\u983c\u5ea6\u304c\u5909\u308f\u3063\u3066\u304d\u307e\u3059\u3002\u3053\u308c\u3092\u300c\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u300d\u3068\u8a00\u3044\u307e\u3059\u3002<\/p>\n

\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u306f\u53b3\u5bc6\u306b\u306f6\u6bb5\u968e\u306b\u5206\u304b\u308c\u308b\u306e\u3067\u3059\u304c\u3001\u6b63\u78ba\u306a\u8aac\u660e\u306f\u30cd\u30c3\u30c8\u4e0a\u306b\u3082\u305f\u304f\u3055\u3093\u3042\u308b\u306e\u3067\u3001\u3082\u3046\u5c11\u3057\u7c21\u5358\u306b\u8aac\u660e\u3057\u307e\u3059\u3002<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Level<\/strong><\/td>\n\u5185\u5bb9<\/strong><\/td>\n<\/tr>\n
1a<\/td>\n\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9<\/td>\n<\/tr>\n
1b<\/td>\n\u5c11\u306a\u304f\u3068\u3082\u4e00\u3064\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13(RCT)<\/td>\n<\/tr>\n
2a<\/td>\n\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8\u3092\u4f34\u308f\u306a\u3044\u540c\u6642\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3092\u4f34\u3046\u30b3\u30db\u30fc\u30c8\u7814\u7a76
\n\uff08\u524d\u5411\u304d\u7814\u7a76\u3001prospective study, concurrent cohort study\u306a\u3069<\/td>\n<\/tr>\n
2b<\/td>\n\u30e9\u30f3\u30c0\u30e0\u5272\u4ed8\u3092\u4f34\u308f\u306a\u3044\u904e\u53bb\u306e\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u3092\u4f34\u3046\u30b3\u30db\u30fc\u30c8\u7814\u7a76
\n\uff08historical cohort study, retrospective cohort study\u306a\u3069\uff09<\/td>\n<\/tr>\n
3<\/td>\n\u75c7\u4f8b\u5bfe\u7167\u7814\u7a76\uff08\u30b1\u30fc\u30b9\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb, \u5f8c\u308d\u5411\u304d\u7814\u7a76\uff09<\/td>\n<\/tr>\n
4<\/td>\n\u51e6\u7f6e\u524d\u5f8c\u306e\u6bd4\u8f03\u306a\u3069\u306e\u524d\u5f8c\u6bd4\u8f03\u3001\u5bfe\u7167\u7fa4\u3092\u4f34\u308f\u306a\u3044\u7814\u7a76<\/td>\n<\/tr>\n
5<\/td>\n\u75c7\u4f8b\u5831\u544a\u3001\u30b1\u30fc\u30b9\u30b7\u30ea\u30fc\u30ba<\/td>\n<\/tr>\n
6<\/td>\n\u5c02\u9580\u5bb6\u500b\u4eba\u306e\u610f\u898b\uff08\u5c02\u9580\u5bb6\u59d4\u54e1\u4f1a\u5831\u544a\u3092\u542b\u3080\uff09<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u53c2\u8003\uff1a\u79d1\u5b66\u7684\u6839\u62e0\u306b\u57fa\u3065\u304f\u809d\u764c\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3 2013\u5e74\u7248<\/a>\uff08PDF\uff09\u3088\u308a<\/p>\n

\u307e\u305a\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u3057\u3066\u3082\u3063\u3068\u3082\u30ec\u30d9\u30eb\u304c\u4f4e\u3044\u306e\u306f\u300c\u5c02\u9580\u5bb6\u306e\u610f\u898b\u300d<\/strong>\u3002<\/p>\n

\u610f\u5916\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u304c\u3001\u300c\u5c02\u9580\u5bb6\u304c\u3053\u3046\u8a00\u3063\u3066\u3044\u308b\u300d\u3068\u3044\u3046\u306e\u306f\u5fc5\u305a\u3057\u3082\u3042\u3066\u306b\u306a\u3089\u305a\u3001\u6839\u62e0\u3068\u3057\u3066\u306f\u3042\u307e\u308a\u610f\u5473\u304c\u3042\u308a\u307e\u305b\u3093\u3002\u300c\u79c1\u306e\u7d4c\u9a13\u4e0a\u306f\u3053\u306e\u6cbb\u7642\u304c\u3088\u304f\u52b9\u304f\u2026\u300d\u3068\u3044\u3063\u305f\u3088\u3046\u306a\u8a71\u306f\u3088\u304f\u3042\u308a\u307e\u3059\u304c\u3001\u305d\u3053\u306b\u306f\u3055\u307e\u3056\u307e\u306a\u30d0\u30a4\u30a2\u30b9<\/strong>\u304c\u542b\u307e\u308c\u3066\u3044\u308b\u53ef\u80fd\u6027\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n

\u30d0\u30a4\u30a2\u30b9<\/strong>\u3068\u3044\u3046\u306e\u306f\u3001\u7d50\u8ad6\u3092\u51fa\u3059\u307e\u3067\u306e\u904e\u7a0b\u306b\u3042\u308b\u60c5\u5831\u53ce\u96c6\u3084\u8a8d\u8b58\u306e\u504f\u308a\u306e\u3053\u3068\u3002\u305f\u3068\u3048\u3070\u300c\u7d4c\u9a13\u4e0a\u3088\u304f\u52b9\u304f\u300d\u3068\u3044\u3046\u4e3b\u5f35\u306f\u3001\u300c\u3088\u304f\u6cbb\u3063\u305f\u75c7\u4f8b\u3060\u3051\u9bae\u660e\u306b\u8a18\u61b6\u3057\u3066\u3044\u308b\u3060\u3051\u3067\u306f\u306a\u3044\u304b\uff1f\u300d<\/strong>\u3068\u3044\u3046\u53cd\u8ad6\u306b\u307e\u3063\u305f\u304f\u8010\u3048\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u305b\u3093\u3002\u5b9f\u969b\u306b\u3001\u4eca\u307e\u3067\u52b9\u304f\u3068\u8a00\u308f\u308c\u3066\u304d\u305f\u6cbb\u7642\u6cd5\u304c\u3001\u7814\u7a76\u306e\u7d50\u679c\u5426\u5b9a\u3055\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n

\u30a8\u30d3\u30c7\u30f3\u30b9\u30ec\u30d9\u30eb\u3092\u9ad8\u3081\u308b\u305f\u3081\u306b\u306f\u3001\u3053\u3046\u3057\u305f\u60c5\u5831\u306e\u504f\u308a\u3092\u6392\u9664\u3059\u308b\u52aa\u529b\u304c\u5fc5\u8981\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n

\u300c\u6a29\u5a01\u8005\u306e\u610f\u898b\u300d\u3088\u308a\u3082\u3046\u5c11\u3057\u4fe1\u983c\u5ea6\u304c\u9ad8\u3044\u306e\u304c\u3001\u300c\u75c7\u4f8b\u5831\u544a\u300d<\/strong>\u3084\u300c\u30b1\u30fc\u30b9\u30b7\u30ea\u30fc\u30ba\uff08\u4e00\u9023\u306e\u75c7\u4f8b\uff09\u300d<\/strong>\u3002\u5b9f\u969b\u306b\u3053\u3046\u3044\u3046\u60a3\u8005\u3055\u3093\uff08\u9054\uff09\u304c\u3044\u307e\u3057\u305f\u3088\u3001\u3068\u3044\u3046\u5831\u544a\u3067\u3059\u3002\u5c02\u9580\u5bb6\u304c\u8a00\u3063\u3066\u3044\u308b\u3060\u3051\u3001\u3068\u3044\u3046\u306e\u3068\u306f\u7570\u306a\u308a\u3001\u5c11\u3057\u306f\u6839\u62e0\u3068\u3057\u3066\u5f37\u3044\u3082\u306e\u304c\u51fa\u3066\u304d\u307e\u3059\u3002<\/p>\n

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 <\/p>\n

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<\/p>\n

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\u307e\u3068\u3081<\/h2>\n

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