著者

飯嶋 久志 大澄 朋香

出版者

一般社団法人日本医薬品情報学会

雑誌

医薬品情報学 (ISSN:13451464)

巻号頁・発行日

vol.18, no.1, pp.22-32, 2016 (Released:2016-06-13)

参考文献数

104

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Objective: Clinical articles are important for individualization of drug therapy.  Especially, meta-analysis is positioned at the highest evidence level.  Therefore, we assessed the Quality Score of Meta-Analysis (QSMA) which provides simple assessments of both the quality and the format of meta-analyses, by applying them to incretin-related drugs as a model.  Furthermore, we attempted to extract clinical data from the literature employing a certain minimum standard.Method: We searched for meta-analyses of incretin-related drugs for diabetes in PubMed and the Cochrane Library, scoring the extracted articles for format using PRISMA statements, and for quality using QSMA.  Additionally, we classified these articles into two groups with a QSMA score of 70% as the basis, and verified the analysis sets (ITT, FAS, PP or APT) and sensitivity analysis.  Furthermore, we looked into those articles that scored 70% or higher to extract data that were deemed to have significant statistical differences.Results: Scoring of the 66 articles studied yielded 69.9±19.4% (mean ± SD) for format and 62.1±17.8% for quality.  These two variables produced a regression line of y=0.777x+7.834.  Comparison of the two groups classified on the basis of a 70% score on QSMA yielded a significant difference in sensitivity analysis only (p<0.05).  Seven effects and five side effects were extracted from articles with a QSMA score of 70% or higher.Conclusion: Although QSMA can provide simple assessment of quality and structure using eight items, analysis sets needs to be verified individually.  As the articles assessed provided statistically endorsed data, the clinical application of QSMA will be an issue in the future.

著者

飯嶋 久志 宇野 弘展 大石 憲司 木村 浩二 西橋 由紀子 寺内 信夫 西岡 直人 田畑 義弘 吉川 清史 黒川 慎吾 石野 良和

出版者

一般社団法人 日本医療情報学会

雑誌

医療情報学 = Japan journal of medical informatics (ISSN:02898055)

巻号頁・発行日

vol.28, no.1, pp.31-37, 2008-08-17

参考文献数

8

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医薬分業とITの進展に伴い,薬局で扱う情報は年々大きくなっており,その効率化にはITの活用が有用な手段といえる.また,国民のIT推進状況も考慮すると,患者への医薬品情報提供にはITの活用が望まれる.そこで,携帯電話のWeb機能を利用した医薬品情報提供と収集を試みた.<br/> システムはクライアントアプリケーションとWebアプリケーションで構成し,サーバとの通信にはSSLを用いた暗号化通信とした.情報提供はE-mailによる能動的情報提供,サーバへアクセスする受動的情報提供とし,さらに患者から服薬状況をサーバへ報告するシステムを構築した.また,本システムをモニター調査等で評価した.<br/> 本システムへのアクセス数は「服用履歴」,「次回服用内容」,「登録情報」などが多かったが,患者からの報告は調査が進むにつれ減少した.また,薬剤師は調剤完了メール,服用履歴などに対する利便性を高く評価した.一方,本システムはレセプトコンピュータよりデータ抽出することから,データ入力の負荷なくデータ収集が可能であった.<br/> 本システムは服用履歴によるコンプライアンスの確認が期待されるが,継続した服用状況の確認には困難が生じた.今後はこれら問題点を改善し,患者利便性と薬物療法の質向上に寄与する必要があろう.

著者

飯嶋 久志 大澄 朋香 小清水 敏昌

出版者

公益社団法人 日本薬学会

雑誌

YAKUGAKU ZASSHI (ISSN:00316903)

巻号頁・発行日

vol.130, no.9, pp.1215-1223, 2010 (Released:2010-09-01)

参考文献数

71

被引用文献数

2 2

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In recent years, Evidence-based Medicine is practiced in medical care, and meta-analysis is positioned as the highest quality research paper. However, there are no unified criteria to evaluate meta-analysis. Thus, we developed and evaluated objective criteria of meta-analysis paper. Meta-analysis was evaluated from the standpoint of format and quality. Format score was developed based on QUOROM statement. Quality scores were evaluated in each step of meta-analysis. We evaluated meta-analysis for advantageous or adverse effect in the relationship between Renin-angiotensin system (RAS) inhibitor and diabetes mellitus. Research articles either in English or Japanese were searched in PubMed and the Cochrane Library in July 2009. Fifty-five studies were evaluated for format and quality score. Format score was 64.5±25.3% (Mean±S.D.), and quality score was 57.1±21.6%. After plotting each score along the X-Y coordinate, format score was correlated with quality score (R2=0.702, p<0.001). In studies with quality score of 70% or higher, RAS inhibitor prevented new-onset diabetes mellitus. Angiotensin converting enzyme (ACE) inhibitor reduced risk of myocardial infarction, however, angiotensin receptor blockers (ARB) increased the incidence in odds ratio 1.21 (95%CI: 1.04-1.40). We evaluated meta-analysis by format and quality score, and these factors showed correlation. Therefore, assessment of quality score leads to prompt and reliable evaluation of meta-analysis. According to articles evaluated by quality score, RAS inhibitor showed effectiveness on diabetes mellitus. However, careful attention must be given in ARB therapy on patients with myocardial infarction risk.