{"id":1656,"date":"2019-03-20T11:34:37","date_gmt":"2019-03-20T02:34:37","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1656"},"modified":"2019-03-20T11:34:37","modified_gmt":"2019-03-20T02:34:37","slug":"%e6%80%a5%e6%80%a7%e9%bc%bb%e5%89%af%e9%bc%bb%e8%85%94%e7%82%8e%ef%bc%8c%e6%80%a5%e6%80%a7%e7%b4%b0%e8%8f%8c%e6%80%a7%e9%bc%bb%e5%89%af%e9%bc%bb%e8%85%94%e7%82%8e%e3%81%ae%e8%a8%ba%e6%96%ad%e3%81%ab","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1656","title":{"rendered":"\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\uff0c\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u8a3a\u65ad\u306b\u6709\u7528\u306a\u75c5\u6b74\uff0c\u8eab\u4f53\u6240\u898b"},"content":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015<br \/>\nMark H. Ebell, Brian McKay, et al. Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusitis and Acute Bacterial Rhinosinusitis. Annals Fam Med 2019; 17:164-172. <\/p>\n<p>\u2015\u8981\u7d04\u2015<br \/>\n\u3010\u80cc\u666f\u3068\u76ee\u7684\u3011<br \/>\n\u904e\u53bb\u306e\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u81e8\u5e8a\u8a3a\u65ad\u306b\u95a2\u3059\u308b\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306f\u5168\u306615\u5e74\u4ee5\u4e0a\u524d\u306e\u3082\u306e\u3067\u3042\u308a\uff0c2\u5909\u91cf\u30e1\u30bf\u89e3\u6790\u306e\u3088\u3046\u306a\u6700\u65b0\u306e\u7d71\u8a08\u5206\u6790\u7684\u624b\u6cd5\u3092\u7528\u3044\u3066\u3044\u306a\u3044\uff0e\u672c\u7814\u7a76\u306e\u76ee\u7684\u306f\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u3084\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u81e8\u5e8a\u8a3a\u65ad\u306b\u95a2\u3059\u308b\u5305\u62ec\u7684\u306a\u30e1\u30bf\u5206\u6790\u3092\u884c\u3046\u3053\u3068\u3067\u3042\u308b\uff0e<br \/>\n\u3010\u65b9\u6cd5\u3011<br \/>\n\u81e8\u5e8a\u7684\u306b\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u3092\u7591\u3046\u5916\u6765\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\uff0c\u611f\u5ea6\u3068\u7279\u7570\u5ea6\u3092\u6e2c\u5b9a\u3057\u5341\u5206\u306a\u60c5\u5831\u3092\u5831\u544a\u3057\u3066\u3044\u308b\u7814\u7a76\u3092Medline\u3067\u63a2\u7d22\u3057\u305f\uff0e\u691c\u7d22\u3055\u308c\u305f1649\u306e\u7814\u7a76\u306e\u3046\u306117\u306e\u7814\u7a76\u304c\u7d44\u307f\u5165\u308c\u57fa\u6e96\uff08inclusion criteria\uff09\u306b\u5408\u81f4\u3057\u305f\uff0e\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306f\u8a55\u4fa1\u304c\u78ba\u5b9a\u3055\u308c\u3066\u3044\u308b\u53c2\u7167\u57fa\u6e96\uff08\u30ec\u30f3\u30c8\u30b2\u30f3\uff0c\u8d85\u97f3\u6ce2\u30a8\u30b3\u30fc\uff0cCT\uff09\u306b\u3088\u308a\u8a3a\u65ad\u3055\u308c\uff0c\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306f\u526f\u9f3b\u8154\u7a7f\u523a\u306b\u3088\u308b\u81bf\u6c41\u306e\u8a3c\u660e\u307e\u305f\u306f\u7d30\u83cc\u57f9\u990a\u967d\u6027\u306b\u3088\u308a\u8a3a\u65ad\u3057\u305f\uff0e\u75c5\u6b74\u3084\u8eab\u4f53\u6240\u898b\u306e\u7cbe\u5ea6\u306e\u898b\u7a4d\u3082\u308a\u3092\u6e2c\u5b9a\u3059\u308b\u305f\u3081\u306b2\u5909\u91cf\u30e1\u30bf\u89e3\u6790\u3092\u7528\u3044\u305f\uff0e<br \/>\n\u3010\u7d50\u679c\u3011<br \/>\n\u526f\u9f3b\u8154\u708e\u3092\u81e8\u5e8a\u7684\u306b\u7591\u3046\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c\u753b\u50cf\u7684\u306b\u78ba\u5b9a\u8a3a\u65ad\u3055\u308c\u305f\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u6709\u75c5\u7387\u306f51\uff05\uff0c\u526f\u9f3b\u8154\u7a7f\u523a\u306b\u3088\u308a\u78ba\u5b9a\u8a3a\u65ad\u3055\u308c\u305f\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u6709\u75c5\u7387\u306f31\uff05\u3067\u3042\u3063\u305f\uff08Table2\uff09\uff0e<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75301.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75301.png\" alt=\"20190320\u5c71\u75301\" width=\"549\" height=\"711\" class=\"alignleft size-full wp-image-1657\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75301.png 549w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75301-232x300.png 232w\" sizes=\"auto, (max-width: 549px) 100vw, 549px\" \/><\/a><\/p>\n<p>\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u3092\u6700\u3082\u3088\u304frule in\u3067\u304d\u308b\u81e8\u5e8a\u6240\u898b\u306f\u4e2d\u9f3b\u9053\u306e\u81bf\u6027\u9f3b\u6c41\uff08\u967d\u6027\u5c24\u5ea6\u6bd4[LR+] 3.2\uff09\uff0c\u5168\u4f53\u7684\u306a\u5370\u8c61\uff08LR\uff0b 3.0\uff09\u3067\u3042\u3063\u305f\uff0e\u6700\u3082\u826f\u304frule out\u3067\u304d\u308b\u6240\u898b\u306f\u5168\u4f53\u7684\u306a\u5370\u8c61\uff08\u9670\u6027\u5c24\u5ea6\u6bd4[LR-] 0.37\uff09\uff0ctransillumination\uff08\u526f\u9f3b\u8154\u306e\u900f\u904e\u7167\u660e\uff09\u304c\u6b63\u5e38\u3067\u3042\u308b\u3053\u3068\uff08LR- 0.55\uff09\uff0c\u5148\u884c\u3059\u308b\u6c17\u9053\u611f\u67d3\u304c\u306a\u3044\u3053\u3068\uff08LR- 0.48\uff09\uff0c\u9f3b\u6c41\u304c\u306a\u3044\u3053\u3068\uff08LR- 0.49\uff09\uff0c\u81bf\u6027\u9f3b\u6c41\u304c\u306a\u3044\u3053\u3068\uff08LR- 0.49\uff09\u3067\u3042\u3063\u305f\uff08Table 3\uff09\uff0e<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75302.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75302.png\" alt=\"20190320\u5c71\u75302\" width=\"784\" height=\"920\" class=\"alignleft size-full wp-image-1658\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75302.png 784w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75302-256x300.png 256w\" sizes=\"auto, (max-width: 784px) 100vw, 784px\" \/><\/a><\/p>\n<p>\u9650\u3089\u308c\u305f\u60c5\u5831\u306b\u57fa\u3065\u304f\u304c\uff0c\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u6700\u826f\u306e\u4e88\u6e2c\u56e0\u5b50\u306f\u5168\u4f53\u7684\u306a\u5370\u8c61\uff08LR+ 3.8\uff0cLR- 0.34\uff09\uff0c\u60aa\u81ed\u75c7\uff08\u606f\u306e\u60aa\u81ed\uff09\uff08LR+ 4.3\uff0cLR\u22120.86\uff09\uff0c\u6b6f\u75db\uff08LR+ 2.0\uff0cLR- 0.77\uff09\u3067\u3042\u3063\u305f\uff08Table\uff14\uff09\uff0e<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75303.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75303.png\" alt=\"20190320\u5c71\u75303\" width=\"785\" height=\"462\" class=\"alignleft size-full wp-image-1659\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75303.png 785w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75303-300x177.png 300w\" sizes=\"auto, (max-width: 785px) 100vw, 785px\" \/><\/a><\/p>\n<p> Clinical decision rule\u304c\u3044\u304f\u3064\u304b\u63d0\u6848\u3055\u308c\u3066\u3044\u308b\u304c\u3069\u306e\u7814\u7a76\u306b\u304a\u3044\u3066\u3082\u524d\u65b9\u8996\u7684\u306b\u6709\u52b9\u6027\u304c\u78ba\u8a8d\u3055\u308c\u3066\u306f\u3044\u306a\u304b\u3063\u305f\uff08Table\uff15\uff09\uff0e<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75304.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75304.png\" alt=\"20190320\u5c71\u75304\" width=\"777\" height=\"873\" class=\"alignleft size-full wp-image-1660\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75304.png 777w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2019\/03\/20190320\u5c71\u75304-267x300.png 267w\" sizes=\"auto, (max-width: 777px) 100vw, 777px\" \/><\/a><\/p>\n<p>\u3010\u7d50\u8ad6\u3011<br \/>\n \u81e8\u5e8a\u7684\u306b\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u3092\u7591\u3046\u60a3\u8005\u306b\u304a\u3044\u3066\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306f\u7d041\/3\u3057\u304b\u8a8d\u3081\u3089\u308c\u306a\u3044\uff0e\u5168\u4f53\u7684\u306a\u5370\u8c61\uff0c\u60aa\u81ed\u75c7\uff0c\u6b6f\u75db\u304c\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u6700\u826f\u306e\u4e88\u6e2c\u56e0\u5b50\u3067\u3042\u3063\u305f\uff0eC-reactive protein\u3084\u5c3f\u691c\u67fb\u3092\u3082\u3061\u3044\u305fClinical decision rule\u306f\u6709\u7528\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u304c\uff0c\u524d\u65b9\u8996\u7684\u306a\u6709\u52b9\u6027\u306e\u78ba\u8a8d\u304c\u5fc5\u8981\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u30112019\u5e743\u670820\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u2015\u6587\u732e\u540d\u2015 Mark H. Ebell, Brian McKay, et al. Accuracy of Signs and Symptoms for the Diagnosis of Acute Rhinosinusi &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1656\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u6025\u6027\u9f3b\u526f\u9f3b\u8154\u708e\uff0c\u6025\u6027\u7d30\u83cc\u6027\u9f3b\u526f\u9f3b\u8154\u708e\u306e\u8a3a\u65ad\u306b\u6709\u7528\u306a\u75c5\u6b74\uff0c\u8eab\u4f53\u6240\u898b<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[17],"tags":[],"class_list":["post-1656","post","type-post","status-publish","format-standard","hentry","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1656","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1656"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1656\/revisions"}],"predecessor-version":[{"id":1661,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1656\/revisions\/1661"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1656"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}