| Project/Area Number |
14570851
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Section | 一般 |
|---|
| Research Field |
Radiation science
|
|---|
| Research Institution | Shiga University of Medical Science |
|---|
Principal Investigator |
TAKAHASHI Masashi Shiga University of Medical Science, Associate Professor, 医学部, 助教授 (20179526)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
MURATA Kiyoshi Shiga University of Medical Science, Professor, 医学部, 教授 (20127038)
NITTA Norihisa Shiga University of Medical Science, Staff, 医学部, 助手 (40324587)
TAKAZAKUAR Ryutaro Shiga University of Medical Science, Staff, 医学部, 助手 (70335181)
|
|---|
| Project Period (FY) |
2002 – 2004
|
| Project Status |
Completed (Fiscal Year 2004)
|
| Budget Amount *help |
¥2,400,000 (Direct Cost: ¥2,400,000)
Fiscal Year 2004: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 2003: ¥500,000 (Direct Cost: ¥500,000)
Fiscal Year 2002: ¥1,300,000 (Direct Cost: ¥1,300,000)
|
|---|
| Keywords | EBM / lung cancer / metastasis / community acquired pneumonia / imaging / CT / MRI / ガイドライン |
|---|
| Research Abstract |
The basic information was collected to establish the imaging guideline using EBM procedure. The following two research questions were set and the related articles were collected and reviewed.
1)How is the imaging procedures used for searching extrapulmonary metastasis?
2)How is the imaging procedure used for the management of community acquired pneumonia(CAP)?
1)The guidelines published from ASCO and ATS/ERS were mainly used and related articles were reviewed. The organs which were discussed were brain, bone, adrenal and liver. The cost-benefit analysis was also discussed. How is the imaging diagnosis used in searching for extrathoracic metastases are mainly divided into the following two ways in English literatures ;
A)The indication should be considered when the clinical symptoms are suspicious of having metastasis. T and N factor also influences the incidence of extrathoracic metastases, as well as, the indication of imaging examination. (ASCO,ATS/ESR)
B)The imaging search for extrathora
… More
cic metastases should be performed regardless whether the symptoms are existed or not. (The Canadian Lung Oncology Group) It should be careful when considering the cost-effective analysis that state of medical insurance system or medical economy is markedly variable among the countries and the indication of the imaging evaluation for the metastasis in lung cancer is also different. Although the diagnostic accuracy and its contribution to the survival rate should be considered, it is needed to establish the guideline with considering the variable social factors including medical insurance system or medical economy of Japan.
2)To address the clinical question "Is CT needed for the management of community acquired pneumonia(CAP)?", a retrospective article survey was conducted with evidence based medicine (EBM) approach. The citations which described the imaging procedure for the patients suspected having CAP were retrieved by "PubMed(1966-2004)" and "Ichushi Web(1983-2004) and then transferred to bibliography software. The abstracts of articles were browsed and the articles in which the diagnostic procedures or its implications for CAP were mainly discussed were selected. The detailed information and evidence level of each manuscript was evaluated with filling "Abstract form". Previously published guidelines through the world regarding the management for CAP were also analyzed. A total of 186 articles were analyzed from the perspective of the imaging for CAP and, as a result, a total of 34 articles in which acceptable descriptions regarding the imaging diagnosis for the CAP were found. There has been no systematic study conducted concerning the CT indication for the CAP and no articles were rated above 2b in the evidence level. These articles have revealed that although CT provides more detailed information than chest radiography, its clinical significance is uncertain. The highly rated evidence justifying the use of CT for the patient with CAP could not be found. Strict guideline for the use of CT in CAP is needed from the aspects of medical cost and radiation exposure. Less
|
