OBJECTIVE: To evaluate an undergraduate curriculum of communication skills by measuring satisfaction of outpatients whom final year students had examined.
METHODS: Cross-sectional surveys were conducted in General Medicine Clinic (GMC) of Saga Medical School (SMS) Hospital in 1999 and 2001. After the clinical clerkship in wards in fifth year, final year students experienced the two-week GMC clerkship, including seven hours of small group lecture in 1999, but partly converted into eight hours of small group discussion with a tutor in 2001. Six items in American Board of Internal Medicine Patient Satisfaction Questionnaire were selected as a validated instrument and incorporated into repeated measures ANOVA.
RESULTS: A total of 177 students were evaluated by 688 outpatients. Overall average score was 3.49+/-0.82. Average score in 2001 was significantly higher than that in 1999 (p<0.001; 3.58+ /-0.76vs 3.36+/-0.87) . The scores of“encouraging and answering questions”and“clear explanations”items were significantly lower than those of other items (3.21+/-0.98 and 3.37+/-0.92; Least Significant Difference) . The interaction between gender and years of curricula (1999 and 2001) was significant (p<0.001) ; female students showed remarkable improvement from 1999 to 2001 (Cohen's delta=0.67) .
CONCLUSIONS: Patient satisfaction scores indicated that undergraduate curriculum for communication skills in SMS improved from 1999 to 2001. Newly implemented small group discussion was a possible reason for the improvement, especially in female students. Further training for the skills of encouraging and answering questions and clear explanations will be the next step.

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BACKGROUND: Although structured abstracts are becoming common in English-language journals, little is known about papers written in languages other than English.
METHODS: To identify the percentages of reports of clinical trials with structured abstracts that are written in languages other than English, we used the PubMed to retrieve clinical trial reports written in seven languages other than English from 1987 to 2001.
RESULTS: A total of 23, 075 reports of clinical trials written in seven languages other than English were identified. Of the 18, 278 reports that included abstracts, the share of structured abstracts in each language was as follows (entire period and 1999-2001 in parenthesis) : German, 17.3% (48.2%) ; French, 16.1% (45.1%) ; Italian, 21.3% (76.3%) ; Spanish, 44.7% (74.9%) ; Russian, 4.9% (17.4%) ; Chinese, 21.3% (100%), and Japanese, 3.5% (10.4%) .
CONCLUSIONS: This study revealed that structured abstracts written in languages other than English have become popular, particularly since the late 1990s. However, the percentages of reports that include structured abstracts differ greatly among these languages.

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OBJECTIVE: To examine Japan's overall biomedical research productivity and its trend in the last decade.
METHODS: Articles published during 1991-2000 were accessed through Medline database. The number of articles having affiliation with a Japanese institution was elicited using standard search strategy.
RESULTS: In total 3.8 million articles were published during 1991-2000 while 330, 513 articles (8.7% of total) were originated from Japan. With language limited to English, there were 3.3 million articles in total and 252, 635 (7.6% of total) from Japan. Yearly numbers of articles significantly increased as a whole and also for Japan. The number of English-language articles from Japan increased by 63% during 2000 compared to 1991 while it was 34% on average for all other countries. On the other hand, the number of Japanese-language articles was 77, 878 with a 16.5% decrease in the same time.
CONCLUSION: The number of English-language articles originating from Japan has been increasing at a pace higher than that for all other countries together.

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In Japan, a government-funded project to develop evidence-based guidelines for the treatment of rheumatoid arthritis started in 1999. Methodologists, including epidemiologists and medical librarians, were asked to participate in this project. Working as a team, the rheumatologists, clinical epidemiologists, and medical librarians reviewed the published evidence systematically. The process and the results, particularly systematic search and review of literature, were assessed from the viewpoint of epidemiology and evidence-based medicine (EBM) . The librarians, supervised by the clinical epidemiologists, searched the literature according to 30 key questions defined by the rheumatologists and classified the articles according to the“level of evidence”. Finally, 379 articles were selected (drug therapy, 207; surgical treatment, 108; rehabilitation/devices, 64) . Meta-analyses and randomized controlled trials accounted for more than 80% of the drug treatment and rehabilitation/device reports, while nearly 70% of the articles retrieved regarding surgical treatment were case series without relevant control groups. The rheumatologists wrote structured abstracts for each article so that they could be used as reference for developing practice guidelines. The literature search, individual original articles, and the PubMed system were examined from the viewpoint of research methodology; the lessons learned were described.
In conclusions, clinical epidemiologists and medical librarians have contributed to developing evidence-based practice guidelines. Clinical epidemiologists were able to work as a coordinator between clinicians and medical librarians. The popularity of EBM requires that expertise in this field be strengthened and made available to a broader audience.

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