著者

Takehiko Oami Yohei Okada Masaaki Sakuraya Tatsuma Fukuda Nobuaki Shime Taka-aki Nakada

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

pp.JE20230227, (Released:2023-12-16)

参考文献数

20

被引用文献数

1

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Background:We evaluated the applicability of automated citation screening in developing clinical practice guidelines.Methods:We prospectively compared the efficiency of citation screening between the conventional (Rayyan) and semi-automated (ASReview software) methods. We searched the literature for five clinical questions (CQs) in the development of the Japanese Clinical Practice Guidelines for the Management of Sepsis and Septic Shock. Objective measurements of the time required to complete citation screening were recorded. Following the first screening round, in the primary analysis, the sensitivity, specificity, positive predictive value, and overall screening time were calculated for both procedures using the semi-automated tool as index and the results of the conventional method as standard reference. In the secondary analysis, the same parameters were compared between the two procedures using the final list of included studies after the second screening session as standard reference.Results:Among the five CQs after the first screening session, the highest and lowest sensitivity, specificity, and positive predictive values were 0.241 and 0.795; 0.991 and 1.000; and 0.482 and 0.929, respectively. In the secondary analysis, the highest sensitivity and specificity in the semi-automated citation screening were 1.000 and 0.997, respectively. The overall screening time per 100 studies was significantly shorter with semi-automated than with conventional citation screening.Conclusions:The potential advantages of the semi-automated method (shorter screening time and higher discriminatory rate for the final list of studies) warrant further validation.Trial registration: This study was submitted to the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR [UMIN000049366]).

著者

Kensuke Nakamura Ryota Inokuchi Kent Doi Tatsuma Fukuda Kurato Tokunaga Susumu Nakajima Eisei Noiri Naoki Yahagi

出版者

一般社団法人 日本内科学会

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

vol.53, no.10, pp.1071-1073, 2014 (Released:2014-05-15)

参考文献数

20

被引用文献数

3 10

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Various unmeasured anions other than lactate appear in the blood of septic patients, including ketones. However, the occurrence of sepsis-induced ketoacidosis without diabetes mellitus has not been reported to date. We herein describe severe ketoacidosis in a patient with septic shock despite the absence of diabetes, alcohol and starvation. A 76-year-old woman presented with septic shock due to acute obstructive cholangitis. She exhibited ketoacidosis and a remarkably strong ion gap, except for ketones. Sepsis alone may lead to ketoacidosis in patients without diabetes under specific conditions. The accumulation of ketones and other strong anions can occur in cases involving a decreased metabolic function. There may be a pathological condition called septic ketoacidosis.