Methidology and Applicaton of Eatimation of Quality Indicator Using Hierarchical Bayesian Models
| Project/Area Number |
17H04146
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Medical and hospital managemen
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| Research Institution | National Center of Neurology and Psychiatry |
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Principal Investigator |
Tachimori Histeru 国立研究開発法人国立精神・神経医療研究センター, トランスレーショナル・メディカルセンター, 室長 (60342929)
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| Co-Investigator(Kenkyū-buntansha) |
伊庭 幸人 統計数理研究所, モデリング研究系, 教授 (30213200)
宮田 裕章 慶應義塾大学, 医学部(信濃町), 教授 (70409704)
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Project Status |
Completed (Fiscal Year 2019)
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| Budget Amount *help |
¥11,960,000 (Direct Cost: ¥9,200,000、Indirect Cost: ¥2,760,000)
Fiscal Year 2019: ¥3,250,000 (Direct Cost: ¥2,500,000、Indirect Cost: ¥750,000)
Fiscal Year 2018: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2017: ¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
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| Keywords | 医療の質 / 階層ベイズモデリング / 小児外科 / 循環器外科 / 消化器外科 / 小児先天性心疾患 / ビッグデータ解析 |
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| Outline of Final Research Achievements |
The aim of this study was to establish and validate risk models of mortality and morbidity associated with 12 major pediatric surgical procedures using the National Clinical Database-Pediatric (NCD-P) data. Overall, 10 and 21 variables were identified for mortality and morbidity, respectively. C-indices of mortality were 0.940 and 0.924 in the development and validation datasets, respectively. C-indices of morbidity were 0.832 and 0.830 in the development and validation datasets, respectively. Based on the NCD-P data, we developed satisfactory risk models for mortality and morbidity prediction in major pediatric surgeries. Based on the results of this study, we have determined the specifications of a risk calculator for the 12 most difficult pediatric surgery procedures in Japan.Based on this specification, we are developing a web-based system to visualize the risk of death and complications by inputting case information into the system.
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| Academic Significance and Societal Importance of the Research Achievements |
施設や地域に，医療の質指標の数値を，全国的な数値とともに報告することで，施設や地域ごとに自らの治療方針を見直し，方針を議論する機会などを提供することを通して医療の質の向上が期待されている。手術リスクを調整した術後の死亡率・罹患率の推定モデルを構築すれば，医療の質を示す指標のひとつとなりうる。本研究では小児外科の12の高難度術式について死亡と主要な合併症のリスクモデルを構築した。それに基づいて，症例の情報を入力することで，死亡と合併症の発生リスクを可視化することが可能となる上のリスクカリキュレータシステムをウェブ上に構築する仕様を決定し実装を進め，小児外科領域の医療の質を高めることに寄与した。
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Report
(4 results)
Research Products
(5 results)
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[Journal Article] Development and validation of risk models for mortality and morbidity in 12 major pediatric surgical procedures: A study from the National Clinical Database-Pediatric of Japan2020
Author(s)
Terui, K., Hirahara, N., Tachimori, H., Kato, N., Fujishiro, J., Watanabe, E., Tomita, H., Okamoto, T., Fujiogi, M., Okamoto, S., Yonekura, T., Miyata, H., & Usui, N.
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Journal Title
Journal of Pediatric Surgery
Volume: T.B.A.
DOI
Related Report
Peer Reviewed
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[Journal Article] 日本小児外科学会NCD連絡委員会National Clinical Database(小児外科領域)Annual Report 2013-20142018
Author(s)
23.臼井規朗, 岡本晋弥, 上原秀一郎, 小笠原有紀, 古賀寛之, 佐々木隆士, 寺脇幹, 照井慶太, 藤代準, 藤野明浩, 文野誠久, 古村眞, 平原憲道, 岡本竜弥, 富田紘史, 藤雄木亨真, 渡辺栄一郎, 米倉竹夫, 家入里志, 伊勢一哉, 佐々木英之, 下野隆一, 高安肇, 尾藤祐子, 宮田裕章, 江角元史郎
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Journal Title
J. Jpn. Soc. Pediatr. Surg.
Volume: 51
Issue: 2
Pages: 314-335
DOI
NAID
ISSN
0288-609X, 2187-4247
Related Report
Open Access
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[Journal Article] Evaluating the quality of data from the Japanese National Clinical Database 2011 via a comparison with regional government report data and medical charts2018
Author(s)
17.Tomotaki, A., Kumamaru, H., Hashimoto, H., Takahashi, A., Ono, M., Iwanaka, T., Miyata, H.
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Journal Title
Surgery Today
Volume: 49
Pages: 65-71
DOI
Related Report
Peer Reviewed / Open Access
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[Presentation] 小児外科手術の医療品質評価 リスクモデル作成の進捗報告2018
Author(s)
照井慶太, 平原憲道, 立森久照, 加藤直広, 藤代準, 渡辺栄一郎, 富田紘史, 岡本竜弥, 藤雄木亨真, 古村眞, 米倉竹夫, 岡本晋弥, 臼井規朗, NCD連絡委員会
Organizer
第 55 回日本小児外科学会学術集会
Related Report
