\u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044\u300d\u3068\u8a00\u3063\u305f\u3089\u305d\u306e\u5f8c\u306b\u306f\u4f55\u304c\u7d9a\u304f\u3067\u3057\u3087\u3046\uff1f<\/p>\n\n\n\n
\u304a\u305d\u3089\u304f\u3001\u300c\u3002\u3002\u3002\u306f\u3057\u306a\u3044\u65b9\u304c\u3044\u3044\u300d\u3067\u3057\u3087\u3046\u3002\u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308b\u300d\u3060\u3063\u305f\u3089\uff1f<\/p>\n\n\n\n
\u304a\u305d\u3089\u304f\u3001\u300c\u3002\u3002\u3002\u3092\u3057\u305f\u65b9\u304c\u3044\u3044\u300d\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n
\u679c\u305f\u3057\u3066\u3053\u308c\u3067\u3044\u3044\u306e\u3067\u3057\u3087\u3046\u304b\uff1f <\/p>\n\n\n\n
\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3067\u63a8\u5968\u3092\u4f5c\u6210\u3059\u308b\u5834\u5408\u306f\u3001\u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044\u304b\u3089\u300d\u300c\u3002\u3002\u3002\u3092\u3057\u306a\u3044\u3053\u3068\u3092\u63a8\u5968\u3059\u308b\u300d\u3067\u3057\u3087\u3046\u304b\uff1f\u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308b\u304b\u3089\u300d\u300c\u3002\u3002\u3002\u3092\u3059\u308b\u3053\u3068\u3092\u63a8\u5968\u3059\u308b\u300d\u3067\u3057\u3087\u3046\u304b\uff1f<\/p>\n\n\n\n
\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u306f\u3042\u308b\u30fb\u306a\u3057\u306e\u3069\u3061\u3089\u304b\u3067\u3057\u3087\u3046\u304b\uff1f\u3055\u3089\u306b\u3001\u76ca\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u5bb3\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u4e21\u65b9\u8003\u3048\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n\n\n\n
US Preventive Task Force (USPSTF)\u306f\u3001\u63a8\u5968\u3092A, B, C, D, I\u306b\u5206\u985e\u3057\u3066\u3044\u308b<\/a>\u3053\u3068\u306b\u3064\u3044\u3066\u4ee5\u524d\u306e\u6295\u7a3f<\/a>\u306e\u4e2d\u3067\u8ff0\u3079\u307e\u3057\u305f\u3002\u3053\u306e\u4e2d\u3067\u3001Grade C\u306f\u201dUSPSTF\u306f\u3001\u5c02\u9580\u5bb6\u306e\u5224\u65ad\u3068\u60a3\u8005\u306e\u597d\u307fPreferences\u306b\u57fa\u3065\u3044\u3066\u3001\u9078\u629e\u7684\u306b\u500b\u4eba\u500b\u4eba\u306e\u60a3\u8005\u306b\u63d0\u4f9b\u3059\u308b\u3053\u3068\u3092\u63a8\u5968\u3059\u308b\u3002\u6b63\u5473\u306e\u76ca\u304c\u5c0f\u3055\u3044\u3053\u3068\u306b\u5c11\u306a\u304f\u3068\u3082\u4e2d\u7b49\u5ea6\u306e\u78ba\u5b9f\u6027\u304c\u3042\u308b\u201d\u3068\u5b9a\u7fa9\u3055\u308c\u3066\u3044\u307e\u3059\u3002\u60a3\u8005\u306e\u597d\u307fPreferences\u306f\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u3068\u540c\u7fa9\u3068\u8003\u3048\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n\n\n\n Grade I\u306f\u201dUSPSTF\u306f\u3001\u73fe\u5728\u306e\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u305d\u306e\u30b5\u30fc\u30d3\u30b9\u306e\u76ca\u3068\u5bb3\u306e\u30d0\u30e9\u30f3\u30b9\u3092\u8a55\u4fa1\u3059\u308b\u306e\u306b\u4e0d\u5341\u5206\u3067\u3042\u308b\u3068\u7d50\u8ad6\u4ed8\u3051\u308b\u3002\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u306a\u3044\u304b\u3001\u8ca7\u5f31\u304b\u3001\u3042\u308b\u3044\u306f\u77db\u76fe\u3057\u3066\u304a\u308a\u3001\u76ca\u3068\u5bb3\u306e\u30d0\u30e9\u30f3\u30b9\u3092\u6c7a\u3081\u3089\u308c\u306a\u3044\u201d\u3068\u5b9a\u7fa9\u3055\u308c\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n \u76ca\u3068\u5bb3\u306e\u30d0\u30e9\u30f3\u30b9the balance of benefits and harms\u306f\u6b63\u5473\u306e\u76cathe net benefit\u3068\u540c\u3058\u610f\u5473\u3067\u3059\u3002\u6b63\u5473\u306e\u76ca\u306f\u3001\u201dThe net benefit is defined as benefit minus harm of the preventive service as implemented in a general, primary care population. \u201d \u3059\u306a\u308f\u3061\u3001\u305d\u306e\u4e88\u9632\u533b\u7642\u30b5\u30fc\u30d3\u30b9\u304c\u4e00\u822c\u306e\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u96c6\u56e3\u3067\u5b9f\u884c\u3055\u308c\u308b\u3068\u304d\u306e\u76ca\u3072\u304f\u5bb3\u304c\u6b63\u5473\u306e\u76ca\u3068\u5b9a\u7fa9\u3055\u308c\u308b\u3001\u3068\u3002\u3053\u3053\u3067\u306f\u76ca\u304b\u3089\u5bb3\u3092\u6e1b\u3058\u305f\uff08\u5f15\u304d\u7b97\u3057\u305f\uff09\u5024\u3092\u6b63\u5473\u306e\u76caNet benefit\u3068\u5b9a\u7fa9\u3057\u3066\u3044\u307e\u3059\u3002<\/p>\n\n\n\n \u4ee5\u4e0a\u3092\u524d\u63d0\u306b\u3001Braithwaite RS\u306e”EBM’s six dangerous words.” \uff08\u6587\u732e\uff09\u306e\u610f\u5473\u3092\u8003\u3048\u3066\u307f\u307e\u3057\u3087\u3046\u3002<\/p>\n\n\n\n “EBM’s six dangerous words.”\u3068\u306f”There is no evidence to suggest…”\u306e\uff16\u3064\u306e\u8a00\u8449\u306e\u3053\u3068\u3067\u3059\u3002\u3064\u307e\u308a\u3001\u300c\u3002\u3002\u3002\u3092\u63d0\u6848\uff08\u793a\u5506\uff09\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u306a\u3044\u300d\u3068\u3044\u3046\u8868\u73fe\u306e\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n Braithwaite RS\u306e\u3053\u306e\u8ad6\u6587\u306b\u304a\u3051\u308b\u4e3b\u5f35\u306f\u3001\u3053\u306e\u8868\u73fe\u306f4\u3064\u306e\u610f\u5473\u3067\u3064\u304b\u308f\u308c\u3066\u3044\u308b\u306e\u3067\u3001\u305d\u306e\u3069\u308c\u306a\u306e\u304b\u3092\u308f\u304b\u308b\u3088\u3046\u306b\u6700\u521d\u304b\u3089\u305d\u308c\u30894\u3064\u306e\u5185\u306e\u3069\u308c\u304b\u306e\u8868\u73fe\u3092\u4f7f\u3044\u307e\u3057\u3087\u3046\u3068\u3044\u3046\u3053\u3068\u3067\u3059\u3002<\/p>\n\n\n\n 1\uff0e\u79d1\u5b66\u7684\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u6c7a\u5b9a\u7684\u3067\u306f\u306a\u304f\u3001\u3069\u308c\u304c\u6700\u5584\u304b\u5206\u3089\u306a\u3044\u3002\uff08USPSTF Grade I\u3067\u30d9\u30a4\u30b8\u30a2\u30f3\u7121\u60c5\u5831\u4e8b\u524d\u5206\u5e03\u306e\u5834\u5408\uff09 1\u306e\u5834\u5408\u3001USPSTF\u306f\u3001\u201d\u81e8\u5e8a\u7684\u8003\u5bdf\u306e\u30bb\u30af\u30b7\u30e7\u30f3\u3092\u8aad\u307f\u3001\u3082\u3057\u3001\u305d\u306e\u30b5\u30fc\u30d3\u30b9\u3092\u63d0\u4f9b\u3059\u308b\u306e\u3067\u3042\u308c\u3070\u3001\u60a3\u8005\u306f\u76ca\u3068\u5bb3\u306e\u30d0\u30e9\u30f3\u30b9\u306e\u4e0d\u78ba\u5b9f\u6027\u3092\u7406\u89e3\u3059\u3079\u304d\u3067\u3042\u308b\u201d\u3068Suggestions for Practice\u3067\u8ff0\u3079\u3066\u3044\u307e\u3059\u3002\u3059\u3079\u304d\u3067\u306f\u306a\u3044\u3068\u6c7a\u3081\u3064\u3051\u3066\u3044\u308b\u308f\u3051\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n\n\n\n 2\u306e\u5834\u5408\u306f\u30011\u306e\u5834\u5408\u3068\u540c\u69d8\u3067\u3059\u304c\u30011\u3068\u6bd4\u3079\u308b\u3068\u305d\u306e\u30b5\u30fc\u30d3\u30b9\u304c\u63d0\u4f9b\u3055\u308c\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u304f\u306a\u308b\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n \uff11\uff0c\uff12\u3067\u4e8b\u524d\u5206\u5e03Prior\u3068\u8a00\u3063\u3066\u3044\u308b\u306e\u306f\u3001Braithwaite RS\u3067\u3059\u3002USPSTF\u306e\u8a18\u8ff0\u306b\u306f\u3042\u308a\u307e\u305b\u3093\u3002\u5f7c\u306e\u8003\u3048\u306f\u3001\u305d\u306e\u6642\u70b9\u306b\u304a\u3051\u308b\u4eee\u8aacHypothesis\u304c\u3042\u3063\u3066\u3001\u305d\u308c\u304c\u6b63\u3057\u3044\u78ba\u7387P(H)\u304c\u3001\u305d\u306e\u5f8c\u30c7\u30fc\u30bfData\u304c\u5f97\u3089\u308c\u308b\u3068\u305d\u306e\u6b63\u3057\u3044\u78ba\u7387P(H|D)\u306f\u30c7\u30fc\u30bf\u304c\u6b63\u3057\u3044\u78ba\u7387P(D)\u3068\u305d\u306e\u4eee\u8aac\u304c\u6b63\u3057\u3044\u6642\u306b\u305d\u306e\u30c7\u30fc\u30bf\u304c\u5f97\u3089\u308c\u308b\u78ba\u7387P(D|H)\u306b\u3088\u3063\u3066\u6c7a\u307e\u308b\u3068\u3044\u3046\u30d9\u30a4\u30ba\u306e\u5b9a\u7406\u306e\u3001P(H)\u306e\u3053\u3068\u3067\u3059\u3002P(H|D) = P(D|H)\u00d7P(H)\/P(D)\u306e\u5f0f\u3067\u8868\u3055\u308c\u307e\u3059\u3002<\/p>\n\n\n\n \u3064\u307e\u308a\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u6c7a\u5b9a\u7684\u3067\u306a\u3044\u3001\u4e0d\u78ba\u5b9f\u6027\u304c\u9ad8\u3044\u5834\u5408\u3067\u3082\u3001\u305d\u306e\u7a0b\u5ea6\u306f\u7570\u306a\u308a\u3001\u201d\u79c1\u306e\u7d4c\u9a13\u3042\u308b\u3044\u306f\u305d\u306e\u4ed6\u306e\u77e5\u8b58\u201d\u306e\u6b63\u3057\u3044\u78ba\u7387=P(H)\u306b\u76f8\u5f53\u3059\u308b\u5024\u306f\u69d8\u3005\u3067\u30011\u306e\u5834\u5408\u306f\u3001\u305d\u308c\u304c0\u306b\u8fd1\u3044\u30012\u306e\u5834\u5408\u306f\u3001\u3082\u3046\u5c11\u3057\u5927\u304d\u3044\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002\u3064\u307e\u308a\u3001\u201d\u4eca\u307e\u3067\u306e\u81ea\u5206\u306e\u7d4c\u9a13\u3084\u9593\u63a5\u7684\u306a\u30c7\u30fc\u30bf\u3001\u7814\u7a76\u7d50\u679c\u304b\u3089\u3001X\u304c\u6709\u52b9\u306e\u53ef\u80fd\u6027\u304c\u5c11\u3057\u3042\u308b\u201d\u3068\u3044\u3046\u5834\u5408\u3068\u3001\u201d\u5168\u304f\u308f\u304b\u3089\u306a\u3044\u304c\u3001X\u306f\u307e\u305a\u52b9\u679c\u304c\u3042\u308b\u53ef\u80fd\u6027\u306f\u6b86\u3069\u30bc\u30ed\u201d\u3068\u3044\u3046\u5834\u5408\u3067\u306f\u3001\u5224\u65ad\u304c\u9055\u3063\u3066\u304d\u307e\u3059\u3002<\/p>\n\n\n\n 3\u306e\u5834\u5408\u306f\u3001\u5bb3\u304c\u76ca\u3092\u4e0a\u56de\u308b\u72b6\u614b\u306b\u306a\u308a\u307e\u3059\u3002\u3060\u304b\u3089\u3001\u3057\u306a\u3044\u65b9\u304c\u3044\u3044\u3002<\/p>\n\n\n\n 4\u306e\u5834\u5408\u306f\u3001\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u306b\u3088\u3063\u3066\u3001\u3042\u308b\u60a3\u8005\u306b\u306f\u3059\u308b\u3053\u3068\u306b\u306a\u308a\u3001\u5225\u306e\u60a3\u8005\u306b\u306f\u3057\u306a\u3053\u3068\u306b\u306a\u308a\u307e\u3059\u3002<\/p>\n\n\n\n \u3068\u3046\u3053\u3068\u304b\u3089\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044\u304b\u3089\u3068\u8a00\u3063\u3066\u3001\u3057\u3066\u306f\u3044\u3051\u306a\u3044\u3068\u3044\u3046\u6c7a\u65ad\u3092\u3059\u308b\u3068\u591a\u304f\u306e\u5834\u5408\u3001\u9593\u9055\u3063\u305f\u6c7a\u65ad\u306b\u306a\u3063\u3066\u3057\u307e\u3046\u3067\u3057\u3087\u3046\u3002<\/p>\n\n\n\n \u81e8\u5e8a\u306e\u73fe\u5834\u3067\u306f\u3001\u4f55\u3082\u3057\u306a\u3044\u3068\u3044\u3046\u9078\u629e\u80a2\u3082\u542b\u3081\u3066\u3001\u3069\u308c\u304b\u306b\u6c7a\u3081\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002\u305d\u306e\u969b\u306b\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044\u304b\u3089\u3057\u306a\u3044\u3001\u3068\u3044\u3046\u8003\u3048\u3001\u307e\u305f\u3001\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u304a\u3044\u3066\u3001\u30e9\u30f3\u30c0\u30e0\u5316\u6bd4\u8f03\u8a66\u9a13\u304c\u306a\u3044\u9818\u57df\u3067\u306f\u3001\u63a8\u5968\u3092\u4f5c\u6210\u3059\u308b\u3053\u3068\u306f\u3067\u304d\u306a\u3044\u3068\u3044\u3046\u8003\u3048\u306f\u3001\u504f\u3063\u305f\u8003\u3048\u3067\u306f\u306a\u3044\u3067\u3057\u3087\u3046\u304b\u3002<\/p>\n\n\n\n \u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u78ba\u5b9f\u6027\u306f\u3001All or nothing\u3042\u308b\u3044\u306f1\u304b0\u304b\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002Quantitative Benefit-Risk Assessment\u3092\u884c\u3046\u969b\u306b\u306f\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u78ba\u5b9f\u6027\u3092\u8868\u3059\u306e\u306b\u3001\u78ba\u7387\u5206\u5e03\u3092\u4f7f\u3044\u307e\u3059\u3002\u4ee5\u524d\u306e\u6295\u7a3f\u3001\u76ca\u3068\u5bb3\u306e\u5b9a\u91cf\u7684\u8a55\u4fa1\u6cd5 Quantitative benefit-harm assessment<\/a>\u3001Keeney and Raiffa\u306eSwing weighting\u3092\u7528\u3044\u305fMCDA<\/a>\u3001Swing weighting\u3092\u7528\u3044\u305fMCDA\u306e\u7d50\u679c<\/a>\u3001\u306a\u3069\u3092\u53c2\u7167\u3057\u3066\u304f\u3060\u3055\u3044\u3002<\/p>\n\n\n\n \u6587\u732e \u540c\u3058\u8ad6\u6587\u304c2020\u5e74\u306b\u518d\u63b2\u3055\u308c\u3066\u3044\u307e\u3059\u3002 \u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044\u300d\u3068\u8a00\u3063\u305f\u3089\u305d\u306e\u5f8c\u306b\u306f\u4f55\u304c\u7d9a\u304f\u3067\u3057\u3087\u3046\uff1f \u304a\u305d\u3089\u304f\u3001\u300c\u3002\u3002\u3002\u306f\u3057\u306a\u3044\u65b9\u304c\u3044\u3044\u300d\u3067\u3057\u3087\u3046\u3002\u300c\u3002\u3002\u3002\u306b\u306f\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u3042\u308b\u300d\u3060\u3063\u305f\u3089\uff1f \u304a\u305d\u3089\u304f\u3001\u300c\u3002\u3002\u3002\u3092\u3057\u305f\u65b9\u304c\u3044\u3044\u300d\u3067\u3057\u3087\u3046\u3002 \u679c\u305f\u3057\u3066\u3053\u308c\u3067\u3044 … “\u30a8\u30d3\u30c7\u30f3\u30b9\u304c\u306a\u3044No evidence” \u306e<\/span>\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5,8,3],"tags":[],"class_list":["post-982","post","type-post","status-publish","format-standard","hentry","category-cpg","category-essay","category-mdm"],"_links":{"self":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/982","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=982"}],"version-history":[{"count":6,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/982\/revisions"}],"predecessor-version":[{"id":991,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=\/wp\/v2\/posts\/982\/revisions\/991"}],"wp:attachment":[{"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=982"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=982"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/info.zanet.biz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=982"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
2\uff0e\u79d1\u5b66\u7684\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u6c7a\u5b9a\u7684\u3067\u306f\u306a\u3044\u304c\u79c1\u306e\u7d4c\u9a13\u3042\u308b\u3044\u306f\u305d\u306e\u4ed6\u306e\u77e5\u8b58\u306f\u201dX\u201d\u3092\u793a\u5506\u3059\u308b\u3002\uff08USPSTF Grade I\u3067”X”\u3092\u793a\u5506\u3059\u308b\u30d9\u30a4\u30b8\u30a2\u30f3\u6709\u60c5\u5831\u4e8b\u524d\u5206\u5e03\u306e\u5834\u5408\uff09
3\uff0e\u3053\u308c\u306f\u76ca\u304c\u306a\u3044\u3053\u3068\u304c\u8a3c\u660e\u3055\u308c\u3066\u3044\u308b(USPSTF Grade D)
4\uff0e\u3053\u308c\u306f\u3069\u3063\u3061\u3064\u304b\u305a\u3067\u3001\u3042\u308b\u60a3\u8005\u306b\u306f\u76ca\u304c\u5bb3\u3092\u4e0a\u56de\u308a\u3001\u5225\u306e\u60a3\u8005\u306b\u306f\u305d\u3046\u3067\u306f\u306a\u3044(USPSTF Grade C)<\/p>\n\n\n\n
Braithwaite RS: A piece of my mind. EBM’s six dangerous words. JAMA 2013;310:2149-50. doi: 10.1001\/jama.2013.281996<\/a> PMID: 24281458<\/a><\/p>\n\n\n\n
Braithwaite RS: EBM’s Six Dangerous Words. JAMA 2020;323:1676-1677. doi: 10.1001\/jama.2020.285<\/a>5 PMID: 32369132<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"