Annals of Clinical Epidemiology
Online ISSN : 2434-4338
Volume 5, Issue 1
Displaying 1-4 of 4 articles from this issue
SEMINAR
  • Takaaki Konishi, Hideo Yasunaga
    Article type: SEMINAR
    2023 Volume 5 Issue 1 Pages 1-4
    Published: 2023
    Released on J-STAGE: January 11, 2023
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    Health technology assessment (HTA) is implemented in the decision-making process for the reimbursement and pricing of drugs and medical devices around the world. This study presented the trend and characteristics of HTA research in Japan and worldwide. HTA research increased since the 2010s. Cancer was a prominent subject and the Markov model was a major analytical model in HTA research both globally and in Japan. In Japan, osteoporosis was a more popular topic, but there were fewer surgical research and review articles compared to the global trend. Since Japanese articles on HTA were much fewer than those from the United States, the United Kingdom, and China, various types of HTA research should be encouraged in Japan to promote product innovation and optimize medical expenditures.

ORIGINAL ARTICLE
  • Masato Takeuchi, Shoichiro Inokuchi, Takeshi Kimura, Narumi Eguchi, Ko ...
    Article type: ORIGINAL ARTICLE
    2023 Volume 5 Issue 1 Pages 5-12
    Published: 2023
    Released on J-STAGE: January 11, 2023
    Advance online publication: September 29, 2022
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    Supplementary material

    BACKGROUND

    Epidemiological data are essential for developing strategies against the current coronavirus disease 2019 (COVID-19) pandemic. Data on COVID-19 epidemiology in Japan are limited owing to a focus on specific regions and patient groups, particularly in the early phase of the pandemic.

    METHODS

    We investigated COVID-19 epidemiology in Japan in 2020 using a large nationwide multihospital database containing insurance claim records and medical records. Inclusion criteria were inpatient and outpatient referrals for COVID-19 in 2020. We analyzed demographic data, comorbidities, drug use, severe COVID-19 risk, and clinical course of hospitalized patients (including death).

    RESULTS

    We identified 11,868 COVID-19 cases from 56 institutions: 6,440 outpatients and 5,428 inpatients. Of the patients, 53.2% had comorbid conditions, the most common of which was tumor (22.1%), and 56.4% were classed as having a high risk of COVID-19. Pharmacological management patterns were generally consistent between the first and second half of 2020, except for glucocorticoid use. The use of unauthorized medications (hydroxychloroquine, ivermectin, and favipiravir) was infrequent. For hospitalized patients, the median length of stay was 10 days, and 2.4% of patients were admitted to intensive care units. Post-COVID-19 all-cause mortality, all-cause 30-day mortality, and in-hospital deaths were recorded for 7.9%, 5.4%, and 4.6% of patients, respectively. Patients with high-risk conditions had a lower survival probability.

    CONCLUSIONS

    This descriptive study of COVID-19 in 2020 identified differences in care across outpatient and inpatient settings and changes in care delivery as the pandemic progressed. These findings could inform strategies for future infectious disease pandemics.

  • Shunichi Fukuhara, Hajime Yamazaki, Takafumi Wakita, John E. Ware Jr., ...
    Article type: ORIGINAL ARTICLE
    2023 Volume 5 Issue 1 Pages 13-19
    Published: 2023
    Released on J-STAGE: January 11, 2023
    Advance online publication: September 29, 2022
    JOURNAL OPEN ACCESS FULL-TEXT HTML

    BACKGROUND

    To prepare for a longitudinal study of the effects of potassium-lowering treatment on quality of life (QOL), we quantified the validity of a new disease-specific instrument for measuring QOL, using data from patients who had hyperkalemia (HK) due to chronic kidney disease (CKD) or chronic heart failure, and were also being treated with potassium binders (PBs).

    METHODS

    In this cross-sectional study, the participants were 98 patients at five outpatient clinics in Japan. The outcome measures were the Medical Outcomes Study 36-item short-form (SF-36), a widely used generic measure of QOL, and the Quality of Life Disease-specific Impact Scale (QDIS-7), a recently-developed disease-specific measure of QOL. Internal-consistency reliability was quantified, and factor analysis was done to confirm hypothesized QOL dimensions. Validation tests used two external criteria: CKD stage, and PB formulation. PB formulation was used because different formulations are associated with different degrees of patients’ burden. Using a previously-described method, we computed the relative validity (RV) of the two measures.

    RESULTS

    Two factor scoring of the SF-36 and one factor scoring of the QDIS-7, as standardized from previous studies, were confirmed. The RVs showed that the QDIS-7 was much more valid than the SF-36, for discriminating between groups defined clinically (by CKD stage), and also between groups defined by PB formulation. Reliability was satisfactory: 0.73–0.95 for the SF-36 and 0.86 for the QDIS-7.

    CONCLUSIONS

    The QDIS-7 with CKD or PB attributions was more valid than the SF-36 for measuring the effects of CKD and of PB formulation on QOL.

  • Michimasa Fujiogi, Takaaki Konishi, Nobuaki Michihata, Yohei Hashimoto ...
    Article type: ORIGINAL ARTICLE
    2023 Volume 5 Issue 1 Pages 20-29
    Published: 2023
    Released on J-STAGE: January 11, 2023
    Advance online publication: September 29, 2022
    JOURNAL OPEN ACCESS FULL-TEXT HTML
    Supplementary material

    BACKGROUND

    Little is known about perioperative outcomes after pediatric thyroidectomy. This study was performed to compare perioperative outcomes between children and adults undergoing thyroid cancer surgery using a nationwide inpatient database in Japan.

    METHODS

    Using the Japanese Diagnosis Procedure Combination database, we identified patients aged 0 to 40 years with thyroid cancer who underwent thyroidectomy from July 2010 to March 2020. To compare the occurrence of in-hospital morbidities including local complications (e.g., recurrent laryngeal nerve paralysis, postoperative bleeding), duration of anesthesia, postoperative length of stay, and total hospitalization costs between children (0–18 years) and adults (19–40 years), we used multivariable logistic regression analysis for the occurrence of in-hospital morbidities and linear regression for other outcomes.

    RESULTS

    For 16,016 eligible patients (666 children vs. 15,350 adults), no significant differences between the two groups were found in any in-hospital morbidity (5.4% vs. 5.9%; adjusted odds ratio [OR], 0.80; 95% confidence interval [CI], 0.57–1.14; P = 0.23), local complications (5.0% vs. 5.5%; OR, 0.80; 95% CI, 0.55–1.15; P = 0.22), recurrent laryngeal nerve paralysis (2.1% vs. 2.4%; OR, 0.78; 95% CI, 0.45–1.35; P = 0.37), or postoperative bleeding (1.7% vs. 1.4%; OR, 0.99; 95% CI, 0.53–1.87; P = 0.98). Children showed a longer duration of anesthesia (difference, 20 minutes; 95% CI, 13–27; P < 0.001) and higher total costs (difference, 445 US dollars; 95% CI, 239–651; P < 0.001) than adults.

    CONCLUSION

    This large nationwide cohort study showed no significant difference in perioperative complications between children and adults undergoing thyroid cancer surgery.

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