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2017/4/23

Jikei Clinical Research Program for Primary-care


EBM
GPMEC 2017422

RSS

EBM


MNA-SF UpToDate





dr.kenta.sato@gmail.com

EBM GPMEC EBM


GPMEC3
No !! EBM
Yes

GPMEC

62

/ 70
60

EBM 30

1
2017/4/23



UpToDate



Pubmed
EBM

Pubmed

SRRCT

SR Systematic review
RCTRandomized control trial

2
2017/4/23




EBM

Pubmed
or

SRRCT

EBM



BPS PCCM EBM


Bio-Medical Disease M
VBM

Psycho Illness/Narrative P EBM

Social Context C






BPS
Relationship
http://www.asahi.com/articles/photo/AS20160126002878.html

3
2017/4/23



EBM System
CHADS-VAScBODE/GOLD
EBM

Summaries UpToDate, Dynamed


PIER(ACP), Clinical Evidence(BMJ)
OK
Pubmed Synopses of syntheses ACP Journal ClubACP
Evidence Based MedicineBMJ
!! Syntheses Cochrane Library
ACP JournalWise, EvidenceUpdates(BMJ)

Synopses of Studies ACP JournalWise, EvidenceUpdates(BMJ)

SRRCT Journal WatchNEJM


Studies PubMed, Google scholar

p2-9 Evidence Based Medicine







http://search.ebscohost.com/
login.aspx?authtype=cpid&custid
=ns080355&lang=ja http://www.ebsco.co.jp/medical
/dynamed/supports/dm_mobileapp.pdf
kich+IDaz

4
2017/4/23

2


Background questions Foreground questions

Simple UTI
Background questions
Complicated DKAAKI

Foreground questions

Complex DM


The SPELL EBM
Chaotic Watchful waiting https://www.slideshare.net/enango/pico-questions20030608-29575030



Background question
EBM


Pubmed PubMedGoogle


Foreground

UpToDateDynamed SRRCT


EBM
!!!
PubMed

5
2017/4/23

SRRCT Best Available Evidence




Efficacy





Effectiveness




Translational 2 researchT2 research
Comparative Effectiveness researchCER

T2DMU40
MNA-SF 2017/04/23
http://www.dogactually.net/blog/2014/09/1-27.html






DOE:Disease Oriented POEM:Patient Oriented SRRCT
Evidence Evidence that Matters
LDL HbA1c
ADL QOL Background
AMIPVC AMIACE
The SPELL
LDL BG
HbA1c http://spell.umin.jp/EBM_materials_BTS.html

6
2017/4/23





Background or Foreground ?
Simple or Complicated or Complex or Chaotic ?
or ?









UpToDateDynamed
PubMe


SRRCTCohortetc.
POEM or DOE ?



QOL




EMR


NSAIDs


g




7
2017/4/23

Step Beyond Resident



EBMin


RSS

E-mail Alert


Foreground question Research question


web
PI


GPMEC
Research question JPCA

8
2017/4/23

by

EBM The SPELL by
web
by web


EBM// by
13
by

5



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