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Research to find out how many undiagnosed esophageal achalasia patients exist in community population

Research Project

Project/Area Number 15K15486
Research Category

Grant-in-Aid for Challenging Exploratory Research

Allocation TypeMulti-year Fund
Research Field Digestive surgery
Research InstitutionTohoku University

Principal Investigator

Ishii Tadashi  東北大学, 大学病院, 教授 (00650657)

Co-Investigator(Kenkyū-buntansha) 亀井 尚  東北大学, 医学系研究科, 教授 (10436115)
中野 徹  東北大学, 医学系研究科, 大学院非常勤講師 (50451571)
藤森 研司  東北大学, 医学系研究科, 教授 (80264539)
大内 憲明  東北大学, 医学系研究科, 客員教授 (90203710)
Research Collaborator Abe Michiaki  
Akaishi Tetsuya  
Shoji Mutsumi  
Koseki Ken  
Takayama Shin  
Ohara Masato  
Nakayama Masaharu  
Project Period (FY) 2015-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥3,380,000 (Direct Cost: ¥2,600,000、Indirect Cost: ¥780,000)
Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2015: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Keywordsレセプトデータ / 食道運動障害 / EGJ outflow obstruction / 食道アカラシア / 地域潜在 / 診断アルゴリズム / 疾患抽出 / 食道運動機能障害 / レセプトデータベース / 抽出 / 地域 / 潜在 / データベース
Outline of Final Research Achievements

Among the information of 789381outpatient's national medical insurance data, we extracted 26736 patients between 10 and 60 years old, who were given suspected diagnosis that can’t be denied esophagus achalasia. Next, we extracted 543 patients with upper gastrointestinal endoscopy already performed and who never been performed barium swallow test.
Then, we conducted a medical chart survey on these patients, and picked up 39 patients among the 543 patients without improved symptoms and definitive diagnosis other than esophageal motility disorders. Finally, we performed barium swallow test on 16 patients who agreed to perform the test, and found one patient with esophagogastric junction (EGJ) outflow obstruction classified as disorders with EGJ outflow obstruction including esophagus achalasia, who had never been diagnosed with the disease before.

Academic Significance and Societal Importance of the Research Achievements

本研究結果から、第一に、食道障害症状を呈する患者に対しては食道透視検査を見落とすことなく実施することが食道運動障害を見落とさない観点から大変重要である、とのより適正な診断ストラテジーを提示することができたこと、第二に、このような見落とされがちな地域に潜在しうる希少疾患患者を掘り起こす新たな手法として、大きな母集団からレセプトデータや電子カルテデータを用いて機械的に当該患者を絞り込む手法を示すことができ、さらに言えばこのようなレセプトデータや電子カルテデータを活用した未来の検診方法の一つのモデルとして提案することができた、という点で大きな研究成果が上がったと考える。

Report

(5 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • 2015 Research-status Report
  • Research Products

    (2 results)

All 2019 2018

All Journal Article (1 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 1 results,  Open Access: 1 results) Presentation (1 results) (of which Int'l Joint Research: 1 results)

  • [Journal Article] Importance of Barium Swallow Test and Chest CT Scan for Correct Diagnosis of Achalasia in the Primary Care Setting2019

    • Author(s)
      Tadashi Ishii, Tetsuya Akaishi, Michiaki Abe, Shin Takayama, Ken Koseki, Takashi Kamei, Toru Nakano
    • Journal Title

      The Tohoku Journal of Experimental Medicine

      Volume: 247 Issue: 1 Pages: 41-49

    • DOI

      10.1620/tjem.247.41

    • NAID

      130007581036

    • ISSN
      0040-8727, 1349-3329
    • Related Report
      2018 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Presentation] Significance of chest CT scans and barium swallow tests in avoiding a delayed diagnosis of achalasia2018

    • Author(s)
      Tadashi Ishii, Tetsuya Akaishi, Michiaki Abe, Shin Takayama, Ken Koseki, Takashi Kamei, Toru Nakano
    • Organizer
      7th World Congress of Clinical Safety
    • Related Report
      2018 Annual Research Report
    • Int'l Joint Research

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Published: 2015-04-16   Modified: 2020-03-30  

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