Innovative EBM method by benchmarking; using analysis of clinical database

• Project/Area Number: 26460856
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Medical and hospital managemen
• Research Institution: The University of Tokyo
• Principal Investigator: Miyata Hiroaki 東京大学, 医学部附属病院, 特任教授 (70409704)
• Research Collaborator: FUKUCHI Eriko 東京大学, 医学部付属病院, 特任研究員 (30775648) ; IWANAKA Tadashi National Clinical Database, 代表理事 (90193755) ; TAKAMOTO Shinichi 三井記念病院, 病院長 (60137833) ; UEDA Yuichi 奈良県総合医療センター, 総長 (80314011) ; TANEMOTO Kazuo 川崎医科大学, 心臓血管外科学教室, 教授 (90330547) ; KOHSAKA Shun 慶應義塾大学, 循環器内科, 特任講師 (30528659)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2016: ¥390,000 (Direct Cost: ¥300,000、Indirect Cost: ¥90,000); Fiscal Year 2015: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2014: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
• Keywords: 臨床データベース / EBM / 医療の質 / ベンチマーキング / ビッグデータ / 医療政策

Outline of Final Research Achievements

The aim of this research is to create an innovative benchmarking method to improve quality of medicine. First year, we analyzed the effectiveness and proceeding frequencies of several clinical procedures which recommendation criteria are on discussion by questionnaire and statistical analysis. We have also visited some facilities which operative performance were either extremely good or bad according to benchmarking. Taking the result of first year, we built a new web system to enable each medical facility set their own task to improve their performance using benchmarked result. Several hospitals have used the system with assistance of clinical experts in the final year.

Research Products

• [Journal Article] Off-pump versus on-pump coronary artery bypass grafting in patients with left ventricular dysfunction (2016)
  • Author(s): Ueki C, Miyata H, Motomura N, Sakaguchi G, Akimoto T, Takamoto S.
  • Journal Title: J Thorac Cardiovasc Surg Volume: 151 Issue: 4 Pages: 1092-8
  • DOI: 10.1016/j.jtcvs.2015.11.023
  • Peer Reviewed
• [Journal Article] National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency (2016)
  • Author(s): Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, Sugihara K, Mori M, Satomi S, Kokudo N, Iwanaka T.
  • Journal Title: Surg Today Volume: 46 Pages: 38-47
  • Peer Reviewed / Open Access
• [Journal Article] Models predicting the risks of six life-threatening morbidities and bile leakage in 14,970 hepatectomy patients registered in the National Clinical Database of Japan. (2016)
  • Author(s): Yokoo H, Miyata H, Konno H, Taketomi A, Kakisaka T, Hirahara N, Wakabayashi G, Gotoh M, Mori M.
  • Journal Title: Medicine (Baltimore) Volume: 95
  • Peer Reviewed / Open Access
• [Journal Article] Risk model of aortic valve replacement after cardiovascular surgery based on a National Japanese Database. (2016)
  • Author(s): Ohira S, Miyata H, Doi K, Motomura N, Takamoto S, Yaku H.
  • Journal Title: Eur J Cardiothorac Surg Volume: 51 Pages: 347-353
  • DOI: 10.1093/ejcts/ezw247
  • Peer Reviewed
• [Journal Article] National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency (2015)
  • Author(s): Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, Sugihara K, Mori M, Satomi S, Kokudo N, Iwanaka T
  • Journal Title: Surg Today Volume: 46 Pages: 38-47
  • Peer Reviewed
• [Journal Article] Effects of Preoperative β-Blocker Use on Clinical Outcomes after Coronary Artery Bypass Grafting.A Report from the Japanese Cardiovascular Surgery Database (2015)
  • Author(s): Kohsaka S, Miyata H, Motomura N, Imanaka K, Fukuda K, Kyo S, Takamoto S
  • Journal Title: Anesthesiology Volume: 124 Issue: 1 Pages: 45-55
  • DOI: 10.1097/aln.0000000000000901
  • Peer Reviewed
• [Journal Article] Operative mortality and complication risk model for all major cardiovascular operations in Japan (2015)
  • Author(s): Miyata H, Tomotaki A, Motomura N, Takamoto S
  • Journal Title: AnnThorac Surg Volume: 99 Pages: 130-9
  • Peer Reviewed
• [Journal Article] Gender Differences in In-Hospital Clinical Outcomes after Percutaneous Coronary Interventions: An Insight from a Japanese Multicenter Registry (2015)
  • Author(s): Numasawa Y, Kohsaka S, Miyata H, Noma S, Suzuki M, Ishikawa S, Nakamura I, Nishi Y, Ohki T, Negishi K, Takahashi T, Fukuda K
  • Journal Title: PLoS One Volume: 10 Pages: 1-1
  • Peer Reviewed
• [Journal Article] Operative Mortality and Complication Risk model for all major cardiovascular surgery in Japan. (2014)
  • Author(s): Hiroaki Miyata, Ai Tomotaki, Noboru Motomura, Shinichi Takamoto.
  • Journal Title: The Annals of Thoracic Surgery Volume: 07 Pages: 038-038
  • Peer Reviewed / Open Access
• [Journal Article] The national clinical database as an initiative for quality improvement in Japan. (2014)
  • Author(s): Murakami A, Hirata Y, Motomura N, Miyata H, Iwanaka T, Takamoto S.
  • Journal Title: Korean J Thorac Cardiovasc Surg. Volume: 47(5) Pages: 437-443
  • Peer Reviewed
• [Journal Article] Nomogram prediction of metachronous colorectal neoplasms in patients with colorectal cancer. (2014)
  • Author(s): Kawai K, Ishihara S, Yamaguchi H, Sunami E, Kitayama J, Miyata H, Watanabe T
  • Journal Title: Annals of Surgery Volume: Epub ahead of print Pages: 1-1
  • Peer Reviewed
• [Journal Article] The Appropriateness Ratings of Percutaneous Coronary Intervention in Japan and its Association with the Trend of Non-Invasive Testings. (2014)
  • Author(s): Inohara T, Kohsaka S, Miyata H, Ueda I, Ishikawa S, Ohki T, Nishi Y, Hayashida K, Maekawa Y, Kawamura A, Higashi T, Fukuda K
  • Journal Title: Journal of the American College of Cardiology. Volume: 7(9) Pages: 1000-9
  • Peer Reviewed
• [Journal Article] Mortality after common rectal surgery in Japan: a study on low anterior resection from a newly established nationwide large-scale clinical database. (2014)
  • Author(s): Matsubara N, Miyata H, Gotoh M, Tomita N, Baba H, Kimura W, Nakagoe T, Simada M, Kitagawa Y, Sugihara K, Mori M
  • Journal Title: Dis Colon Rectum Volume: 57(9) Pages: 1075-81
  • Peer Reviewed
• [Journal Article] Prognostic Impact of Primary Tumor Resection and Lymph Node Dissection in Stage IV Colorectal Cancer with Unresectable Metastasis: A Propensity Score Analysis in a Multicenter Retrospective Study (2014)
  • Author(s): Ishihara S, Hayama T, Yamada H, Nozawa K, Matsuda K, Miyata H, Yoneyama S, Tanaka T, Tanaka J, Kiyomatsu T, Kawai K, Nozawa H, Kanazawa T, Kazama S, Yamaguchi H, Sunami E, Kitayama J, Hashiguchi Y, Sugihara K, Watanabe T
  • Journal Title: Ann Surg Oncol Volume: 21(9) Pages: 2949-55
  • Peer Reviewed
• [Journal Article] Surgical results of reoperative tricuspid surgery: analysis from the Japan Cardiovascular Surgery Database. (2014)
  • Author(s): Umehara N, Miyata H, Motomura N, Saito S, Yamazaki K
  • Journal Title: Interact Cardiovasc Thorac Surg Volume: 19(1) Pages: 82-7
  • Peer Reviewed
• [Journal Article] Radial coronary interventions and post-procedural complication rates in the real world: a report from a Japanese multicenter percutaneous coronary intervention registry. (2014)
  • Author(s): Mizuno A, Kohsaka S, Miyata H, Koide K, Asano T, Ohki T, Negishi K, Fukuda K, Nishi Y
  • Journal Title: Int J Cardiol Volume: 172(1). Pages: 226-7
  • Peer Reviewed / Open Access
• [Journal Article] A Risk Model for Esophagectomy Using Data of 5354 Patients Included in a Japanese Nationwide Web-Based Database. (2014)
  • Author(s): Takeuchi H, Miyata H, Gotoh M, Kitagawa Y, Baba H, Kimura W, Tomita N, Nakagoe T, Shimada M, Sugihara K, Mori M
  • Journal Title: Ann Surg Volume: Epub ahead of print Pages: 1-1
  • Peer Reviewed
• [Journal Article] Results of data verification of the Japan congenital cardiovascular database, 2008 to 2009. (2014)
  • Author(s): Tomotaki A, Miyata H, Hashimoto H, Murakami A, Ono M
  • Journal Title: World J Pediatr Congenit Heart Surg Volume: 5(1) Pages: 47-53
  • Peer Reviewed
• [Presentation] JCVSDによる医療の質向上プロジェクト (2017)
  • Author(s): 宮田裕章
  • Organizer: 第47回日本心臓血管外科学会学術総会
  • Place of Presentation: グランドニッコー東京 台場
  • Year and Date: 2017-02-27
  • Invited
• [Presentation] シンポジウム Ⅲ 医療ビッグデータがもたらす社会変革 患者視点に基づく医療を実現する医療ビッグデータ (2014)
  • Author(s): 宮田裕章
  • Organizer: ASIAN AGING SUMMIT
  • Place of Presentation: 東京
  • Year and Date: 2014-11-11 – 2014-11-13
  • Invited
• [Presentation] 特別企画 日本発信の膵切データ (2014)
  • Author(s): 宮田裕章，木村理
  • Organizer: 第41回日本膵切研究会
  • Place of Presentation: 東京
  • Year and Date: 2014-08-22 – 2014-08-23
  • Invited
• [Presentation] シンポジウム03.消化器外科領域における内視鏡外科手術のさらなる発展に向けた課題とその克服 NCD報告： 大規模臨床データベースを用いた内視鏡外科手術の効果・適応評価の有用性と方法論的課題 (2014)
  • Author(s): 宮田裕章
  • Organizer: 第69回日本消化器外科学会総会
  • Place of Presentation: 福島
  • Year and Date: 2014-07-16 – 2014-07-18
  • Invited
• [Presentation] 特別企画 2）外科治療データベースの国際間比較とその連携へのステップ Evaluating procedure details of Japanese and U.S.Gastroenterological surgery patients (2014)
  • Author(s): 宮田裕章
  • Organizer: 第69回日本消化器外科学会総会
  • Place of Presentation: 福島
  • Year and Date: 2014-07-16 – 2014-07-18
  • Invited
• [Presentation] 乳癌ビックデータの現状と展望（NCD- 乳癌登録）：乳癌ビックデータの現状と展望（NCD-乳癌登録）：NCD登録を用いた研究の現状と乳癌領域への応用 (2014)
  • Author(s): 宮田裕章，友滝愛，平原憲道，新倉直樹，徳田裕，岩中督
  • Organizer: 第22回日本乳癌学会学術総会
  • Place of Presentation: 大阪
  • Year and Date: 2014-07-10 – 2014-07-12
  • Invited
• [Presentation] 科学的な安全対策に転換するために何が必要か、我々が明日からでもできることは何か―アカデミアの立場から (2014)
  • Author(s): 宮田裕章
  • Organizer: 第 160回レギュラトリーサイエンス エキスパート研修会
  • Place of Presentation: 東京
  • Year and Date: 2014-07-09
  • Invited
• [Presentation] SL2 特別講演2 NCD の今後の展開. SL2－1 呼吸器外科領域におけるNational Clinical Database の可能性. (2014)
  • Author(s): 宮田裕章
  • Organizer: 第31回日本呼吸器外科学会総会
  • Place of Presentation: 東京
  • Year and Date: 2014-05-28 – 2014-05-30
  • Invited
• [Presentation] 特別企画（3）「NCD の利活用―専門医制度，医療水準評価のこれから―」SP-3-6 National Clinical Database における2014 年の現状と課題 (2014)
  • Author(s): 宮田裕章
  • Organizer: 第114回日本外科学定期学術集会
  • Place of Presentation: 京都
  • Year and Date: 2014-04-03 – 2014-04-05
  • Invited