{"id":1935,"date":"2020-07-16T11:43:54","date_gmt":"2020-07-16T02:43:54","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=1935"},"modified":"2020-07-16T11:43:54","modified_gmt":"2020-07-16T02:43:54","slug":"%e7%99%ba%e7%97%87%e5%be%8c48%e6%99%82%e9%96%93%e4%bb%a5%e4%b8%8a%e7%b5%8c%e9%81%8e%e3%81%97%e3%81%a6%e3%81%84%e3%81%a6%e3%82%82%e3%82%aa%e3%82%bb%e3%83%ab%e3%82%bf%e3%83%9f%e3%83%93%e3%83%ab%e3%81%ab","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=1935","title":{"rendered":"\u767a\u75c7\u5f8c48\u6642\u9593\u4ee5\u4e0a\u7d4c\u904e\u3057\u3066\u3044\u3066\u3082\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306b\u3088\u308b\u6cbb\u7642\u306f\u3001\u5b63\u7bc0\u6027\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u306e\u75c7\u72b6\u6301\u7d9a\u6642\u9593\u3092\u6e1b\u5c11\u3055\u305b\u308b"},"content":{"rendered":"<p>\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat&#8217;s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n<p>-\u6587\u732e\u540d-<br \/>\nChristopher C Butler, et al. Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: an open-label, pragmatic, randomised controlled trial. Lancet. 2020; vol.395 Jan 4: 42-52.<\/p>\n<p>-\u8981\u7d04\u2010<br \/>\nIntroduction:<br \/>\n\u30fb\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u591a\u304f\u306e\u56fd\u3067\u306f\u30d7\u30e9\u30a4\u30de\u30ea\u30b1\u30a2\u9818\u57df\u3067\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306b\u5bfe\u3057\u3066\u6297\u30a6\u30a4\u30eb\u30b9\u85ac\u304c\u51e6\u65b9\u3055\u308c\u308b\u3053\u3068\u306f\u591a\u304f\u306a\u3044\u3002<br \/>\n\u305d\u306e\u7406\u7531\u3068\u3057\u3066\u3001\u81e8\u5e8a\u7684\u306a\u52b9\u679c\u306e\u8584\u3055\u3001\u8cbb\u7528\u5bfe\u52b9\u679c\u3001\u5614\u6c17\u30fb\u5614\u5410\u3068\u3044\u3063\u305f\u526f\u4f5c\u7528\u3001\u3069\u3093\u306a\u60a3\u8005\u306b\u5bfe\u3057\u3066\u6709\u52b9\u304b\u306b\u3064\u3044\u3066\u524d\u5411\u304d\u3067\u696d\u754c\u8cc7\u91d1\u306e\u5165\u3089\u306a\u3044pragmatic\u306a\u7814\u7a76\u3067\u660e\u3089\u304b\u306b\u3055\u308c\u3066\u3044\u306a\u3044\u3001\u3068\u3044\u3063\u305f\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u308b\u3002<br \/>\n\u30fb\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u306e\u691c\u67fb\u3067\u967d\u6027\u3068\u306a\u3063\u305f\u3089\u6cbb\u7642\u3092\u958b\u59cb\u3059\u308b\u306e\u304b\u3001\u75c7\u72b6\u306e\u307f\u3067\u6cbb\u7642\u3092\u958b\u59cb\u3059\u308b\u306e\u304b\u3082\u306f\u3063\u304d\u308a\u3057\u3066\u3044\u306a\u3044\u3002<br \/>\n\u30fbCDC\u306f\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u3068\u8a3a\u65ad\u3055\u308c\u305f\u3042\u308b\u3044\u306f\u7591\u308f\u308c\u308b\u5165\u9662\u60a3\u8005\u3067\u3001\u91cd\u75c7\u3082\u3057\u304f\u306f\u5408\u4f75\u75c7\u306e\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u4eba\u306b\u3067\u304d\u308b\u3060\u3051\u65e9\u304f\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3092\u958b\u59cb\u3059\u308b\u3053\u3068\u3092\u63a8\u5968\u3057\u3066\u3044\u308b\u3002\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u304c\u7591\u308f\u308c\u308b\u75c7\u72b6\u3092\u6709\u3059\u308b\u5916\u6765\u60a3\u8005\u306b\u5bfe\u3057\u3066\u3082\u767a\u75c7\u5f8c48\u6642\u9593\u4ee5\u5185\u3067\u3042\u308c\u3070\u3001\u6cbb\u7642\u3092\u8003\u616e\u3059\u308b\u3001\u3068\u3055\u308c\u3066\u3044\u308b\u3002\u30e8\u30fc\u30ed\u30c3\u30d1\u306e\u63a8\u5968\u3082\u307b\u307c\u540c\u69d8\u3068\u306a\u3063\u3066\u3044\u308b\u3002<br \/>\n\u30fb\u3053\u308c\u307e\u3067\u884c\u308f\u308c\u305fmeta-analyses\u3067\u306f\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306f\u3001\u6210\u4eba\u306e\u75c7\u72b6\u5bdb\u89e3\u307e\u3067\u306e\u5e73\u5747\u6642\u9593\u304c\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u306617.8\u6642\u9593(95%CI 27.1-9.3)\u77ed\u304f\u3001\u6700\u521d\u306e\u75c7\u72b6\u5bdb\u89e3\u307e\u3067\u306e\u6642\u9593\u306f16.8\u6642\u9593(95%CI 21.8-8.4)\u77ed\u304b\u3063\u305f\u3002\u305f\u3060\u3057\u3001meta-analyses\u306b\u542b\u307e\u308c\u305f\u7814\u7a76\u306e\u4e2d\u306b\u306f\u3001underrecruiting\uff08\u63a1\u7528\u4e0d\u8db3\uff1f\uff09\u3001\u7d50\u679c\u306e\u9078\u629e\u7684\u5831\u544a\u3001\u5c0f\u5150\u3084\u9ad8\u9f62\u8005\u306e\u4e0d\u8db3\u30011\u30b7\u30fc\u30ba\u30f3\u306e\u307f\u306e\u8a55\u4fa1\u3001\u306a\u3069\u306e\u9650\u754c\u304c\u6307\u6458\u3055\u308c\u3066\u3044\u308b\u3002<br \/>\n\u30fb\u307e\u305f\u3001\u8cbb\u7528\u5bfe\u52b9\u679c\u306b\u5f71\u97ff\u3059\u308b\u65e5\u5e38\u751f\u6d3b\u3078\u306e\u5fa9\u5e30\u3084QOL\u3001\u533b\u7642\u9700\u8981\u304c\u3001\u6297\u30a6\u30a4\u30eb\u30b9\u85ac\u306b\u3088\u3063\u3066\u6539\u5584\u3059\u308b\u304b\u306f\u308f\u304b\u3063\u3066\u3044\u306a\u3044\u3002<br \/>\n\u30fb\u305d\u3053\u3067\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306e\u60a3\u8005\u306b\u5bfe\u3057\u3066\u901a\u5e38\u306e\u30b1\u30a2\u306b\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3092\u8ffd\u52a0\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u3001\u6539\u5584\u307e\u3067\u306e\u6642\u9593\u3092\u6e1b\u3089\u3059\u52b9\u679c\u304c\u3042\u308b\u304b\u3069\u3046\u304b\u3001\u30ad\u30fc\u3068\u306a\u308b\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u3082\u542b\u3081\u3066\u8a55\u4fa1\u3059\u308b\u3053\u3068\u3068\u3057\u305f\u3002<\/p>\n<p>Method:<br \/>\nStudy design: ALIC4E, an investigator-initiated, open-label, pragmatic, response-adaptive, platform, randomised controlled trial https:\/\/bmjopen.bmj.com\/content\/8\/7\/e021032<br \/>\nParticipants: influenza-like illness=\u7a81\u7136\u306e\u767a\u71b1\uff0b\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u547c\u5438\u5668\u75c7\u72b6\uff08\u54b3\u3001\u54bd\u982d\u75db\u3001\u9f3b\u6c41\uff09\uff0b\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u5168\u8eab\u75c7\u72b6\uff08\u982d\u75db\u3001\u7b4b\u8089\u75db\u3001\u767a\u6c57\u3001\u60aa\u5bd2\u3001\u5026\u6020\u611f\uff09\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u306e\u6d41\u884c\u671f\u9593\u4e2d\u306b\u898b\u3089\u308c\u3001\u75c7\u72b6\u6301\u7d9a\u6642\u9593\u304c72\u6642\u9593\u4ee5\u5185<br \/>\n\u9664\u5916\u57fa\u6e96\uff1a\u6162\u6027\u814e\u4e0d\u5168\u3001\u514d\u75ab\u4e0d\u5168\uff08\u7d4c\u53e3\u30b9\u30c6\u30ed\u30a4\u30c9\u306e\u9577\u671f\u4f7f\u7528\u3001\u5316\u5b66\u7642\u6cd5\u3001\u514d\u75ab\u75be\u60a3\uff09\u3001\u533b\u5e2b\u306e\u5224\u65ad\u3067\u6297\u30a6\u30a4\u30eb\u30b9\u85ac\u3092\u3059\u3050\u306b\u958b\u59cb\u3057\u305f\u307b\u3046\u304c\u826f\u3044\u3042\u308b\u3044\u306f\u5165\u9662\u304c\u5fc5\u8981\u3068\u5224\u65ad\u3055\u308c\u305f\u4eba\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u30fb\u30a2\u30ec\u30eb\u30ae\u30fc\u30012\u9031\u9593\u4ee5\u5185\u306b\u9078\u629e\u7684\u5916\u79d1\u624b\u8853\u306a\u3069\u5168\u8eab\u9ebb\u9154\u3092\u5fc5\u8981\u3068\u3059\u308b\u4eba\u3001\u4f59\u547d6\u30f6\u6708\u4ee5\u5185\u306e\u4eba\u3001\u91cd\u7be4\u306a\u809d\u969c\u5bb3\u3001\u767a\u75c7\u5f8c72\u6642\u9593\u4ee5\u5185\u306b\u30e9\u30f3\u30c0\u30e0\u5316\u5272\u4ed8\u304c\u3067\u304d\u306a\u3044\u4eba\u30017\u65e5\u4ee5\u5185\u306b\u30ef\u30af\u30c1\u30f3\u6442\u53d6\u304c\u5fc5\u8981\u306a\u4eba\u3001\uff08\u4e00\u90e8\u306e\u5730\u57df\u3067\u306f\uff09\u598a\u5a66\u3001\u6388\u4e73\u5a66<br \/>\nPrimary Outcome: \u56de\u5fa9\u307e\u3067\u306e\u6642\u9593\uff1d\u65e5\u5e38\u751f\u6d3b\u3078\u306e\u5fa9\u5e30\u3001\u767a\u71b1\u3001\u982d\u75db\u3001\u7b4b\u8089\u75db\u304cminor or no problem\u3068\u8a55\u4fa1\u3055\u308c\u308b<br \/>\n\u3000\u203b\u3057\u3083\u3079\u308c\u306a\u3044\u5c0f\u5150\u306e\u5834\u5408\u306f\u3001\u982d\u75db\u3084\u7b4b\u8089\u75db\u306e\u4ee3\u308f\u308a\u306b\u4f9d\u5b58\u7684(clinginess)\u3067\u3042\u308b\u304b\u3069\u3046\u304b\u3067\u8a55\u4fa1\u3055\u308c\u308b<br \/>\nSecondary Outcome: \u8cbb\u7528\u5bfe\u52b9\u679c\uff1d\u5165\u9662\u306e\u767a\u751f\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306b\u95a2\u9023\u3059\u308b\u5408\u4f75\u75c7\u3001\u533b\u7642\u6a5f\u95a2\u3078\u306e\u518d\u8a3a\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306e\u5bdb\u89e3\u307e\u3067\u306e\u6642\u9593\u3001\u65b0\u305f\u306a\u3042\u308b\u3044\u306f\u5897\u60aa\u3059\u308b\u75c7\u72b6\u306e\u51fa\u73fe\u3001\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u304c\u6700\u521d\u306b\u8efd\u6e1b\u3059\u308b\u307e\u3067\u306e\u6642\u9593\u3001\u6297\u83cc\u85ac\u3092\u542b\u3080\u85ac\u5264\u306e\u4f7f\u7528\u3001\u5bb6\u5ead\u5185\u3067\u306e\u611f\u67d3\u4f1d\u64ad\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306e\u75c7\u72b6\u306e\u81ea\u5df1\u7ba1\u7406<\/p>\n<p>Results:<br \/>\n\u30fb\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u306e\u6d41\u884c\u671f 3\u30b7\u30fc\u30ba\u30f3(2016\u5e741\u670815\u65e5\u304b\u30892018\u5e744\u670812\u65e5\u307e\u3067)<br \/>\n\u30fb\u30e8\u30fc\u30ed\u30c3\u30d115\u30f5\u56fd\u3001209\u306eprimary care practice\u304c\u53c2\u52a0<br \/>\nFigure 1: Study profile<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff11.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff11-300x232.png\" alt=\"JC\u307f\u304d\uff11\" width=\"300\" height=\"232\" class=\"alignnone size-medium wp-image-1936\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff11-300x232.png 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff11-1024x793.png 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u30fb\u30b7\u30fc\u30ba\u30f3\u9593\u3001\u30b0\u30eb\u30fc\u30d7\u9593\u3067\u80cc\u666f\u306b\u5dee\u306f\u306a\u3044[Table 1]<br \/>\n\u3010Primary outcome\u3011<br \/>\n\u30fbUsual care group\u306e\u56de\u5fa9\u307e\u3067\u306e\u6642\u9593\u306f6.73\u65e5\u9593(95% Bayesian credible interval[BCrI] 6.50-6.96)[Figure 2]<br \/>\n\u30fbUsual care plus oseltamivir group\u306e\u56de\u5fa9\u307e\u3067\u306e\u6642\u9593\u306f5.71\u65e5\u9593<br \/>\n\u30fbOseltamivir\u306b\u3088\u308b\u77ed\u7e2e\u52b9\u679c\u306f1.02\u65e5\u9593(BCrI 0.74-1.31)[Figure 3]<br \/>\n\u30fb12\u6b73\u4ee5\u4e0b\u3001\u4f75\u5b58\u75c7\u306a\u3057\u3001\u8efd\u75c7\u3001\u767a\u75c7\u5f8c48\u6642\u9593\u4ee5\u5185\u306e\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u3067\u306f\u30010.70\u65e5\u9593(BCrI 0.30-1.20)\u77ed\u7e2e<br \/>\n\u30fb65\u6b73\u4ee5\u4e0a\u3001\u4f75\u5b58\u75c7\u3042\u308a\u3001\u4e2d\u7b49\u75c7\u304b\u3089\u91cd\u75c7\u3001\u767a\u75c7\u5f8c48\u6642\u9593\u4ee5\u4e0a\u306e\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u3067\u306f\u30012.3-3.2\u65e5\u9593\u77ed\u7e2e\uff08\u901a\u5e38\u306f11\u221213\u65e5\u9593\uff09<br \/>\n\u2192\u9ad8\u9f62\u3001\u4f75\u5b58\u75c7\u3042\u308a\u3001\u91cd\u75c7\u5ea6\u304c\u9ad8\u3044\u300148\u6642\u9593\u4ee5\u4e0a\u306e\u5834\u5408\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306b\u3088\u308b\u52b9\u679c\u304c\u9ad8\u3044\u3002<br \/>\nFigure 2: Estimated mean days to recovery for all subgroups in the usual care intention-to-treat population<\/p>\n<p><a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff12.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff12-300x233.jpg\" alt=\"JC\u307f\u304d\uff12\" width=\"300\" height=\"233\" class=\"alignnone size-medium wp-image-1937\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff12-300x233.jpg 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff12-1024x795.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Figure 3: Estimated mean days of oseltamivir benefit for all subgroups in the intention-to-treat population<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff13.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff13-300x231.jpg\" alt=\"JC\u307f\u304d\uff13\" width=\"300\" height=\"231\" class=\"alignnone size-medium wp-image-1938\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff13-300x231.jpg 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff13-1024x787.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>Figure 4: Modelled oseltamivir benefit by influenza status in the intention-to-treat population<br \/>\n<a href=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff14.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff14-300x75.jpg\" alt=\"JC\u307f\u304d\uff14\" width=\"300\" height=\"75\" class=\"alignnone size-medium wp-image-1939\" srcset=\"https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff14-300x75.jpg 300w, https:\/\/www.hcfm.jp\/journal\/wp-content\/uploads\/2020\/07\/JC\u307f\u304d\uff14-1024x255.jpg 1024w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<p>\u3010Secondary outcome\u3011[table 2]<br \/>\n\u30fb\u533b\u7642\u6a5f\u95a2\u3078\u306e\u518d\u8a3a\u3001\u5165\u9662\u3001\u80ba\u708e\u306e\u5408\u4f75\u3001\u30a2\u30bb\u30c8\u30a2\u30df\u30ce\u30d5\u30a7\u30f3\u3082\u3057\u304f\u306f\u30a4\u30d6\u30d7\u30ed\u30d5\u30a7\u30f3\u3092\u542b\u3080\u5e02\u8ca9\u85ac\u306e\u4f7f\u7528\u306f\u4e21\u7fa4\u3067\u6709\u610f\u5dee\u306a\u3057\u3002<br \/>\n\u30fbUsual care plus oseltamivir group\u3067\u306f\u3001\u6297\u83cc\u85ac\u306e\u4f7f\u7528\u3068\u5bb6\u5ead\u5185\u3067\u306e\u611f\u67d3\u4f1d\u64ad\u304c\u5c11\u306a\u3044\u50be\u5411\u306b\u3042\u308a\u3001\u5614\u6c17\u30fb\u5614\u5410\u306e\u65b0\u305f\u306a\u767a\u751f\u306fusual care group\u3068\u6bd4\u8f03\u3057\u3066\u591a\u304f\u3001\u3088\u308a\u9577\u6642\u9593\u6301\u7d9a\u3057\u3066\u3044\u305f\u3002<\/p>\n<p>Discussion:<br \/>\n\u30fb\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u967d\u6027\u306e\u4eba\u3068\u3001\u9670\u6027\u306e\u4eba\u3068\u306e\u9593\u3067\u52b9\u679c\u306b\u5dee\u304c\u306a\u304b\u3063\u305f\u3002\u3082\u3063\u3068\u3044\u3046\u3068\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u967d\u6027\u306e\u4eba\u3068\u3001\u4ed6\u306e\u30a6\u30a4\u30eb\u30b9\u306b\u967d\u6027\u3060\u3063\u305f\u4eba\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6A\u306e\u4eba\u3068B\u306e\u4eba\u3067\u3082\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u3002\u3053\u308c\u307e\u3067\u306e\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u69d8\u75be\u60a3\u306b\u5bfe\u3059\u308b\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3068\u30d7\u30e9\u30bb\u30dc\u3092\u6bd4\u8f03\u3057\u305f\u7814\u7a76\u3067\u306f\u3001\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u3068\u78ba\u5b9a\u3057\u305f\u4eba\u3068\u305d\u3046\u3067\u306a\u3044\u4eba\u3092\u6bd4\u8f03\u3057\u305f\u5834\u5408\u3001\u81e8\u5e8a\u7684\u306b\u6709\u610f\u3067\u306f\u306a\u3044\u304c\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u3092\u4f7f\u7528\u3057\u305f\u65b9\u304c\u75c7\u72b6\u6301\u7d9a\u6642\u9593\u306f5\u6642\u9593\u77ed\u304b\u3063\u305f\u3068\u3055\u308c\u3066\u3044\u308b\u3002\u4eca\u56de\u306e\u7814\u7a76\u3067\u306f\u75c7\u72b6\u65e5\u8a8c\u30921\u65e51\u56de\u306e\u307f\u8a18\u9332\u3057\u3066\u3082\u3089\u3063\u3066\u3044\u305f\u305f\u3081\u3001\u5c0f\u3055\u306a\u5dee\u3092\u691c\u51fa\u3067\u304d\u306a\u304b\u3063\u305f\u53ef\u80fd\u6027\u304c\u3042\u308b\u3002\u307e\u305f\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306e\u4f5c\u7528\u6a5f\u5e8f\u3068\u3057\u3066\u3088\u308a\u5e83\u7bc4\u306a\u30a6\u30a4\u30eb\u30b9\u3078\u306e\u52b9\u679c\u304c\u3042\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3002\u3042\u308b\u3044\u306f\u691c\u67fb\u306e\u611f\u5ea6\u3084\u624b\u6280\u306e\u554f\u984c\u304b\u3082\u3057\u308c\u306a\u3044\u3002<br \/>\n\u30fb\u30d7\u30e9\u30bb\u30dc\u3068\u6bd4\u8f03\u3057\u306a\u3044\u30c7\u30b6\u30a4\u30f3\u306b\u3057\u305f\u305f\u3081\u3001\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u304c\u3069\u306e\u7a0b\u5ea6\u7d50\u679c\u306b\u5bc4\u4e0e\u3057\u305f\u306e\u304b\u3001\u4ed6\u306e\u5f71\u97ff\u304c\u3042\u3063\u305f\u306e\u304b\u306f\u308f\u304b\u3089\u306a\u3044\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u30112020\u5e747\u67081\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat&#8217;s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 -\u6587\u732e\u540d- Christopher C Butler, et al.  &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=1935\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u767a\u75c7\u5f8c48\u6642\u9593\u4ee5\u4e0a\u7d4c\u904e\u3057\u3066\u3044\u3066\u3082\u30aa\u30bb\u30eb\u30bf\u30df\u30d3\u30eb\u306b\u3088\u308b\u6cbb\u7642\u306f\u3001\u5b63\u7bc0\u6027\u30a4\u30f3\u30d5\u30eb\u30a8\u30f3\u30b6\u306e\u75c7\u72b6\u6301\u7d9a\u6642\u9593\u3092\u6e1b\u5c11\u3055\u305b\u308b<\/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":[33,17],"tags":[],"class_list":["post-1935","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1935","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=1935"}],"version-history":[{"count":2,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1935\/revisions"}],"predecessor-version":[{"id":1941,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/1935\/revisions\/1941"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1935"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1935"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1935"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}