{"id":943,"date":"2015-12-03T10:25:55","date_gmt":"2015-12-03T01:25:55","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=943"},"modified":"2015-12-03T10:25:55","modified_gmt":"2015-12-03T01:25:55","slug":"%e3%80%90ebm%e3%81%ae%e5%ad%a6%e3%81%b3%e3%80%91%e8%84%82%e8%b3%aa%e7%95%b0%e5%b8%b8%e7%97%87%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b%e3%82%b9%e3%82%bf%e3%83%81%e3%83%b3","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=943","title":{"rendered":"\u3010EBM\u306e\u5b66\u3073\u3011\u8102\u8cea\u7570\u5e38\u75c7\u306b\u5bfe\u3059\u308b\u30b9\u30bf\u30c1\u30f3"},"content":{"rendered":"<p><strong>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO<\/strong><br \/>\n\u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011<br \/>\n2015\u5e749\u670828\u65e5<br \/>\n\u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011<br \/>\n5\u5e74\u3076\u308a\u306e\u5e02\u6c11\u5065\u8a3a\u3067LDL203,T.Chol270\u3092\u6307\u6458\u3055\u308c\u305f65\u6b73\u5973\u6027\u3002\u7279\u306b\u5927\u304d\u306a\u65e2\u5f80\u3082\u306a\u304f\u30011\u65e540\u5206\u7a0b\u5ea6\u6563\u6b69\u3059\u308b\u306a\u3069\u5065\u5eb7\u306b\u306f\u6c17\u3092\u3064\u3051\u3066\u3044\u308b\u65b9\u3068\u3044\u3046\u81ea\u8ca0\u306e\u3042\u308b\u65b9\u30025\u5e74\u524d\u306e\u5065\u8a3a\u3067\u306f\u7279\u8a18\u4e8b\u9805\u306a\u3057\u3002\u5144\u5f1f\u3067\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u306e\u85ac\u3092\u98f2\u3093\u3067\u3044\u308b\u4eba\u304c\u3044\u305f\u305f\u3081\u3001\u81ea\u5206\u3082\u3064\u3044\u306b\u85ac\u3092\u98f2\u307e\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u304b\u3068\u4e0d\u5b89\u306b\u601d\u3044\u306a\u304c\u3089\u5c0f\u751f\u5916\u6765\u53d7\u8a3a\u3068\u306a\u3063\u305f\u3002\u8a3a\u5bdf\u4e0a\u9ec4\u8272\u816b\u3084\u9ec4\u75b8\u3001\u7532\u72b6\u817a\u816b\u5927\u306a\u3069\u8a8d\u3081\u305a\u3001\u8840\u7cd6\u3001\u814e\u30fb\u809d\u6a5f\u80fd\u3001\u7532\u72b6\u817a\u6a5f\u80fd\u306b\u3082\u5927\u304d\u306a\u7570\u5e38\u3092\u8a8d\u3081\u306a\u304b\u3063\u305f\u3002\u55ab\u7159\u306a\u3057\u3000\u98f2\u9152\u306a\u3057\u3000\u5bb6\u65cf\u6b74\u3000\u7236\uff1b\u98df\u9053\u764c\u3000\u6bcd\uff1b\u5fc3\u4e0d\u5168\u3001\u30da\u30fc\u30b9\u30e1\u30fc\u30ab\u30fc\u7559\u7f6e\u5f8c\u3002\u300c\u6295\u85ac\u305b\u305a\u306b\u7d4c\u904e\u3092\u307f\u308b\u75c7\u4f8b\u300d\u3068\u8003\u3048\u305f\u304c\u3001\u4eca\u56de\u4e00\u6b21\u6587\u732e\u306b\u9061\u308a\u6587\u732e\u4e0a\u306e\u541f\u5473\u3092\u7d4c\u305f\u610f\u601d\u6c7a\u5b9a\u3092\u884c\u3046\u3053\u3068\u306b\u3057\u305f\u3002<br \/>\nP\uff1b\u5fc3\u8840\u7ba1\u7cfb\u30a4\u30d9\u30f3\u30c8\u306e\u65e2\u5f80\u306e\u306a\u3044\u9ad8\u9f62\u5973\u6027<br \/>\nI(E)\uff1b\u30b9\u30bf\u30c1\u30f3\u6295\u4e0e\u7fa4<br \/>\nC\uff1b\u30d7\u30e9\u30bc\u30dc\u6295\u4e0e\u7fa4\u3068\u6bd4\u8f03\u3057\u3066<br \/>\nO\uff1b\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u767a\u751f\u7387\u306b\u5dee\u304c\u51fa\u308b\u304b<\/p>\n<p><strong>STEP2\u3000\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\u6587\u732e\u306e\u540d\u524d<\/strong><br \/>\n\u3010\u898b\u3064\u3051\u305f\u8ad6\u6587\u3011<br \/>\nPrimary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet. 2006 Sep 30;368(9542):1155-63.<\/p>\n<p><strong>STEP3\u3000\u8ad6\u6587\u306e\u8a55\u4fa1<br \/>\nSTEP3-1\u3000\u8ad6\u6587\u306ePECO\u306f\u60a3\u8005\u306ePECO\u3068\u5408\u81f4\u3059\u308b\u304b\uff1f<\/strong><br \/>\nP\uff1b\u51a0\u52d5\u8108\u75be\u60a3\u65e2\u5f80\u306e\u306a\u3044\u8efd\uff5e\u4e2d\u7b49\u5ea6\uff08\u7dcf\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u5024220\uff5e270mg\/dL\uff09\u306e\u9ad8\u8102\u8840\u75c7\u60a3\u8005<br \/>\nI\uff1b\u98df\u4e8b\u7642\u6cd5\uff0b\u30d7\u30e9\u30d0\u30b9\u30bf\u30c1\u30f3\uff0810\uff5e20mg\/\u65e5\uff09\u7fa4<br \/>\nC\uff1b\u98df\u4e8b\u7642\u6cd5\u5358\u72ec\u7fa4<br \/>\nO\uff1b\u51a0\u52d5\u8108\u75be\u60a3\u306e\u767a\u75c7\u306b\u5dee\u304c\u51fa\u308b\u304b<br \/>\n\u2192\u60a3\u8005\u306ePECO\u3068\u3000(\u5408\u81f4\u3059\u308b\u3000\u30fb\u3000<strong>\u591a\u5c11\u7570\u306a\u308b\u304cOK<\/strong>\u3000\u30fb\u3000\u5927\u304d\u304f\u7570\u306a\u308b\u305f\u3081\u4e0d\u9069\u5207)<\/p>\n<p><strong>STEP3-2\u8ad6\u6587\u306e\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306e\u8a55\u4fa1\uff1b\u5185\u7684\u59a5\u5f53\u6027\u306e\u8a55\u4fa1<\/strong><br \/>\n\u2460\u7814\u7a76\u65b9\u6cd5\u304cRCT\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f\u96a0\u853d\u5316\u3068\u76f2\u691c\u5316\u306f\u3055\u308c\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u2192\u30e9\u30f3\u30c0\u30e0\u5272\u308a\u4ed8\u3051\u304c\u3000\uff08\u3000<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u2192\u96a0\u853d\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u2192\u76f2\u691c\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000\u3055\u308c\u3066\u3044\u308b\u3000\u30fb\u3000\u3000<strong>\u3055\u308c\u3066\u3044\u306a\u3044<\/strong>\u3000\uff09\u2190\u4e0d\u5b8c\u5168<br \/>\n\u5b9f\u969b\u306eT able\u3067\u4ecb\u5165\u7fa4\u3068\u5bfe\u7167\u7fa4\u306f\u540c\u3058\u3088\u3046\u306a\u96c6\u56e3\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f<br \/>\n\u2192\uff08\u3000<strong>\u306a\u3063\u3066\u3044\u308b<\/strong>\u3000\u30fb\u3000\u306a\u3063\u3066\u3044\u306a\u3044\u3000\uff09<br \/>\n\u2461\u89e3\u6790\u65b9\u6cd5\u306fITT(intention to treat)\u304b\uff1f<br \/>\n\u2192ITT\u304c\u3000\uff08<strong>\u3055\u308c\u3066\u3044\u308b<\/strong>\u3000\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\uff09<\/p>\n<p><strong>STEP3-3\u3000\u8ad6\u6587\u3067\u898b\u3044\u3060\u3055\u308c\u305f\u7d50\u679c\u306e\u8a55\u4fa1<\/strong><br \/>\nOutcome\u306b\u3064\u3044\u3066\u3001\u4ee5\u4e0b\u306e\u5024\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u3010\u2460\u6cbb\u7642\u52b9\u679c\u306e\u6709\u7121\uff1b P\u5024\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u3000\u203bFigure1\u3092\u53c2\u7167\u3000(5.3\u5e74\u5f8c\u306e\u7d50\u679c)<br \/>\n\u3000\u3000\u25cfPrimary endpoints\u3067\u306f\u51a0\u52d5\u8108\u75be\u60a3\u3001\u5fc3\u7b4b\u6897\u585e\u3001\u51a0\u52d5\u8108\u518d\u6f45\u6d41\u8853<br \/>\n\u3000\u3000\u25cfSecondary endpoints\u3067\u306f\u51a0\u52d5\u8108\u75be\u60a3+\u8133\u6897\u585e\u3001\u5168\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8<br \/>\n\u3000\u3067P&lt;0.05\u3068\u306a\u308a\u6709\u610f\u5dee\u3042\u308a\u3002<br \/>\n\u3010\u2461\u6cbb\u7642\u52b9\u679c\u306e\u5927\u304d\u3055\uff1b\u6bd4\u306e\u6307\u6a19\u3068\u5dee\u306e\u6307\u6a19\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u3000\u3000\u30fb RR(\u3042\u308b\u3044\u306fHR\u30fbOR)\u3092\u78ba\u8a8d\u3059\u308b<br \/>\n\u3000\u3000\u30fbARR\u3068NNT\u3092\u8a08\u7b97\u3059\u308b<br \/>\n\u3000\u203bFigure2\u3092\u53c2\u7167<br \/>\n\u3000\u3000ARR=101\/3966-66\/3866=0.0084<br \/>\n\u3000\u3000NNT=1\/ARR=119(\u201cResults\u201d\u5185\u306b\u3082\u8a18\u8f09\u3042\u308a)<br \/>\n\u3010\u2462\u6cbb\u7642\u52b9\u679c\u306e\u3086\u3089\u304e\uff1b\u4fe1\u983c\u533a\u9593\u3092\u78ba\u8a8d\u3059\u308b\u3011<br \/>\n\u3000P\u5024\u3068\u540c\u69d8\u306e\u9805\u76ee\u3067\u6709\u610f\u5dee\u3042\u308a\u3002<br \/>\n\u3000(\u305f\u3060\u3057\u3001\u51a0\u52d5\u8108\u518d\u6f45\u6d41\u8853\u306e\u9805\u76ee\u4ee5\u5916\u306f\u304a\u304a\u3088\u305d0.5-0.9\u7a0b\u5ea6\u306b\u5165\u308a\u3001\u5e45\u306f\u5e83\u3044\u5370\u8c61\u3002)<\/p>\n<p><strong>STEP4\u3000\u60a3\u8005\u3078\u306e\u9069\u7528<\/strong><br \/>\n\u3010\u2460\u8ad6\u6587\u306e\u60a3\u8005\u3068\u3001\u76ee\u306e\u524d\u306e\u60a3\u8005\u304c\u3001\u7d50\u679c\u304c\u9069\u5fdc\u3067\u304d\u306a\u3044\u307b\u3069\u7570\u306a\u3063\u3066\u3044\u306a\u3044\u304b\uff1f\u3011<br \/>\n\u3000\u8ad6\u6587\u306e\u5bfe\u8c61\u8005(Table 1)\u306f\u5973\u6027\u306e\u5360\u6709\u7387\u304c70%\u3068\u9ad8\u304f\u3001\u5973\u6027\u306e\u55ab\u7159\u7387\u304c\u4f4e\u3044\u70b9\u3001\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u306e\u5e73\u5747\u5024\u306a\u3069\u306f\u4e00\u81f4\u3057\u3066\u3044\u308b\u3002\u4e00\u65b9\u3001\u5e74\u9f62\u304c\u5c11\u3057\u82e5\u3044\u70b9\u3084\u9ad8\u8840\u5727\u3084\u6295\u85ac\u4f8b\u304c40%\u5f31\u3092\u5360\u3081\u3066\u3044\u308b\u70b9\u306a\u3069\u306f\u82e5\u5e72\u7570\u306a\u308b\u3002<br \/>\n\u3000\u767b\u9332\u60a3\u8005\u306f\u5168\u3066\u75c5\u9662\u306e\u5916\u6765\u53d7\u8a3a\u60a3\u8005\u3067\u3042\u308b\u305f\u3081\u3001\u8a3a\u7642\u6240\u306e\u60a3\u8005\u3068\u306f\u80cc\u666f\u304c\u7570\u306a\u308b\u70b9\u3082\u3042\u308b\u304c\u3001\u4eca\u56de\u306e\u75c7\u4f8b\u306b\u306f\u9069\u7528\u53ef\u80fd\u306a\u70b9\u3082\u591a\u3044\u3068\u8003\u3048\u308b\u3002<br \/>\n\u3010\u2461\u6cbb\u7642\u305d\u306e\u3082\u306e\u306f\u5fe0\u5b9f\u306b\u5b9f\u884c\u53ef\u80fd\u304b\uff1f\u3011<br \/>\n\u3000\u6295\u85ac\u3057\u3066\u3044\u3066\u3082\u3001\u764c\u306e\u767a\u751f\u7387\u3084\u7dcf\u6b7b\u4ea1\u306b\u5dee\u304c\u306a\u3044\u3053\u3068\u3001(\u767a\u75c7\u3059\u308b\u3068\u81f4\u547d\u7387\u306e\u9ad8\u3044)\u6a2a\u7d0b\u7b4b\u878d\u89e3\u75c7\u306e\u767a\u751f\u304c\u30bc\u30ed\u306a\u306e\u306f\u30e1\u30ea\u30c3\u30c8\u3002<br \/>\n\u3000\u30e1\u30d0\u30ed\u30c1\u30f3\u306e\u85ac\u4fa1\u3082100\u70b9\u3092\u4e0b\u56de\u3063\u3066\u304a\u308a\u30b3\u30b9\u30c8\u9762\u3067\u3082\u554f\u984c\u306a\u3057\u3002<br \/>\n\u3010\u2463\u60a3\u8005\u306e\u8003\u3048\u30fb\u55dc\u597d\u306f\u3069\u3046\u306a\u306e\u304b\uff1f\u3011<br \/>\n\u3000\u60a3\u8005\u306f\u5065\u5eb7\u610f\u8b58\u306e\u9ad8\u3044\u65b9\u3067\u3042\u308a\u3001\u57fa\u672c\u7684\u306b\u306f\u300c\u85ac\u306b\u3088\u308b\u6cbb\u7642\u306f\u6700\u5f8c\u306e\u624b\u6bb5\u300d\u3068\u3044\u3046\u8a8d\u8b58\u304c\u3042\u308b\u65b9\u3060\u3063\u305f\u3002\u6bcd\u89aa\u306b\u5fc3\u75be\u60a3\u304c\u3042\u3063\u305f\u3053\u3068\u3082\u8003\u616e\u3057\u3001\u30b9\u30bf\u30c1\u30f3\u6295\u4e0e\u306b\u3088\u308b\u5fc3\u8840\u7ba1\u30a4\u30d9\u30f3\u30c8\u306eNNT\u3092\u8aac\u660e\u3057\u305f\u3068\u3053\u308d\u518d\u5ea6\u6295\u85ac\u5e0c\u671b\u306f\u3055\u308c\u306a\u304b\u3063\u305f\u3002\u4eca\u5f8c\u3082\u5b9a\u671f\u7684\u306b\u5065\u8a3a\u306f\u53d7\u3051\u3089\u308c\u308b\u4e88\u5b9a\u3067\u3042\u308a\u3001follow\u53ef\u80fd\u306a\u3053\u3068\u306f\u78ba\u8a8d\u3057\u3064\u3064\u3001\u6b21\u56de\u534a\u5e74\u5f8c\u306b\u518d\u5ea6\u30d5\u30a9\u30ed\u30fc\u3068\u3057\u305f\u3002<\/p>\n<p>\u3010\u958b\u50ac\u65e5\u3011<br \/>\n2015\u5e7410\u670814\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"<p>STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO \u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011 2015\u5e749\u670828\u65e5 \u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011 5\u5e74\u3076\u308a\u306e\u5e02\u6c11\u5065\u8a3a\u3067LDL203,T.Chol270\u3092\u6307\u6458\u3055\u308c\u305f65\u6b73\u5973\u6027\u3002\u7279\u306b\u5927\u304d\u306a\u65e2\u5f80\u3082\u306a\u304f\u30011\u65e540\u5206 &hellip; <a href=\"https:\/\/www.hcfm.jp\/journal\/?p=943\" class=\"more-link\">\u7d9a\u304d\u3092\u8aad\u3080 <span class=\"screen-reader-text\">\u3010EBM\u306e\u5b66\u3073\u3011\u8102\u8cea\u7570\u5e38\u75c7\u306b\u5bfe\u3059\u308b\u30b9\u30bf\u30c1\u30f3<\/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-943","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\/943","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=943"}],"version-history":[{"count":5,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/943\/revisions"}],"predecessor-version":[{"id":948,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/943\/revisions\/948"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=943"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=943"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=943"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}