SlideShare a Scribd company logo
1 of 58
—       —

    "
            "
•                    "
•                              "
•              "
•                                             "
•                S         "
•  Body"of"Evidence"
•                                         "

                   JMLA"       2013.2.8
創立日:1923年6月2日 83床
創立者:大原孫三郎




       JMLA"   2013.2.8   "
!

           "
!
                            QOL
                                  "
    !




        JMLA"   2013.2.8"         4"
• 
     ""
• 

                  "


          JMLA"       2013.2.8"   5"
•                                     !
•                                         !
!
              !
     60$100   !
                     !




                  JMLA"   2013.2.8"           6"
• 
• 
     – 
     – 
     – 
• 
     – 
• 
• 
     – 
     – 


          JMLA"       2013.2.8   "
                  7
DPC                               "
      21      7              12

                                      16000"
                                      16000"

                                      14000"
                                      14000"

                                      12000"
                                      12000"
                                      10000"

                                      10000"
                                      8000"

                                      8000"
                                      6000"


                                      4000"
                                      6000"

                                      2000"
                                      4000"

                                      0"
                                      2000"


                                      0"


      JMLA"       2013.2.8                     "
2001   H13



2004    16       1   25           41   12
2005    17       2   24           37   14
2006    18       3   27           43   16
2007    19       4   23           42   16
2008    20       5   27           39   18
2009    21       6   28           48   19
2010    22       7   24           48   24
2011    23       8   31           46   25
2012    24       9   30           48   19
             JMLA"    2013.2.8"             10"
JMLA"   2013.2.8"   11"
•                          "
     –                                        "
     –                                                    "
       →                                              "
•  2006    "
     –                                            "
     –                 "
     –                         "
     –                                                "

               JMLA"               2013.2.8
•  2007                    "
  –       "
  – 
          "
•  2007               "
  –                                          "
  –             "
  –                            "
  –                                      "
    →                                "

              JMLA"       2013.2.8
•                                    "
     –                                   "
•             "
     – 
                      "
•                     "
     – 
                  "

          JMLA"           2013.2.8
•                               "
•                "
•                                       "
•                                   "
• 
     "



         JMLA"       2013.2.8
"

•  2006        MD"Consult,"ProQuest,"
   ScienceDirect"
•  2007                                 "
•  2008                               "
  –  UpToDate,"DynaMed,"                           "
  –  PubMed,"                              "
•  2010 "
  –                SFX                                 "
•  2011 "
  –                         "

                    JMLA"       2013.2.8
"

•                                            "
• 
          "

•                                    "
     –                                   "
     –                               "



              JMLA"   2013.2.8
"

•                                     "
     –                                    "
          •                                                      "
          •                                          "
     –                                                   "
          •                                      "
               –    Endnote                                  "
          • 
               "
          •                                                          "
               –       SPSS                          "

                              JMLA"       2013.2.8
"

•                                            "
     –                                           "
•  2012                                  "
     – 
          "
     –                                           "
     –                "



              JMLA"       2013.2.8
2012
45,000"
40,000"
35,000"
30,000"
25,000"
20,000"
15,000"
10,000"
 5,000"
     0"
          S     H     "K          K

              JMLA"    2013.2.8
•                                     "
     –                                            "
          •                                   "
          •                           "
          •                      "
•                            "
     –                                    "
          •            "
          • 

               JMLA"       2013.2.8
"
23
•                           3        5

• 
      1      1     1

• 
• 


24   JMLA"       2013.2.8       24
risk ratio RR
•               relative risk
• 

•          10                     8
     0.8                        0.5




25                 JMLA"      2013.2.8   25
•                           3        5

• 
      1      1     1

• 
• 


26   JMLA"       2013.2.8       26
• 


• 




27   JMLA"   2013.2.8   27
• 


•                                 3
     50




28        JMLA"   2013.2.8   28
Evidence                       …




    BMJ 1998; 317: 1246-1248
  情報は多すぎる。だからこそ、見極め
  る目が必要になっている
            JMLA"   2013.2.8
"  ××                 ○○
"              □□
          !!
" 
"  5000                         50
                               !!
" 


                    JMLA"   2013.2.8
• 

• 
• 

• 

• 



     JMLA"   2013.2.8
• 
• 
• 
• 
•  →




       JMLA"   2013.2.8
•             "
     – 
                   "
     – 
                                     "
     – 

          "


                  JMLA"   2013.2.8
•                "
     – 
                 "
     – 
                                        "
     – 
          "

•  Browne"MN:"In"“Asking"the"Right"Ques[ons:"A"
   guide"to"cri[cal"thinking”"9th"ed."2009 "

                     JMLA"   2013.2.8
•                                "
     –    "
     –        "
     –                                           "
•                                "
     –                               "
     –                    "
     –                                   "
     –                                       "

              JMLA"   2013.2.8
S
6S
                                           Systems

                                         Summaries
                                        Synopses"of"
                                         Syntheses
                                          Syntheses

                                   Synopses"of"Studies

                                               Studies
DiCenso, A, Bayley, L , Haynes, RB: ACP Journal Club. Editorial: Accessing preappraised evidence:
fine-tuning the 5S model into a 6S model. Ann Intern Med 2009; 151: JC3-2, JC3-3.
                                       JMLA"        2013.2.8
6S
             Systems:"

          Summaries:"

         Synopses"of"
     Syntheses:"
        Syntheses:"

 Synopses"of"Studies:"

         Studies:"

         JMLA"       2013.2.8
6S
           Systems:"                               • 
                                                   • 


         Summaries:"                               • UpToDate,"DynaMed
                                            GL     • Evidence`based"Guideline


      Synopses"of"Syn`                             • Evidence`based"
      theses:"                   SR                • SR              DARE,"Minds


                                                   • Cochrane"Library
       Syntheses:"
                                            (SR)   •       PubMed


                                                   • Evidence`based"        ACP"Journal"
Synopses"of"Studies:"
                                                     Club,"Evidence`based"Medicine"



        Studies:"                                  • PubMed,"Science"Direct,"ProQuest,"
                                                                ,"



                         JMLA"   2013.2.8
6S
           Systems:"



         Summaries:"



      Synopses"of"Syn`
      theses:"


       Syntheses:"



Synopses"of"Studies:"



        Studies:"



                         JMLA"   2013.2.8
6S
            Systems:"
                                      Data Mining, Practice based
                                               Evidence
          Summaries:"



       Synopses"of"Syn`
       theses:"


        Syntheses:"



 Synopses"of"Studies:"



         Studies:"



                          JMLA"   2013.2.8
UpToDate                                                  "
                                                    PDA
                                                              "
DynaMed
                                   PubMed



Cochrane"Library

                                                    1

                       "   PDF                  "
 ScineceDirect,"
ProQuest,"
                   "

                           JMLA"     2013.2.8
•  PubMed

• 
            PDF

     –  →

•                                    SFX



                  JMLA"   2013.2.8
Systems:"
                                   • 
         Summaries:"

                                   • 
      Synopses"of"Syn`
      theses:"


       Syntheses:"
                                            –  DynaMed
Synopses"of"Studies:"
                                            – 
                                                         PubMed
        Studies:"



                         JMLA"   2013.2.8
Body"of"Evidence" "
Body"of"Evidence
• 
                                           "
     –                                         "
     –                                 "
          •                       "
          •     "
          •           "
          • 



                    JMLA"   2013.2.8
Antman EM, et al. JAMA, 1992. 268: 240-8.
                       JMLA"     2013.2.8
Body"of"Evidence
• 
                                                     "
     –  Evidence"Gap"           "
• 

                                                 "
     –                          Body"of"Evidence     "
     –                                       "


                        JMLA"        2013.2.8"           51
"
         Corbyn"Z:"Nature"2012"Oct.4




•                               "
     –  PubMed   2012 5 3                      2,047 "
•                                   43.4   "
• 
         "

                       JMLA"   2013.2.8
6S
           Systems:"                               • 
                                                   • 


         Summaries:"                               • UpToDate,"DynaMed
                                            GL     • Evidence`based"Guideline


      Synopses"of"Syn`                             • Evidence`based"
      theses:"                   SR                • SR              DARE,"Minds


                                                   • Cochrane"Library
       Syntheses:"
                                            (SR)   •       PubMed


                                                   • Evidence`based"        ACP"Journal"
Synopses"of"Studies:"
                                                     Club,"Evidence`based"Medicine"



        Studies:"                                  • PubMed,"Science"Direct,"ProQuest,"
                                                                ,"



                         JMLA"   2013.2.8
•             "
•                   "

•                             "
     –                             "
•                         "
     –  S   Body"of"Evidence                 "


                  JMLA"           2013.2.8
•                    "
     – 
                                 "
     –  PubMed   Google                                  "
     –                               "
•                                                    "
     – 
                                            "
     – 

                         JMLA"           2013.2.8"           56"
• 
     –  Endnote
     –                               PubMed
• 
     – 
          • 
     –  100               1          1   PubMed



                  JMLA"   2013.2.8
•                         "
     –                             "
•                                  "
     –                        90               "
     –                5                                    "
•             "
     –            "
•                                                              "
     –                                                               "
     –                                                 "
•                 S            "
     –                                                                            "
•  Body"of"Evidence"
     –                                                                                "
•                                                          "
     –                                             "
     –                                                                        "

                                       JMLA"                       2013.2.8

More Related Content

Viewers also liked

指導教員に怒られない方法 メール編
指導教員に怒られない方法 メール編指導教員に怒られない方法 メール編
指導教員に怒られない方法 メール編Yosuke Uozumi
 
論文の考察の書き方
論文の考察の書き方論文の考察の書き方
論文の考察の書き方Yosuke Uozumi
 
第41回集中治療医学会 教育講演スライド ガイドライン作成過程
第41回集中治療医学会 教育講演スライド ガイドライン作成過程第41回集中治療医学会 教育講演スライド ガイドライン作成過程
第41回集中治療医学会 教育講演スライド ガイドライン作成過程敏雄 福岡
 
ジュニアのためのプレゼンテーション2014
ジュニアのためのプレゼンテーション2014ジュニアのためのプレゼンテーション2014
ジュニアのためのプレゼンテーション2014敏雄 福岡
 
Trauma conference 10th
Trauma conference 10thTrauma conference 10th
Trauma conference 10th敏雄 福岡
 
藤田学園 医学教育・看護教育とEBM
藤田学園 医学教育・看護教育とEBM藤田学園 医学教育・看護教育とEBM
藤田学園 医学教育・看護教育とEBM敏雄 福岡
 
日病図書委員会 シンポジウム 2016s
日病図書委員会 シンポジウム 2016s日病図書委員会 シンポジウム 2016s
日病図書委員会 シンポジウム 2016s敏雄 福岡
 
倉敷中央病院 救急の現状 2013年
倉敷中央病院 救急の現状 2013年倉敷中央病院 救急の現状 2013年
倉敷中央病院 救急の現状 2013年敏雄 福岡
 
抄録の書き方講座もどき
抄録の書き方講座もどき抄録の書き方講座もどき
抄録の書き方講座もどきTKS OND
 

Viewers also liked (11)

指導教員に怒られない方法 メール編
指導教員に怒られない方法 メール編指導教員に怒られない方法 メール編
指導教員に怒られない方法 メール編
 
08 臨床教育の方法論
08 臨床教育の方法論08 臨床教育の方法論
08 臨床教育の方法論
 
論文の考察の書き方
論文の考察の書き方論文の考察の書き方
論文の考察の書き方
 
第41回集中治療医学会 教育講演スライド ガイドライン作成過程
第41回集中治療医学会 教育講演スライド ガイドライン作成過程第41回集中治療医学会 教育講演スライド ガイドライン作成過程
第41回集中治療医学会 教育講演スライド ガイドライン作成過程
 
ジュニアのためのプレゼンテーション2014
ジュニアのためのプレゼンテーション2014ジュニアのためのプレゼンテーション2014
ジュニアのためのプレゼンテーション2014
 
Trauma conference 10th
Trauma conference 10thTrauma conference 10th
Trauma conference 10th
 
抄読会120904
抄読会120904抄読会120904
抄読会120904
 
藤田学園 医学教育・看護教育とEBM
藤田学園 医学教育・看護教育とEBM藤田学園 医学教育・看護教育とEBM
藤田学園 医学教育・看護教育とEBM
 
日病図書委員会 シンポジウム 2016s
日病図書委員会 シンポジウム 2016s日病図書委員会 シンポジウム 2016s
日病図書委員会 シンポジウム 2016s
 
倉敷中央病院 救急の現状 2013年
倉敷中央病院 救急の現状 2013年倉敷中央病院 救急の現状 2013年
倉敷中央病院 救急の現状 2013年
 
抄録の書き方講座もどき
抄録の書き方講座もどき抄録の書き方講座もどき
抄録の書き方講座もどき
 

More from 敏雄 福岡

倉敷中央病院 実績紹介 2015年DPC患者調査から
倉敷中央病院 実績紹介 2015年DPC患者調査から倉敷中央病院 実績紹介 2015年DPC患者調査から
倉敷中央病院 実績紹介 2015年DPC患者調査から敏雄 福岡
 
倉敷中央病院 救命救急センター 救急統計2013 2014
倉敷中央病院 救命救急センター 救急統計2013 2014倉敷中央病院 救命救急センター 救急統計2013 2014
倉敷中央病院 救命救急センター 救急統計2013 2014敏雄 福岡
 
抄読会 Mallampati 20130924 final2
抄読会 Mallampati 20130924 final2抄読会 Mallampati 20130924 final2
抄読会 Mallampati 20130924 final2敏雄 福岡
 
検査部 院内研修会2015 s
検査部 院内研修会2015 s検査部 院内研修会2015 s
検査部 院内研修会2015 s敏雄 福岡
 
EBM入門 書き直し4
EBM入門 書き直し4EBM入門 書き直し4
EBM入門 書き直し4敏雄 福岡
 
岡山大学 Gimシンポ
岡山大学 Gimシンポ岡山大学 Gimシンポ
岡山大学 Gimシンポ敏雄 福岡
 
地域医療シンポジウム救急研修2014
地域医療シンポジウム救急研修2014地域医療シンポジウム救急研修2014
地域医療シンポジウム救急研修2014敏雄 福岡
 
救急統計2014 一周年パーティ
救急統計2014 一周年パーティ救急統計2014 一周年パーティ
救急統計2014 一周年パーティ敏雄 福岡
 
CASP Systematic Review ミニレクチャー2014.2.24
CASP Systematic Review ミニレクチャー2014.2.24CASP Systematic Review ミニレクチャー2014.2.24
CASP Systematic Review ミニレクチャー2014.2.24敏雄 福岡
 
研修医人工呼吸セミナー2008
研修医人工呼吸セミナー2008研修医人工呼吸セミナー2008
研修医人工呼吸セミナー2008敏雄 福岡
 
Harvey circulatory system
Harvey circulatory systemHarvey circulatory system
Harvey circulatory system敏雄 福岡
 
Pharmacokinetics icu setting_2007_nagoya
Pharmacokinetics icu setting_2007_nagoyaPharmacokinetics icu setting_2007_nagoya
Pharmacokinetics icu setting_2007_nagoya敏雄 福岡
 
研究デザイン演習聖マリ2
研究デザイン演習聖マリ2研究デザイン演習聖マリ2
研究デザイン演習聖マリ2敏雄 福岡
 
Stress Ulcer Prophylaxis in ICU
Stress Ulcer Prophylaxis in ICUStress Ulcer Prophylaxis in ICU
Stress Ulcer Prophylaxis in ICU敏雄 福岡
 
倉敷中央病院 第1回レジデント同窓会
倉敷中央病院 第1回レジデント同窓会倉敷中央病院 第1回レジデント同窓会
倉敷中央病院 第1回レジデント同窓会敏雄 福岡
 
Symposium about Medical Education 2007.10.27
Symposium about Medical Education 2007.10.27Symposium about Medical Education 2007.10.27
Symposium about Medical Education 2007.10.27敏雄 福岡
 
partial ventilatory assist lecture aprc2001
partial ventilatory assist lecture aprc2001partial ventilatory assist lecture aprc2001
partial ventilatory assist lecture aprc2001敏雄 福岡
 
医療の標準化とその功罪
医療の標準化とその功罪医療の標準化とその功罪
医療の標準化とその功罪敏雄 福岡
 
ガイドラインと日常診療
ガイドラインと日常診療ガイドラインと日常診療
ガイドラインと日常診療敏雄 福岡
 

More from 敏雄 福岡 (19)

倉敷中央病院 実績紹介 2015年DPC患者調査から
倉敷中央病院 実績紹介 2015年DPC患者調査から倉敷中央病院 実績紹介 2015年DPC患者調査から
倉敷中央病院 実績紹介 2015年DPC患者調査から
 
倉敷中央病院 救命救急センター 救急統計2013 2014
倉敷中央病院 救命救急センター 救急統計2013 2014倉敷中央病院 救命救急センター 救急統計2013 2014
倉敷中央病院 救命救急センター 救急統計2013 2014
 
抄読会 Mallampati 20130924 final2
抄読会 Mallampati 20130924 final2抄読会 Mallampati 20130924 final2
抄読会 Mallampati 20130924 final2
 
検査部 院内研修会2015 s
検査部 院内研修会2015 s検査部 院内研修会2015 s
検査部 院内研修会2015 s
 
EBM入門 書き直し4
EBM入門 書き直し4EBM入門 書き直し4
EBM入門 書き直し4
 
岡山大学 Gimシンポ
岡山大学 Gimシンポ岡山大学 Gimシンポ
岡山大学 Gimシンポ
 
地域医療シンポジウム救急研修2014
地域医療シンポジウム救急研修2014地域医療シンポジウム救急研修2014
地域医療シンポジウム救急研修2014
 
救急統計2014 一周年パーティ
救急統計2014 一周年パーティ救急統計2014 一周年パーティ
救急統計2014 一周年パーティ
 
CASP Systematic Review ミニレクチャー2014.2.24
CASP Systematic Review ミニレクチャー2014.2.24CASP Systematic Review ミニレクチャー2014.2.24
CASP Systematic Review ミニレクチャー2014.2.24
 
研修医人工呼吸セミナー2008
研修医人工呼吸セミナー2008研修医人工呼吸セミナー2008
研修医人工呼吸セミナー2008
 
Harvey circulatory system
Harvey circulatory systemHarvey circulatory system
Harvey circulatory system
 
Pharmacokinetics icu setting_2007_nagoya
Pharmacokinetics icu setting_2007_nagoyaPharmacokinetics icu setting_2007_nagoya
Pharmacokinetics icu setting_2007_nagoya
 
研究デザイン演習聖マリ2
研究デザイン演習聖マリ2研究デザイン演習聖マリ2
研究デザイン演習聖マリ2
 
Stress Ulcer Prophylaxis in ICU
Stress Ulcer Prophylaxis in ICUStress Ulcer Prophylaxis in ICU
Stress Ulcer Prophylaxis in ICU
 
倉敷中央病院 第1回レジデント同窓会
倉敷中央病院 第1回レジデント同窓会倉敷中央病院 第1回レジデント同窓会
倉敷中央病院 第1回レジデント同窓会
 
Symposium about Medical Education 2007.10.27
Symposium about Medical Education 2007.10.27Symposium about Medical Education 2007.10.27
Symposium about Medical Education 2007.10.27
 
partial ventilatory assist lecture aprc2001
partial ventilatory assist lecture aprc2001partial ventilatory assist lecture aprc2001
partial ventilatory assist lecture aprc2001
 
医療の標準化とその功罪
医療の標準化とその功罪医療の標準化とその功罪
医療の標準化とその功罪
 
ガイドラインと日常診療
ガイドラインと日常診療ガイドラインと日常診療
ガイドラインと日常診療
 

Recently uploaded

Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...
Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...
Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...Angel
 
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...Sheetaleventcompany
 
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...GENUINE ESCORT AGENCY
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableJanvi Singh
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan 087776558899
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Sheetaleventcompany
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Sheetaleventcompany
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Sheetaleventcompany
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...Sheetaleventcompany
 
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsApp
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsAppMost Beautiful Call Girl in Chennai 7427069034 Contact on WhatsApp
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsAppjimmihoslasi
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...rajnisinghkjn
 
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...dishamehta3332
 
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...soniya pandit
 
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...Sheetaleventcompany
 
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Sheetaleventcompany
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...dishamehta3332
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Control of Local Blood Flow: acute and chronic
Control of Local Blood Flow: acute and chronicControl of Local Blood Flow: acute and chronic
Control of Local Blood Flow: acute and chronicMedicoseAcademics
 
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan CytotecJual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotecjualobat34
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryJyoti singh
 

Recently uploaded (20)

Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...
Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...
Bandra East [ best call girls in Mumbai Get 50% Off On VIP Escorts Service 90...
 
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...
Jaipur Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Jaipur No💰...
 
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 9630942363 Top Class Ahmedabad Escort Service A...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
Cara Menggugurkan Kandungan Dengan Cepat Selesai Dalam 24 Jam Secara Alami Bu...
 
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
Premium Call Girls Nagpur {9xx000xx09} ❤️VVIP POOJA Call Girls in Nagpur Maha...
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
 
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
❤️Chandigarh Escorts Service☎️9814379184☎️ Call Girl service in Chandigarh☎️ ...
 
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsApp
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsAppMost Beautiful Call Girl in Chennai 7427069034 Contact on WhatsApp
Most Beautiful Call Girl in Chennai 7427069034 Contact on WhatsApp
 
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
👉 Chennai Sexy Aunty’s WhatsApp Number 👉📞 7427069034 👉📞 Just📲 Call Ruhi Colle...
 
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...
Whitefield { Call Girl in Bangalore ₹7.5k Pick Up & Drop With Cash Payment 63...
 
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
🚺LEELA JOSHI WhatsApp Number +91-9930245274 ✔ Unsatisfied Bhabhi Call Girls T...
 
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
💚Chandigarh Call Girls Service 💯Piya 📲🔝8868886958🔝Call Girls In Chandigarh No...
 
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
Pune Call Girl Service 📞9xx000xx09📞Just Call Divya📲 Call Girl In Pune No💰Adva...
 
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
Race Course Road } Book Call Girls in Bangalore | Whatsapp No 6378878445 VIP ...
 
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Shahdol Just Call 8250077686 Top Class Call Girl Service Available
 
Control of Local Blood Flow: acute and chronic
Control of Local Blood Flow: acute and chronicControl of Local Blood Flow: acute and chronic
Control of Local Blood Flow: acute and chronic
 
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan CytotecJual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
Jual Obat Aborsi Di Dubai UAE Wa 0838-4800-7379 Obat Penggugur Kandungan Cytotec
 
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room DeliveryCall 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
Call 8250092165 Patna Call Girls ₹4.5k Cash Payment With Room Delivery
 

Jmla病院見学2013

  • 1. — " "
  • 2. •  " •  " •  " •  " •  S " •  Body"of"Evidence" •  " JMLA" 2013.2.8
  • 4. ! " ! QOL " ! JMLA" 2013.2.8" 4"
  • 5. •  "" •  " JMLA" 2013.2.8" 5"
  • 6. •  ! •  ! ! ! 60$100 ! ! JMLA" 2013.2.8" 6"
  • 7. •  •  –  –  –  •  –  •  •  –  –  JMLA" 2013.2.8 " 7
  • 8. DPC " 21 7 12 16000" 16000" 14000" 14000" 12000" 12000" 10000" 10000" 8000" 8000" 6000" 4000" 6000" 2000" 4000" 0" 2000" 0" JMLA" 2013.2.8 "
  • 9.
  • 10. 2001 H13 2004 16 1 25 41 12 2005 17 2 24 37 14 2006 18 3 27 43 16 2007 19 4 23 42 16 2008 20 5 27 39 18 2009 21 6 28 48 19 2010 22 7 24 48 24 2011 23 8 31 46 25 2012 24 9 30 48 19 JMLA" 2013.2.8" 10"
  • 11. JMLA" 2013.2.8" 11"
  • 12. •  " –  " –  " → " •  2006 " –  " –  " –  " –  " JMLA" 2013.2.8
  • 13. •  2007 " –  " –  " •  2007 " –  " –  " –  " –  " → " JMLA" 2013.2.8
  • 14. •  " –  " •  " –  " •  " –  " JMLA" 2013.2.8
  • 15. •  " •  " •  " •  " •  " JMLA" 2013.2.8
  • 16. " •  2006 MD"Consult,"ProQuest," ScienceDirect" •  2007 " •  2008 " –  UpToDate,"DynaMed," " –  PubMed," " •  2010 " –  SFX " •  2011 " –  " JMLA" 2013.2.8
  • 17. " •  " •  " •  " –  " –  " JMLA" 2013.2.8
  • 18. " •  " –  " •  " •  " –  " •  " –  Endnote " •  " •  " –  SPSS " JMLA" 2013.2.8
  • 19. " •  " –  " •  2012 " –  " –  " –  " JMLA" 2013.2.8
  • 21. •  " –  " •  " •  " •  " •  " –  " •  " •  JMLA" 2013.2.8
  • 22. "
  • 23. 23
  • 24. •  3 5 •  1 1 1 •  •  24 JMLA" 2013.2.8 24
  • 25. risk ratio RR •  relative risk •  •  10 8 0.8 0.5 25 JMLA" 2013.2.8 25
  • 26. •  3 5 •  1 1 1 •  •  26 JMLA" 2013.2.8 26
  • 27. •  •  27 JMLA" 2013.2.8 27
  • 28. •  •  3 50 28 JMLA" 2013.2.8 28
  • 29.
  • 30. Evidence … BMJ 1998; 317: 1246-1248 情報は多すぎる。だからこそ、見極め る目が必要になっている JMLA" 2013.2.8
  • 31. "  ×× ○○ "  □□ !! "  "  5000 50 !! "  JMLA" 2013.2.8
  • 34. •  " –  " –  " –  " JMLA" 2013.2.8
  • 35. •  " –  " –  " –  " •  Browne"MN:"In"“Asking"the"Right"Ques[ons:"A" guide"to"cri[cal"thinking”"9th"ed."2009 " JMLA" 2013.2.8
  • 36. •  " –  " –  " –  " •  " –  " –  " –  " –  " JMLA" 2013.2.8
  • 37. S
  • 38. 6S Systems Summaries Synopses"of" Syntheses Syntheses Synopses"of"Studies Studies DiCenso, A, Bayley, L , Haynes, RB: ACP Journal Club. Editorial: Accessing preappraised evidence: fine-tuning the 5S model into a 6S model. Ann Intern Med 2009; 151: JC3-2, JC3-3. JMLA" 2013.2.8
  • 39. 6S Systems:" Summaries:" Synopses"of" Syntheses:" Syntheses:" Synopses"of"Studies:" Studies:" JMLA" 2013.2.8
  • 40. 6S Systems:" •  •  Summaries:" • UpToDate,"DynaMed GL • Evidence`based"Guideline Synopses"of"Syn` • Evidence`based" theses:" SR • SR DARE,"Minds • Cochrane"Library Syntheses:" (SR) •  PubMed • Evidence`based" ACP"Journal" Synopses"of"Studies:" Club,"Evidence`based"Medicine" Studies:" • PubMed,"Science"Direct,"ProQuest," ," JMLA" 2013.2.8
  • 41. 6S Systems:" Summaries:" Synopses"of"Syn` theses:" Syntheses:" Synopses"of"Studies:" Studies:" JMLA" 2013.2.8
  • 42. 6S Systems:" Data Mining, Practice based Evidence Summaries:" Synopses"of"Syn` theses:" Syntheses:" Synopses"of"Studies:" Studies:" JMLA" 2013.2.8
  • 43. UpToDate " PDA " DynaMed PubMed Cochrane"Library 1 " PDF " ScineceDirect," ProQuest," " JMLA" 2013.2.8
  • 44. •  PubMed •  PDF –  → •  SFX JMLA" 2013.2.8
  • 45.
  • 46. Systems:" •  Summaries:" •  Synopses"of"Syn` theses:" Syntheses:" –  DynaMed Synopses"of"Studies:" –  PubMed Studies:" JMLA" 2013.2.8
  • 48. Body"of"Evidence •  " –  " –  " •  " •  " •  " •  JMLA" 2013.2.8
  • 49.
  • 50. Antman EM, et al. JAMA, 1992. 268: 240-8. JMLA" 2013.2.8
  • 51. Body"of"Evidence •  " –  Evidence"Gap" " •  " –  Body"of"Evidence " –  " JMLA" 2013.2.8" 51
  • 52. " Corbyn"Z:"Nature"2012"Oct.4 •  " –  PubMed 2012 5 3 2,047 " •  43.4 " •  " JMLA" 2013.2.8
  • 53. 6S Systems:" •  •  Summaries:" • UpToDate,"DynaMed GL • Evidence`based"Guideline Synopses"of"Syn` • Evidence`based" theses:" SR • SR DARE,"Minds • Cochrane"Library Syntheses:" (SR) •  PubMed • Evidence`based" ACP"Journal" Synopses"of"Studies:" Club,"Evidence`based"Medicine" Studies:" • PubMed,"Science"Direct,"ProQuest," ," JMLA" 2013.2.8
  • 54.
  • 55. •  " •  " •  " –  " •  " –  S Body"of"Evidence " JMLA" 2013.2.8
  • 56. •  " –  " –  PubMed Google " –  " •  " –  " –  JMLA" 2013.2.8" 56"
  • 57. •  –  Endnote –  PubMed •  –  •  –  100 1 1 PubMed JMLA" 2013.2.8
  • 58. •  " –  " •  " –  90 " –  5 " •  " –  " •  " –  " –  " •  S " –  " •  Body"of"Evidence" –  " •  " –  " –  " JMLA" 2013.2.8