原著
複数指標を用い同時に比較検討を行える新しい統計表示法NMatrixは腰部脊柱管狭窄症の治療同効薬の特性を明示し症例に最適な薬剤の簡便な選択を促す
2017 年 32 巻 1 号 p. 32-40
詳細
2017 年 32 巻 1 号 p. 32-40
Objective. It is often difficult to compare the characteristics of a medicine with those of others based on common standards, whereas the application of rational standards would be expected to facilitate the comparison of medicines with similar effects. The present study was conducted to clarify the characteristics of individual medicines and to examine whether rational standards allow the most appropriate medicines to be chosen.
Methods. Participants diagnosed with lumbar spinal stenosis (LSS)were assessed for QOL and ADL based on the Roland–Morris Disability Questionnaire,JOA score, VAS, and the presence of intermittent claudication (IC). Four medicines–beraprost sodium, ethyl icosapentate (EPA), sarpogrelate hydrochloride, and limaprost alfadex (PGE1), were prescribed in a random manner. These four medicines were assessed independently in four studies using the same study design and size in each case. Using the NMatrix, the characteristics of the four medicines and the results of mutual comparisons could be displayed concisely and clearly in one matrix based on significance levels. This work involved analyzing pooled data from the four studies.
Results. All four medicines improved IC–one of the characteristic symptoms of LSS–by 12 weeks after administration. PGE1 required more time than the other medicines to affect IC. EPA appeared to almost significantly ameliorate some items at every point, though the evidence was insufficient.
Conclusions. The NMatrix concisely and clearly displays the characteristics of “medicines with similar effects” for the treatment of lumbar spinal stenosis,and can help physicians to choose the optimal medicine based on rational criteria for individual patients, according to their symptoms and progress. The NMatrix functions as a powerful tool to clarify the estimation of values, according to the concept of Health Technology Assessement, Quality Adjusted Life Years, and personalized medicine. It is important to recognize the NMatrix not as a method of analyzing but as a method of presenting statistics.
