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Development of an objective method to know when to start advance care planning and verification of its effectiveness

Research Project

Project/Area Number 19H03866
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Review Section Basic Section 58010:Medical management and medical sociology-related
Research InstitutionUniversity of Tsukuba

Principal Investigator

Hamano Jun  筑波大学, 医学医療系, 講師 (10709190)

Co-Investigator(Kenkyū-buntansha) 香川 璃奈  筑波大学, 医学医療系, 講師 (10824675)
讃岐 勝  筑波大学, 医学医療系, 助教 (40524880)
山口 拓洋  東北大学, 医学系研究科, 教授 (50313101)
森田 達也  一般社団法人コミュニティヘルス研究機構, 精神腫瘍学研究部, 研究部長 (70513000)
竹内 文乃  慶應義塾大学, 医学部(信濃町), 講師 (80511196)
宮下 光令  東北大学, 医学系研究科, 教授 (90301142)
Project Period (FY) 2019-04-01 – 2023-03-31
Project Status Completed (Fiscal Year 2022)
Budget Amount *help
¥15,210,000 (Direct Cost: ¥11,700,000、Indirect Cost: ¥3,510,000)
Fiscal Year 2021: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000)
Fiscal Year 2020: ¥5,200,000 (Direct Cost: ¥4,000,000、Indirect Cost: ¥1,200,000)
Fiscal Year 2019: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Keywords予後予測 / アドバンス・ケア・プランニング / 緩和ケア
Outline of Research at the Start

本研究は、血液検査データだけで特定の進行がん患者の予後を予測する方法を開発し、予測結果を自動的に電子カルテに表示することでアドバンス・ケア・プランニング(自らが望む人生の最終段階の医療・ケアについて医師や家族と話し合うこと)の実践が増えるか?ということを検証する。本研究によって、進行がん患者とアドバンス・ケア・プランニングを開始する適切なタイミングが判断できる方法が確立すると同時に、心不全患者における予後予測指標の開発に取り組むことで、将来的にあらゆる疾患でタイミング良くアドバンス・ケア・プランニングが実践できる方法の確立に展開できる研究である。

Outline of Final Research Achievements

The prediction model developed in this research project in FY2020 was tested for accuracy using other databases, and the external validity of the prediction model was confirmed. In addition, we searched for ways in which the developed prognostic model could be communicated to physicians and patients, targeting cancer patients and their bereaved families, and found that approximately 60% of patients would like to know their prognosis on the Internet. The study also revealed that there are concerns regarding the accuracy of prognostic models and the protection of personal information. The study also revealed that a certain number of patients and their families want to know not only the prognosis of life but also the prognosis of function.

Academic Significance and Societal Importance of the Research Achievements

血液検査データのみを用いて、進行がん患者の生命予後を高い精度で予測する指標を開発できることが分かった。また、約60%のがん患者が、インターネット上で予後予測を知りたいという希望がある一方で、予測モデルの精度や個人情報保護に関する懸念があることも明らかになった。そして、生命予後だけでなく機能予後を知りたいと考えている患者、家族が一定数いることが明らかになった。本研究成果から、がん患者の生命予後を客観的なデータから予測することは可能であるが、予測モデルの精度や個人情報保護については、今後の検討が必要であることが示唆された。また、生命予後だけでなく機能予後予測モデル開発の必要性も明らかになった。

Report

(3 results)
  • 2022 Final Research Report ( PDF )
  • 2020 Annual Research Report
  • 2019 Annual Research Report
  • Research Products

    (11 results)

All 2020 2019

All Journal Article (6 results) (of which Int'l Joint Research: 2 results,  Peer Reviewed: 6 results,  Open Access: 3 results) Presentation (4 results) (of which Int'l Joint Research: 1 results) Book (1 results)

  • [Journal Article] Comparison of the prevalence and associated factors of hyperactive delirium in advanced cancer patients between inpatient palliative care and palliative home care2020

    • Author(s)
      Hamano Jun、Mori Masanori、Ozawa Taketoshi、Sasaki Jun、Kawahara Masanori、Nakamura Asumi、Hashimoto Kotaro、Hisajima Kazuhiro、Koga Tomoyuki、Goto Keiji、Fukumoto Kazuhiko、Morimoto Yuri、Goshima Masahiro、Sekimoto Go、Baba Mika、Oya Kiyofumi、Matsunuma Ryo、Azuma Yukari、Imai Kengo、Morita Tatsuya、Shinjo Takuya
    • Journal Title

      Cancer Medicine

      Volume: 10 Issue: 3 Pages: 1166-1179

    • DOI

      10.1002/cam4.3661

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] HOme-based Longitudinal Investigation of the multidiSciplinary Team Integrated Care (HOLISTIC): protocol of a prospective nationwide cohort study2020

    • Author(s)
      Liao Jung-Yu、Chen Ping-Jen、Wu Yu-Lin、Cheng Ching-Hsia、Yu Sang-Ju、Huang Chi-Hsien、Li Chia-Ming、Wang Ying-Wei、Zhang Kai-Ping、Liu I-Te、Umegaki Hiroyuki、Hamano Jun、Mori Masanori、Petersen Irene、Sampson Elizabeth L.、Hsiung Chao A.
    • Journal Title

      BMC Geriatrics

      Volume: 20 Issue: 1

    • DOI

      10.1186/s12877-020-01920-1

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Variations in vital signs at the end of life in non-cancer patients: a retrospective study2020

    • Author(s)
      Hosoi Takahiro、Ozone Sachiko、Hamano Jun
    • Journal Title

      Annals of Palliative Medicine

      Volume: 9 Issue: 5 Pages: 2678-2683

    • DOI

      10.21037/apm-20-1054

    • NAID

      120007146565

    • Related Report
      2020 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Current Engagement in Advance Care Planning in Japan and Its Associated Factors2019

    • Author(s)
      Inoue Megumi、Hanari Kyoko、Hamano Jun、Gallagher Joshua、Tamiya Nanako
    • Journal Title

      Gerontology and Geriatric Medicine

      Volume: 5 Pages: 1-7

    • DOI

      10.1177/2333721419892694

    • NAID

      120007132765

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Int'l Joint Research
  • [Journal Article] Associated factors for discussing advance directives with family physicians by noncancer outpatients in Japan2019

    • Author(s)
      Hamada Shuhei、Haruta Junji、Hamano Jun、Maeno Takami、Maeno Tetsuhiro
    • Journal Title

      Journal of General and Family Medicine

      Volume: 20 Issue: 3 Pages: 82-92

    • DOI

      10.1002/jgf2.238

    • NAID

      120007133652

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed / Open Access
  • [Journal Article] Prevalence and Characteristics of Patients Being at Risk of Deteriorating and Dying in Primary Care2019

    • Author(s)
      Hamano Jun、Oishi Ai、Kizawa Yoshiyuki
    • Journal Title

      Journal of Pain and Symptom Management

      Volume: 57 Issue: 2 Pages: 266-272.e1

    • DOI

      10.1016/j.jpainsymman.2018.11.006

    • Related Report
      2019 Annual Research Report
    • Peer Reviewed
  • [Presentation] 経口摂取不良になった非がん患者の生存期間に関連する因子の探索:後方視的観察研究2020

    • Author(s)
      細井崇弘、小曽根早知子、後藤亮平、濵野淳
    • Organizer
      第11回日本プライマリ・ケア連合学会学術大会
    • Related Report
      2020 Annual Research Report
  • [Presentation] Latest topics and future direction of palliative medicine in Japan2019

    • Author(s)
      浜野 淳
    • Organizer
      第24回 日本緩和医療学会 学術大会
    • Related Report
      2019 Annual Research Report
  • [Presentation] 多職種におけるEnd of life discussionの実態と関連する要因2019

    • Author(s)
      浜野 淳
    • Organizer
      第24回 日本緩和医療学会 学術大会
    • Related Report
      2019 Annual Research Report
  • [Presentation] Supportive and Palliative Care Indicators Tool (SPICT) to identify patients for palliative care; Perspectives of Japanese family physicians2019

    • Author(s)
      Ai Oishi, Jun Hamano
    • Organizer
      WONCA APR Conference 2019
    • Related Report
      2019 Annual Research Report
    • Int'l Joint Research
  • [Book] 人生の最終段階における薬の使い方&緩和ケア2020

    • Author(s)
      濵野淳
    • Total Pages
      7
    • Publisher
      じほう
    • Related Report
      2020 Annual Research Report

URL: 

Published: 2019-04-18   Modified: 2024-01-30  

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