| Project/Area Number |
10045075
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| Research Category |
Grant-in-Aid for Scientific Research (C).
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Public health/Health science
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| Research Institution | Teikyo University |
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Principal Investigator |
YAMAOKA Kazue Teikyo University, School of Jurisprudence, Associate Professor, 法学部, 助教授 (50091038)
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| Co-Investigator(Kenkyū-buntansha) |
YANO Eiji Teikyou University, School of Medicine, Professor, 医学部, 教授 (50114690)
MICHEL Barry ハーバード大学, 公衆衛生学部, 助教授
DAVID Bates ハーバード大学, 公衆衛生学部, 助教授
DAVID Christ ハーバード大学, 公衆衛生学部, 教授
JOSEPH Brain ハーバード大学, 公衆衛生学部, 教授
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| Project Period (FY) |
1998 – 1999
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| Project Status |
Completed (Fiscal Year 1999)
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| Budget Amount *help |
¥2,400,000 (Direct Cost: ¥2,400,000)
Fiscal Year 1999: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1998: ¥1,600,000 (Direct Cost: ¥1,600,000)
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| Keywords | Evidence Based Medicine / evaluation / workplace health examination / liver function tests / urine glucose / sensitivity / high risk strategy / population strategy / 職域健診 |
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| Research Abstract |
The theme "Evaluation in Preventive Medicine" can be paraphrased as "Evidence Based Medicine in Prevention." Having made remarkable achievements against tuberculosis, prevention in Japan seems to have shifted too much to secondary prevention. However, in the present study, Khaw contrasted two preventive strategies: high risk approach and population approach and pointed out several limitations of the former. She concluded that reducing levels of risk in the whole population by lifestyle or environmental changes would have substantially greater potential benefit. In addition, Christiani reported that the US Task Force for Preventive Services evaluated many examination items for periodic health checkups and made weighted recommendations. When the results are simply applied to the mandatory examination items in the workplace in Japan, most of the items do not have sufficient evidence. In fact, when Yano evaluated the screening program in Japan, he found very poor sensitivity of the mandato
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ry liver function tests and common practice of inappropriate way of urine glucose examination. Bates discussed using computers to provide decision support in medicine, with a special focus on moving towards the practice of evidence-based medicine. He suggested that for quality measurement to be practical, it has to be integrated with provision of routine care, suggesting that information systems should be used whenever possible to gather important data as care is provided. While huge volume of information in preventive medicine has been produced in Japan, their utilization has not been very much discussed, To achieve further utilization of the results of current periodic health examinations Yamaoka demonstrated her trial based on two procedures: (1) A population strategy to detect health related characteristics in a small group and (2) Evaluation using Individual Difference Quotient. Brain made a concluding remark by emphasizing the importance of public health mind in medicine to achieve Evidence Based Medicine. Less
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