{"id":3651,"date":"2013-08-20T16:50:04","date_gmt":"2013-08-20T07:50:04","guid":{"rendered":"http:\/\/fujiitoshiki.com\/improvesociety\/?p=3651"},"modified":"2017-04-09T17:11:17","modified_gmt":"2017-04-09T08:11:17","slug":"post-3651","status":"publish","type":"post","link":"https:\/\/www.fujiitoshiki.com\/improvesociety\/?p=3651","title":{"rendered":"\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306e\u6709\u7121\u3092funnel plot\u306b\u3088\u308a\u78ba\u8a8d\u3059\u308b"},"content":{"rendered":"<div class=\"theContentWrap-ccc\"><p>\u3000\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3084\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3044\u3066\uff0c\u8907\u6570\u306e\u30b3\u30db\u30fc\u30c8\u8a66\u9a13\u3084\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u30c7\u30fc\u30bf\u3092\u7d71\u5408\u3057\u305f\u308a\u7d2f\u7a4d\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u884c\u3046\u306a\u3069\u3057\u3066\u3088\u308a\u7cbe\u5ea6\u306e\u9ad8\u3044\u89e3\u6790\u3092\u884c\u3044\u307e\u3059\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\u305d\u3053\u306b\u306f\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u3068\u3044\u3046\u504f\u308a\u3092\u907f\u3051\u308b\u4e8b\u306f\u3067\u304d\u307e\u305b\u3093\uff0e\u9670\u6027\u306e\u7d50\u679c\u306e\u51fa\u305f\u8a66\u9a13\uff0c\u7121\u52b9\u306e\u7d50\u679c\u306e\u51fa\u305f\u8a66\u9a13\u306a\u3069\u306f\u6295\u7a3f\u3055\u308c\u306b\u304f\u304f\uff0c\u63a1\u7528\u3055\u308c\u306b\u304f\u3044\u50be\u5411\u304c\u3042\u308b\u305f\u3081\u3067\u3059\uff0e\u4eee\u306b\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306e\u304b\u304b\u3063\u305f\u8ad6\u6587\u3070\u304b\u308a\u3067\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3084\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304c\u884c\u308f\u308c\u305f\u5834\u5408\uff0c\u8aa4\u3063\u305f\u6cbb\u7642\u6cd5\u304c\u9078\u629e\u3055\u308c\u308b\u5371\u967a\u6027\u304c\u9ad8\u307e\u308a\u307e\u3059\uff0efunnel plot \u306f\u305d\u306e\u3088\u3046\u306a\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u3092\u78ba\u8a8d\u3059\u308b\u305f\u3081\u306e\u65b9\u6cd5\u3067\u3059\uff0e<\/p>\n<p>\u3000\u6a2a\u8ef8\u306b\u30aa\u30c3\u30ba\u6bd4\u3084\u76f8\u5bfe\u5371\u967a\u5ea6\uff0c\u30cf\u30b6\u30fc\u30c9\u6bd4\u306a\u3069\u3092\u53d6\u308a\uff0c\u7e26\u8ef8\u306b\u306f\u6a19\u6e96\u8aa4\u5dee\u306e\u9006\u6570\u3092\u53d6\u3063\u3066\u30d7\u30ed\u30c3\u30c8\u3057\u307e\u3059\uff0e\u6a19\u6e96\u8aa4\u5dee\u306f\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u306b\u4f9d\u5b58\u3059\u308b\u305f\u3081\uff0c\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u304c\u5927\u304d\u3044\u307b\u3069\u6a19\u6e96\u8aa4\u5dee\u306f\u5c0f\u3055\u304f\u306a\u308a\uff0c\u5f93\u3063\u3066\u305d\u306e\u9006\u6570\u306f\u5927\u304d\u304f\u306a\u308a\u307e\u3059\uff0e\u8907\u6570\u306e\u8a66\u9a13\u3092 funnel plot \u306b\u30d7\u30ed\u30c3\u30c8\u3059\u308b\u3068\uff0c\u7406\u60f3\u7684\u306a\u72b6\u614b\u3067\u306f\u6f0f\u6597\u3092\u3072\u3063\u304f\u308a\u8fd4\u3057\u305f\u3088\u3046\u306a\u5de6\u53f3\u5bfe\u79f0\u306e\u5f62\u306b\u306a\u308a\u307e\u3059\uff0e\u3057\u304b\u3057\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u304c\u5b58\u5728\u3059\u308b\u5834\u5408\u306f\u3044\u305a\u308c\u304b\u7247\u65b9\u304c\u3059\u3063\u307d\u308a\u629c\u3051\u843d\u3061\u305f\u5f62\u306b\u306a\u308a\u307e\u3059\uff0e<\/p>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u3092\u63cf\u304f\u306b\u306f\u6a19\u6e96\u8aa4\u5dee\u3092\u6c42\u3081\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u304c\uff0c\u52b9\u679c\u91cf\u306e\u70b9\u63a8\u5b9a\u5024\u304a\u3088\u3073\u305d\u306e 95 % \u4fe1\u983c\u533a\u9593\u304c\u5206\u304b\u3063\u3066\u3044\u308b\u5834\u5408\uff0c\u5927\u62b5\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3084\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u306f\u63b2\u8f09\u3055\u308c\u3066\u3044\u308b\u3082\u306e\u3067\u3059\u304c\uff0c\u4e0b\u8a18\u306e\u8a08\u7b97\u3067\u6a19\u6e96\u8aa4\u5dee\u3092\u6c42\u3081\u308b\u3053\u3068\u304c\u3067\u304d\u307e\u3059\uff0e<\/p>\n<p><img src='https:\/\/s0.wp.com\/latex.php?latex=%5Cdisplaystyle+%5Cmathrm%7B95%5C%25CI%7D+%3D+Exp%28LN%28%5Cmathrm%7BES%7D%29%5Cpm1.96%5Ctimes%5Cmathrm%7BSE%7D%29%5C%5C++%5Cmathrm%7BSE%7D%3D%5Cfrac%7BLN%28%5Cmathrm%7BES%7D%2F%5Cmathrm%7B95%5C%25LL%7D%29%7D%7B1.96%7D%3D%5Cfrac%7BLN%28%5Cmathrm%7B95%5C%25UL%7D%2F%5Cmathrm%7BES%7D%29%7D%7B1.96%7D&#038;bg=T&#038;fg=000000&#038;s=0' alt='\\displaystyle \\mathrm{95\\%CI} = Exp(LN(\\mathrm{ES})\\pm1.96\\times\\mathrm{SE})\\\\  \\mathrm{SE}=\\frac{LN(\\mathrm{ES}\/\\mathrm{95\\%LL})}{1.96}=\\frac{LN(\\mathrm{95\\%UL}\/\\mathrm{ES})}{1.96}' title='\\displaystyle \\mathrm{95\\%CI} = Exp(LN(\\mathrm{ES})\\pm1.96\\times\\mathrm{SE})\\\\  \\mathrm{SE}=\\frac{LN(\\mathrm{ES}\/\\mathrm{95\\%LL})}{1.96}=\\frac{LN(\\mathrm{95\\%UL}\/\\mathrm{ES})}{1.96}' class='latex' \/><\/p>\n<p>ES: effect size, SE: standard error, 95%CI: 95 % confidence interval, 95%LL: 95 % Lower Limit, 95%UL: 95 % Upper Limit<\/p>\n<p>References:<br \/>\n<a href=\"\/\/www.bmj.com\/content\/315\/7109\/629?view=long&#038;pmid=9310563\" title=\"Bias in meta-analysis detected by a simple, graphical test\" target=\"_blank\">Bias in meta-analysis detected by a simple, graphical test<\/a> <a href=\"\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2127453\/pdf\/9310563.pdf\" title=\"Bias in meta-analysis detected by a simple, graphical test.pdf\" target=\"_blank\">(pdf)<\/a><br \/>\n<a href=\"\/\/onlinelibrary.wiley.com\/doi\/10.1002\/sim.4780070807\/abstract\" title=\"A note on graphical presentation of estimated odds ratios from several clinical trials\" target=\"_blank\">A note on graphical presentation of estimated odds ratios from several clinical trials<\/a><br \/>\n<a href=\"\/\/en.wikipedia.org\/wiki\/Funnel_plot\" title=\"Funnel plot\" target=\"_blank\">Funnel plot (Wikipedia)<\/a><\/p>\n<h1>Bias in meta-analysis detected by a simple, graphical test<\/h1>\n<p>Matthias Egger, George Davey  Smith, Martin Schneider, Christoph Minder<\/p>\n<h2>\u8981\u7d04<\/h2>\n<h3>\u5bfe\u8c61<\/h3>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u306b\u5bfe\u3059\u308b\u52b9\u679c\u306e\u63a8\u5b9a\u5024\u3092\u30d7\u30ed\u30c3\u30c8\u3057\u305f\u3082\u306e\u3067\u3042\u308a\uff0c\u5927\u898f\u6a21\u8a66\u9a13\u306b\u3088\u308a\u5f8c\u307b\u3069\u77db\u76fe\u3092\u793a\u3059\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3051\u308b\u30d0\u30a4\u30a2\u30b9\u3092\u691c\u51fa\u3059\u308b\u306e\u306b\u6709\u7528\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u6211\u3005\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u5927\u898f\u6a21\u8a66\u9a13\u3068\u6bd4\u8f03\u3057\u305f\u969b\u306b\u7d50\u679c\u306e\u4e0d\u4e00\u81f4\u3092\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u304c\u4e88\u6e2c\u3059\u308b\u304b\u5426\u304b\u8a66\u9a13\u3057\uff0c\u51fa\u7248\u3055\u308c\u305f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u30d0\u30a4\u30a2\u30b9\u306e\u6709\u75c5\u7387\u3092\u8a55\u4fa1\u3057\u305f\uff0e<\/p>\n<h3>\u30c7\u30b6\u30a4\u30f3<\/h3>\n<p>\u3000\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u5358\u65bd\u8a2d\u5927\u898f\u6a21\u8a66\u9a13\u306e\u30da\u30a2\u3092\u540c\u5b9a\u3059\u308b\u305f\u3081 Medline \u691c\u7d22\uff08\u7d50\u679c\u306e\u4e00\u81f4\u306f\u52b9\u679c\u304c\u540c\u3058\u65b9\u5411\u3092\u5411\u3044\u3066\u304a\u308a\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u63a8\u5b9a\u5024\u304c\u8a66\u9a13\u306e 30 % \u672a\u6e80\u3067\u3042\u308b\u3068\u4eee\u5b9a\u3057\u3066\u3044\u308b\uff09\uff0e 1993 \u5e74\u304b\u3089 1996 \u5e74\u307e\u3067\u306e 4 \u3064\u306e\u4e3b\u8981\u306a\u4e00\u822c\u7684\u306a\u533b\u5b66\u96d1\u8a8c\u304b\u3089\u624b\u52d5\u3067\u691c\u7d22\u3057\u305f\u4e2d\u304b\u3089\u62bd\u51fa\u3057\u305f 37 \u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\uff0c1996 \u5e74\u4e8c\u56de\u76ee\u306b\u767a\u884c\u3055\u308c\u305f Cochrane Database of Systematic Reviews \u304b\u3089\u62bd\u51fa\u3057\u305f 38 \u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff0e<\/p>\n<h3>\u4e3b\u8981\u8ee2\u5e30\u8a08\u6e2c<\/h3>\n<p>\u3000\u7cbe\u5ea6\u306b\u5bfe\u3059\u308b\u6a19\u6e96\u6b63\u898f\u504f\u5dee\u306e\u56de\u5e30\u304b\u3089\u5207\u7247\u306b\u3088\u308a\u6e2c\u5b9a\u3055\u308c\u305f\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u975e\u5bfe\u79f0\u6027\u306e\u7a0b\u5ea6\uff0e<\/p>\n<h3>\u7d50\u679c<\/h3>\n<p>\u3000\u540c\u5b9a\u3055\u308c\u305f 8 \u5bfe\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u5927\u898f\u6a21\u8a66\u9a13\u306b\u304a\u3044\u3066\uff085 \u5bfe\u306f\u5fc3\u8840\u7ba1\u533b\u7642\u304b\u3089\u62bd\u51fa\u3055\u308c 1 \u5bfe\u306f\u7cd6\u5c3f\u75c5\u533b\u7642\u304b\u3089\uff0c1 \u5bfe\u306f\u8001\u4eba\u533b\u7642\u304b\u3089\uff0c1 \u5bfe\u306f\u5468\u7523\u671f\u533b\u7642\u304b\u3089\uff094 \u5bfe\u306f\u4e00\u81f4\u3057\uff0c4 \u5bfe\u306f\u4e00\u81f4\u3057\u306a\u304b\u3063\u305f\uff0e\u4e0d\u4e00\u81f4\u306e\u30b1\u30fc\u30b9\u306f\u7686\uff0c\u3088\u308a\u5927\u898f\u6a21\u306a\u8a66\u9a13\u3067\u8a3c\u660e\u3055\u308c\u305f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3060\u3063\u305f\uff0e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u306f\u4e0d\u4e00\u81f4\u306e 4 \u5bfe\u306e\u3046\u3061\u306e 3 \u5bfe\u306b\u51fa\u73fe\u3057\u3066\u3044\u305f\u304c\uff0c\u4e00\u81f4\u3057\u3066\u3044\u305f\u5bfe\u306b\u306f\u5168\u304f\u51fa\u73fe\u3057\u306a\u304b\u3063\u305f\uff0e14 \u96d1\u8a8c (38 %) \u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068 5 \u96d1\u8a8c (13 %) \u306e\u30b3\u30af\u30e9\u30f3\u30ec\u30d3\u30e5\u30fc\u306b\u304a\u3044\u3066\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u306f\u30d0\u30a4\u30a2\u30b9\u304c\u5b58\u5728\u3059\u308b\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u305f\uff0e<\/p>\n<h3>\u8003\u5bdf<\/h3>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u3068\u3044\u3046\u7c21\u4fbf\u306a\u89e3\u6790\u306b\u3088\u308a\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3051\u308b\u30d0\u30a4\u30a2\u30b9\u304c\u5b58\u5728\u3059\u308b\u3089\u3057\u3044\u3053\u3068\u306e\u6709\u7528\u306a\u30c6\u30b9\u30c8\u3092\u3082\u305f\u3089\u3059\uff0e\u3057\u304b\u3057\u691c\u51fa\u8a31\u5bb9\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304c\u5c0f\u898f\u6a21\u8a66\u9a13\u306e\u9650\u5b9a\u3055\u308c\u305f\u6570\u306b\u57fa\u3065\u304f\u6642\u306b\u9650\u3089\u308c\uff0c\u305d\u306e\u7d50\u679c\u306f\u6ce8\u610f\u6df1\u304f\u53d6\u308a\u6271\u3046\u3079\u304d\u3067\u3042\u308b\uff0e<\/p>\n<h2>\u5c0e\u5165<\/h2>\n<p>\u3000\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306f\u533b\u7642\u4ecb\u5165\u306e\u30ea\u30b9\u30af\u3068\u30d9\u30cd\u30d5\u30a3\u30c3\u30c8\u306b\u304a\u3051\u308b\u6700\u3082\u6709\u7528\u306a\u30a8\u30d3\u30c7\u30f3\u30b9\u3067\u3042\u308a\uff0c\u81e8\u5e8a\u7814\u7a76\u3068\u516c\u8846\u885b\u751f\u306b\u304a\u3051\u308b\u610f\u601d\u6c7a\u5b9a\u3092\u901a\u77e5\u3059\u308b\u3082\u306e\u3067\u3042\u308b\uff0e\u305d\u306e\u3088\u3046\u306a\u30ec\u30d3\u30e5\u30fc\u306f\u53ef\u80fd\u306a\u3089\u3044\u3064\u3067\u3082\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u57fa\u3065\u304f\u3079\u304d\u3067\u3042\u308b\uff0e\u300e\u89e3\u6790\u8005\u306b\u3088\u3063\u3066\u8003\u616e\u3055\u308c\u305f\u3044\u304f\u3064\u304b\u306e\u72ec\u7acb\u3057\u305f\u81e8\u5e8a\u8a66\u9a13\u3092\u7d50\u5408\u3059\u308b\u304b\u7d71\u5408\u3057\u305f\u7d71\u8a08\u89e3\u6790\u306f\uff0c\u7d50\u5408\u53ef\u80fd\u3067\u3042\u308b\u3079\u304d\u3060\u300f\u3068\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u3044\u304f\u3064\u304b\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u6240\u898b\u306f\u5f8c\u306b\u3088\u308a\u5927\u898f\u6a21\u306a\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u306b\u3088\u3063\u3066\u77db\u76fe\u304c\u660e\u3089\u304b\u306b\u306a\u308b\u3082\u306e\u3067\u3042\u308b\uff0e\u305d\u306e\u3088\u3046\u306a\u4e0d\u4e00\u81f4\u306f\u6280\u8853\u3092\u5e83\u304f\u50b7\u3064\u3051\u3066\uff0c\u6700\u521d\u304b\u3089\u8ad6\u4e89\u306e\u7684\u306b\u306a\u3063\u3066\u304d\u305f\uff0e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304c\u30df\u30b9\u30ea\u30fc\u30c7\u30a3\u30f3\u30b0\u3057\u3066\u3044\u308b\u3088\u3046\u306b\u898b\u3048\u308b\u306e\u306f\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u3084\u591a\u304f\u306e\u4ed6\u306e\u30d0\u30a4\u30a2\u30b9\u306e\u5b58\u5728\u3092\u8003\u3048\u308c\u3070\u9a5a\u304f\u3053\u3068\u3067\u306f\u306a\u304f\uff0c\u30ed\u30b1\u30fc\u30b7\u30e7\u30f3\u3084\u9078\u629e\uff0c\u7814\u7a76\u306e\u7d50\u5408\u306b\u3088\u308a\u5c0e\u5165\u3055\u308c\u308b\u306e\u304b\u3082\u77e5\u308c\u306a\u3044\uff0e<\/p>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u306b\u5bfe\u3059\u308b\u8a66\u9a13\u306e\u52b9\u679c\u63a8\u5b9a\u5024\u3092\u30d7\u30ed\u30c3\u30c8\u3057\u305f\u3082\u306e\u3067\u3042\u308a\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u691c\u8a3c\u3092\u8a55\u4fa1\u3059\u308b\u306e\u306b\u6709\u7528\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u305d\u306e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u3068\u3044\u3046\u306e\u306f\u4ee5\u4e0b\u306e\u4e8b\u5b9f\u306b\u57fa\u3065\u3044\u3066\u3044\u308b\uff0e\u57fa\u790e\u6cbb\u7642\u52b9\u679c\u306e\u63a8\u5b9a\u306b\u304a\u3051\u308b\u7cbe\u5ea6\u306f\uff0c\u8981\u7d20\u3068\u306a\u308b\u7814\u7a76\u306e\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u304c\u5897\u3048\u308b\u306b\u5f93\u3044\u5897\u52a0\u3059\u308b\uff0e\u5c0f\u898f\u6a21\u8a66\u9a13\u306e\u7d50\u679c\u306f\u30b0\u30e9\u30d5\u306e\u5e95\u8fba\u306b\u5e83\u304f\u5206\u5e03\u3057\uff0c\u8a66\u9a13\u304c\u3088\u308a\u5927\u898f\u6a21\u306b\u306a\u308b\u307b\u3069\u72ed\u304f\u306a\u308b\uff0e\u30d0\u30a4\u30a2\u30b9\u306e\u5b58\u5728\u3057\u306a\u3044\u72b6\u614b\u3067\u306f\u5206\u5e03\u306f\u5de6\u53f3\u5bfe\u79f0\u306e\u9006\u3055\u307e\u306e\u6f0f\u6597\u306b\u4f3c\u305f\u5f62\u3092\u3059\u308b\u7b48\u3067\u3042\u308b\uff0e\u9006\u306b\uff0c\u3082\u3057\u30d0\u30a4\u30a2\u30b9\u304c\u5b58\u5728\u3059\u308b\u306a\u3089\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u6b6a\u307f\uff0c\u975e\u5bfe\u79f0\u306b\u306a\u308b\u7b48\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u4fa1\u5024\u306f\u3053\u308c\u307e\u3067\u7cfb\u7d71\u7684\u306b\u691c\u8a3c\u3055\u308c\u305f\u3053\u3068\u304c\u306a\u304f\uff0c\u5bfe\u79f0\u6027\uff08\u307e\u305f\u306f\u975e\u5bfe\u79f0\u60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\u5171\u540c\u8a08\u753b\u3067\u96fb\u5b50\u7684\u306b\u666e\u53ca\u3057\u3066\u3044\u308b\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u7528\u3044\u305f\uff0e<\/p>\n<h2>\u65b9\u6cd5<\/h2>\n<h3>\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u306e\u8a08\u6e2c<\/h3>\n<p>\u3000\u6211\u3005\u306f\u7dda\u5f62\u56de\u5e30\u6cd5\u3092\u7528\u3044\u3066\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u3092\u8a08\u6e2c\u3057\uff0c\u30aa\u30c3\u30ba\u6bd4\u306e\u81ea\u7136\u5bfe\u6570\u30b9\u30b1\u30fc\u30eb\u3092\u7528\u3044\u305f\uff0e\u73fe\u5728\u306e\u72b6\u6cc1\u3067\u306f\u56de\u5e30\u76f4\u7dda\u304c\u539f\u70b9\u3092\u901a\u308b\u3068\u3044\u3046\u5236\u7d04\u3092\u8ab2\u3055\u308c\u306a\u3044\u306b\u3082\u95a2\u308f\u3089\u305a\uff0c\u3053\u308c\u306f Galbraith \u306e\u653e\u5c04\u72b6\u30d7\u30ed\u30c3\u30c8\u306e\u56de\u5e30\u5206\u6790\u306b\u5bfe\u5fdc\u3057\u3066\u3044\u308b\uff0e\u6a19\u6e96\u6b63\u898f\u504f\u5dee\u306f\u30aa\u30c3\u30ba\u6bd4\u3092\u305d\u308c\u81ea\u8eab\u306e\u6a19\u6e96\u8aa4\u5dee\u3067\u9664\u3057\u305f\u3068\u5b9a\u7fa9\u3055\u308c\u308b\u304c\uff0c\u63a8\u5b9a\u7cbe\u5ea6\u306b\u5bfe\u3057\u3066\u56de\u5e30\u3057\uff0c\u5f8c\u8005\u306f\u6a19\u6e96\u8aa4\u5dee\u306e\u9006\u6570\u3068\u3057\u3066\u5b9a\u7fa9\u3055\u308c\u308b\uff08\u56de\u5e30\u5f0f\u306f\u6b21\u306e\u3088\u3046\u306b\u5b9a\u7fa9\u3055\u308c\u308b\uff1aSND = a + b x precision\uff09\uff0e\u7cbe\u5ea6\u304c\u4e3b\u306b\u30b5\u30f3\u30d7\u30eb\u30b5\u30a4\u30ba\u306b\u4f9d\u5b58\u3059\u308b\u3088\u3046\u306b\uff0c\u5c0f\u898f\u6a21\u8a66\u9a13\u306f x \u8ef8\u4e0a\u3067\u306f 0 \u306b\u8fd1\u3065\u304f\uff0e\u5c0f\u898f\u6a21\u8a66\u9a13\u306f\u30aa\u30c3\u30ba\u6bd4\u306e\u7d71\u4e00\u5024\u304b\u3089\u306e\u5dee\u7570\u3092\u63d0\u4f9b\u3059\u308b\u304c\uff0c\u6a19\u6e96\u8aa4\u5dee\u304c\u5927\u304d\u304f\u306a\u308b\u305f\u3081\u306b\u7d50\u679c\u3068\u3057\u3066\u6a19\u6e96\u6b63\u898f\u504f\u5dee\u306f 0 \u70b9\u306b\u8fd1\u304f\u306a\u308b\uff0e\u5c0f\u898f\u6a21\u8a66\u9a13\u306f\u4e21\u8ef8\u5171\u306b 0 \u70b9\uff0c\u3064\u307e\u308a\u539f\u70b9\u306b\u8fd1\u3065\u304f\u7b48\u3067\u3042\u308b\uff0e\u9006\u306b\u5927\u898f\u6a21\u8a66\u9a13\u306f\u6b63\u78ba\u306a\u63a8\u5b9a\u5024\u3092\u3082\u305f\u3089\u3057\uff0c\u3082\u3057\u6cbb\u7642\u304c\u6709\u52b9\u306a\u3089\u5927\u304d\u306a\u6a19\u6e96\u6b63\u898f\u504f\u5dee\u3092\u3082\u305f\u3089\u3059\uff0e\u8a66\u9a13\u306e\u96c6\u5408\u304c\u540c\u8cea\u306a\u3089\u305d\u306e\u70b9\u306f\u9078\u629e\u30d0\u30a4\u30a2\u30b9\u306b\u3088\u3063\u3066\u6b6a\u307e\u305a\uff0c\u6a19\u6e96\u6b63\u898f\u504f\u5dee\u304c\u30bc\u30ed\u3068\u306a\u308b (a = 0) \u539f\u70b9\u3092\u901a\u308b\u76f4\u7dda\u4e0a\u306b\u5206\u5e03\u3059\u308b\u306f\u305a\u3067\u3042\u308a\uff0c\u50be\u304d b \u306f\u52b9\u679c\u306e\u30b5\u30a4\u30ba\u3068\u65b9\u5411\u3092\u793a\u3057\u3066\u3044\u308b\uff0e\u3053\u306e\u72b6\u6cc1\u306f\u5de6\u53f3\u5bfe\u79f0\u306e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u5bfe\u5fdc\u3059\u308b\uff0e<\/p>\n<p>\u3000\u4eee\u306b\u975e\u5bfe\u79f0\u304c\u5b58\u5728\u3059\u308b\u5834\u5408\uff0c\u7cfb\u7d71\u7684\u5927\u898f\u6a21\u8a66\u9a13\u306e\u7d50\u679c\u3068\u306f\u7570\u306a\u308b\u7d50\u679c\u304c\u5c0f\u898f\u6a21\u8a66\u9a13\u3067\u51fa\u308b\u3088\u3046\u306b\uff0c\u56de\u5e30\u76f4\u7dda\u306f\u539f\u70b9\u3092\u901a\u3089\u306a\u3044\u7b48\u3067\u3042\u308b\uff0e\u5207\u7247 a \u306f\u975e\u5bfe\u79f0\u6027\u306e\u8a08\u6e2c\u3092\u63d0\u4f9b\u3059\u308b\uff0e\u30bc\u30ed\u304b\u3089\u306e\u504f\u5dee\u304c\u5927\u304d\u3044\u307b\u3069\u975e\u5bfe\u79f0\u304c\u3088\u308a\u9855\u8457\u3068\u306a\u308b\uff0e\u5c0f\u898f\u6a21\u8a66\u9a13\u304c\u3088\u308a\u5927\u304d\u304f\u5f37\u56fa\u306a\u52b9\u679c\u3092\u6709\u3059\u308b\u306a\u3089\uff0c\u5bfe\u6570\u8ef8\u306e\u539f\u70b9\u3088\u308a\u4e0b\u306b\u56de\u5e30\u76f4\u7dda\u304c\u6765\u308b\u3088\u3046\u306b\u306a\u308b\u306f\u305a\u3067\u3042\u308b\uff0e\u305d\u308c\u6545\uff0c\u9670\u6027\u306e\u7d50\u679c\u306f\u5c0f\u898f\u6a21\u8a66\u9a13\u306b\u304a\u3044\u3066\u306f\u5927\u898f\u6a21\u8a66\u9a13\u3088\u308a\u3082\u3088\u308a\u9855\u8457\u306a\u5229\u76ca\u3092\u793a\u5506\u3059\u308b\u306f\u305a\u3067\u3042\u308b\uff0e\u3042\u308b\u72b6\u6cc1\u3067\u306f\uff08\u4f8b\u3048\u3070\u3044\u304f\u3064\u304b\u306e\u5c0f\u898f\u6a21\u8a66\u9a13\u30681\u3064\u306e\u5927\u898f\u6a21\u8a66\u9a13\u304c\u5b58\u5728\u3059\u308b\u3088\u3046\u306a\u5834\u5408\uff09\uff0c\u63a8\u5b9a\u52b9\u679c\u306e\u5206\u6563\u306e\u9006\u6570\u306b\u3088\u308a\u89e3\u6790\u306b\u52a0\u91cd\u3059\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u691c\u51fa\u529b\u304c\u4e0a\u6607\u3059\u308b\uff0e\u6211\u3005\u306f\u52a0\u91cd\u3057\u305f\u5834\u5408\u3068\u3057\u306a\u3044\u5834\u5408\u306e\u4e21\u8005\u306b\u3064\u3044\u3066\u691c\u8a0e\u3057\uff0c\u89e3\u6790\u306e\u7d50\u679c\u3092\u7528\u3044\u3066\u3088\u308a 0 \u304b\u3089\u306e\u504f\u5dee\u304c\u5927\u304d\u306a\u5207\u7247\u3092\u6c42\u3081\u305f\uff0e<\/p>\n<p>\u3000\u7570\u8cea\u6027\u306e\u3059\u3079\u3066\u306e\u691c\u67fb\u3068\u306f\u5bfe\u7167\u7684\u306b\uff0c\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u30c6\u30b9\u30c8\u306f\u7570\u8cea\u6027\u3092\u7279\u7570\u7684\u306b\u8a55\u4fa1\u3057\uff0c\u3053\u306e\u72b6\u6cc1\u3067\u306f\u3088\u308a\u5f37\u529b\u306a\u30c6\u30b9\u30c8\u3092\u63d0\u4f9b\u3059\u308b\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\uff0c\u3069\u3093\u306a\u7570\u8cea\u6027\u306e\u89e3\u6790\u3082\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u542b\u307e\u308c\u308b\u8a66\u9a13\u306e\u6570\u306b\u4f9d\u5b58\u3057\u3066\u304a\u308a\uff0c\u305d\u308c\u3089\u306f\u4e00\u822c\u306b\u5c0f\u898f\u6a21\u3067\uff0c\u8a66\u9a13\u306e\u7d71\u8a08\u5b66\u7684\u691c\u51fa\u529b\u306b\u9650\u754c\u304c\u3042\u308b\uff0e\u305d\u308c\u6545\u6211\u3005\u306f\u975e\u5bfe\u79f0\u6027\u306e\u6839\u62e0\u3092 P < 0.1 \u306b\u8a2d\u5b9a\u3057\u305f\uff0e\u305d\u3057\u3066\u5207\u7247\u3092 90 % \u4fe1\u983c\u533a\u9593\u3067\u8868\u73fe\u3057\u305f\uff0e\u540c\u3058\u6709\u610f\u6c34\u6e96\u3092\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3051\u308b\u7570\u8cea\u6027\u306e\u4ee5\u524d\u306e\u89e3\u6790\u306b\u3082\u7528\u3044\u305f\uff0e<\/p>\n<h3>\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u30de\u30c3\u30c1\u30f3\u30b0\u3059\u308b\u5927\u898f\u6a21\u7121\u4f5c\u70ba\u8a66\u9a13\u306e\u540c\u5b9a<\/h3>\n<p>\uff08\u4e2d\u7565\uff09<\/p>\n<h3>\u7d50\u679c\u306e\u4e00\u81f4\u30fb\u4e0d\u4e00\u81f4<\/h3>\n<p>\uff08\u4e2d\u7565\uff09<\/p>\n<h3>\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u304a\u3051\u308b\u975e\u5bfe\u79f0\u6027\u306e\u983b\u5ea6<\/h3>\n<p>\uff08\u4e2d\u7565\uff09<\/p>\n<h2>\u7d50\u679c<\/h2>\n<p>\u3000\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u5927\u898f\u6a21\u8a66\u9a13\u3092\u542b\u3093\u3067\u3044\u308b 8 \u5bfe\u304c\u540c\u5b9a\u3055\u308c\u305f (Table 1)\uff0e5 \u5bfe\u306f\u5fc3\u8840\u7ba1\u533b\u5b66\uff0c1 \u5bfe\u306f\u7cd6\u5c3f\u75c5\u533b\u5b66\uff0c1 \u5bfe\u306f\u8001\u4eba\u533b\u5b66\uff0c1 \u5bfe\u306f\u5468\u7523\u671f\u533b\u5b66\u304b\u3089\u3060\u3063\u305f\uff0e\u5927\u898f\u6a21\u8a66\u9a13\u306e\u7cbe\u5ea6\u304c 14.4 \u3067\u3042\u308b\u306e\u3068\u6bd4\u8f03\u3057\u3066\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304b\u3089\u306e\u52b9\u679c\u63a8\u5b9a\u5024\u306f\u5e73\u5747\u7cbe\u5ea6 7.9 \u3092\u6709\u3057\u3066\u3044\u305f\uff0e4 \u5bfe\u306e\u4e00\u81f4\u3068 4 \u5bfe\u306e\u4e0d\u4e00\u81f4\u3068\u304c\u3042\u3063\u305f (Fig 1)\uff0e\u5168\u4f8b\u306b\u304a\u3044\u3066\u4e0d\u4e00\u81f4\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u7d50\u679c\u3067\u3042\u308a\uff0c\u305d\u308c\u3089\u306f\u5927\u898f\u6a21\u8a66\u9a13\u3088\u308a\u3082\u6709\u76ca\u306a\u52b9\u679c\u3092\u8a3c\u660e\u3057\u305f\u3082\u306e\u3067\u3042\u3063\u305f\uff0e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e 4 \u5206\u306e 3 \u306e\u4e0d\u4e00\u81f4\u306f\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304c\u7d71\u8a08\u7684\u6709\u610f (P < 0.1) \u306b\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u3092\u793a\u3057\u3066\u3044\u305f\uff0e\u4e00\u81f4\u3057\u305f\u5bfe\u306e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u5168\u304f\u6709\u610f\u306a\u975e\u5bfe\u79f0\u3092\u793a\u3055\u306a\u304b\u3063\u305f (Fig 2, Table 2)\uff0e<\/p>\n<p><figure id=\"attachment_7649\" aria-describedby=\"caption-attachment-7649\" style=\"width: 288px\" class=\"wp-caption aligncenter\"><a href=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_-288x300.jpg\" alt=\"\" width=\"288\" height=\"300\" class=\"size-medium wp-image-7649\" srcset=\"https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_-288x300.jpg 288w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_-768x801.jpg 768w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_-982x1024.jpg 982w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_-1200x1252.jpg 1200w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F1.large_.jpg 1227w\" sizes=\"auto, (max-width: 288px) 85vw, 288px\" \/><\/a><figcaption id=\"caption-attachment-7649\" class=\"wp-caption-text\">Fig.1<\/figcaption><\/figure><br \/>\n<figure id=\"attachment_7650\" aria-describedby=\"caption-attachment-7650\" style=\"width: 176px\" class=\"wp-caption aligncenter\"><a href=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F2.large_.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F2.large_-176x300.jpg\" alt=\"\" width=\"176\" height=\"300\" class=\"size-medium wp-image-7650\" srcset=\"https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F2.large_-176x300.jpg 176w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F2.large_-602x1024.jpg 602w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F2.large_.jpg 752w\" sizes=\"auto, (max-width: 176px) 85vw, 176px\" \/><\/a><figcaption id=\"caption-attachment-7650\" class=\"wp-caption-text\">Fig.2<\/figcaption><\/figure><\/p>\n<p>\u3000\u5927\u898f\u6a21\u8a66\u9a13\u3088\u308a\u3082\u6570\u5e74\u65e9\u304f\u51fa\u7248\u3055\u308c\u305f 3 \u3064\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u305f\u3081\u306e\u4ed8\u52a0\u7684\u306a\u8a66\u9a13\u304c\u540c\u5b9a\u3055\u308c\u305f\uff0e\u3053\u308c\u3089\u306f\u66f4\u306b\u6700\u8fd1\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304b\u3089\u62bd\u51fa\u3055\u308c\u305f\uff0e\u5fc3\u7b4b\u6897\u585e\u306b\u304a\u3051\u308b\u30de\u30b0\u30cd\u30b7\u30a6\u30e0\u9759\u6ce8\u8a66\u9a13\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u304c 5 \u3064\u306e\u4ed8\u52a0\u7684\u306a\u8a66\u9a13\u3068\u3068\u3082\u306b\u66f4\u65b0\u3055\u308c\u305f\u6642\uff0c\u305d\u306e\u5207\u7247\u306f\u3088\u308a\u5927\u304d\u306a\u975e\u5bfe\u79f0\u6027\u3092\u793a\u3057\u305f (- 1.36 (90%CI &#8211; 2.06 to &#8211; 0.66), P = 0.05)\uff0e13 \u306e\u4ed8\u52a0\u7684\u8a66\u9a13\u304c\u5fc3\u4e0d\u5168\u306b\u5bfe\u3059\u308b ACE \u963b\u5bb3\u85ac\u306e\u8a66\u9a13\u306e\u89e3\u6790\u306b\u52a0\u3048\u3089\u308c\u305f\u6642\uff0c\u6563\u5e03\u56f3\u306f\u307e\u3060\u5bfe\u79f0\u6027\u3092\u4fdd\u3063\u3066\u3044\u305f (\u5207\u7247 0.07 (- 0.53 to 0.67), P = 0.85)\uff0e\u6c0f\u5b50\u7647\u524d\u75c7\u4e88\u9632\u306e\u305f\u3081\u306e\u30a2\u30b9\u30d4\u30ea\u30f3\u306e\u89e3\u6790\u304c\u66f4\u65b0\u3055\u308c\u305f\u6642\u306b\u306f 9 \u3064\u306e\u4ed8\u52a0\u7684\u8a66\u9a13\u304c\u8ffd\u52a0\u3055\u308c\uff0c\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u975e\u5bfe\u79f0\u6027\u3068\u306a\u3063\u305f (\u5207\u7247 &#8211; 1.49 (- 2.20 to &#8211; 0.79), P = 0.003) (Fig 3)\uff0e<\/p>\n<figure id=\"attachment_7651\" aria-describedby=\"caption-attachment-7651\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_-300x228.jpg\" alt=\"\" width=\"300\" height=\"228\" class=\"size-medium wp-image-7651\" srcset=\"https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_-300x228.jpg 300w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_-768x584.jpg 768w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_-1024x779.jpg 1024w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_-1200x913.jpg 1200w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F3.large_.jpg 1280w\" sizes=\"auto, (max-width: 300px) 85vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-7651\" class=\"wp-caption-text\">Fig.3<\/figcaption><\/figure>\n<p>\u3000Figure 4 \u306b 38 \u306e Cochrane \u30ec\u30d3\u30e5\u30fc\u304a\u3088\u3073 37 \u306e\u96d1\u8a8c\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e\u56de\u5e30\u5207\u7247\u306e\u5206\u5e03\u3092\u793a\u3057\u305f\uff0e\u30d0\u30a4\u30a2\u30b9\u304c\u5b58\u5728\u3057\u306a\u3044\u72b6\u614b\u3067\u306f\u30e9\u30f3\u30c0\u30e0\u306a\u5909\u52d5\u306b\u3088\u308a\u5207\u7247\u306f\u30bc\u30ed\u70b9\u3092\u4e2d\u5fc3\u306b\u5bfe\u79f0\u6027\u306b\u96c6\u307e\u308b\u7b48\u3067\u3042\u308a\uff0c\u967d\u6027\u5024\u3068\u9670\u6027\u5024\u304c\u540c\u6570\u3068\u306a\u308b\u7b48\u3067\u3042\u308b\uff0e\u3057\u304b\u3057\u89b3\u5bdf\u3055\u308c\u305f\u7d50\u679c\u306f\u305d\u3046\u3067\u306f\u306a\u304b\u3063\u305f\uff0e\u5206\u5e03\u306f\u9670\u6027\u5024\u306b\u504f\u4f4d\u3057\u3066\u304a\u308a\uff0cCochrane \u30ec\u30d3\u30e5\u30fc\u306b\u304a\u3044\u3066\u306f\u5e73\u5747\u3067 &#8211; 0.24 (- 0.65 to 0.17), \u96d1\u8a8c\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3044\u3066\u306f &#8211; 1.00 (- 1.50 to &#8211; 0.49) \u3067\u3042\u3063\u305f\uff0eCochrane \u30ec\u30d3\u30e5\u30fc\u3067\u306f\u5207\u7247\u306b\u306f 24 \u306e\u9670\u6027\u5024\u3068 14 \u306e\u967d\u6027\u5024\u304c\u5b58\u5728\u3057 (sign test, P = 0.10)\uff0c\u96d1\u8a8c\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3044\u3066\u306f 26 \u306e\u9670\u6027\u5024\u3068 11 \u306e\u967d\u6027\u5024\u304c\u5b58\u5728\u3057\u305f (sign test, P = 0.007)\uff0eCochrane \u30ec\u30d3\u30e5\u30fc\u306e 5 \u7de8 (13%) \u3068\u96d1\u8a8c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306e 14 \u7de8 (38%) \u306b\u7d71\u8a08\u7684\u306b\u6709\u610f\u306a\u975e\u5bfe\u79f0\u6027\u306e\u6839\u62e0\u3092\u8a8d\u3081\u305f\uff0e<\/p>\n<figure id=\"attachment_7652\" aria-describedby=\"caption-attachment-7652\" style=\"width: 211px\" class=\"wp-caption aligncenter\"><a href=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_.jpg\"><img loading=\"lazy\" decoding=\"async\" src=\"\/\/fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_-211x300.jpg\" alt=\"\" width=\"211\" height=\"300\" class=\"size-medium wp-image-7652\" srcset=\"https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_-211x300.jpg 211w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_-768x1091.jpg 768w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_-721x1024.jpg 721w, https:\/\/www.fujiitoshiki.com\/improvesociety\/wp-content\/uploads\/F4.large_.jpg 901w\" sizes=\"auto, (max-width: 211px) 85vw, 211px\" \/><\/a><figcaption id=\"caption-attachment-7652\" class=\"wp-caption-text\">Fig.4<\/figcaption><\/figure>\n<p><H2>\u8003\u5bdf<\/h2>\n<p>\u3000\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u304b\u3089\u967d\u6027\u306e\u6240\u898b\u3060\u3051\u3092\u9078\u629e\u3057\u3066\u51fa\u7248\u3059\u308b\u3053\u3068\u306f\u53c2\u8003\u6587\u732e\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u30ec\u30d3\u30e5\u30fc\u306b\u304a\u3044\u3066\u8003\u616e\u3059\u3079\u304d\u61f8\u5ff5\u3067\u3042\u308b\uff0e\u4eee\u306b\u53c2\u8003\u6587\u732e\u304c\u6cbb\u7642\u52b9\u679c\u306e\u5229\u76ca\u3092\u8a3c\u660e\u3059\u308b\u8a66\u9a13\u304c\u61f8\u5ff5\u3055\u308c\u308b\u5834\u5408\uff0c\u305d\u3057\u3066\u6cbb\u7642\u52b9\u679c\u304c\u7121\u3044\u3053\u3068\u3092\u8a3c\u660e\u3057\u305f\u7b49\u3057\u304f\u6709\u52b9\u306a\u8a66\u9a13\u304c\u51fa\u7248\u3055\u308c\u306a\u3044\u307e\u307e\u3067\u3042\u3063\u305f\u5834\u5408\uff0c\u679c\u305f\u3057\u3066\u3053\u308c\u3089\u306e\u53c2\u8003\u6587\u732e\u306e\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306f\u81e8\u5e8a\u8a3a\u7642\u3084\u4fdd\u5065\u653f\u7b56\u306e\u610f\u601d\u6c7a\u5b9a\u306b\u304a\u3044\u3066\u3069\u308c\u3060\u3051\u5ba2\u89b3\u7684\u306a\u6307\u6a19\u3068\u3057\u3066\u5f79\u7acb\u3064\u3067\u3042\u308d\u3046\u304b\uff0e\u3053\u306e\u3088\u3046\u306a\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306e\u3053\u306e\u6f5c\u5728\u7684\u306b\u6df1\u523b\u306a\u7d50\u679c\u306f\u66ab\u304f\u306e\u9593\u8a8d\u8b58\u3055\u308c\u3066\u304a\u308a\uff0c\u4e16\u754c\u898f\u6a21\u306e\u767b\u9332\u306e\u958b\u59cb\u6642\u306b\u306f\u7e70\u308a\u8fd4\u3057\u547c\u3070\u308c\u3066\u304d\u305f\uff0e\u8a66\u9a13\u306e\u767b\u9332\u3068\uff0c\u51fa\u7248\u3055\u308c\u305f\u8a66\u9a13\u3068\u3055\u308c\u306a\u304b\u3063\u305f\u8a66\u9a13\u3068\u306e\u7d50\u679c\u3092\u4fdd\u6301\u3059\u308b\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9\u3092\u69cb\u7bc9\u3059\u308c\u3070\u554f\u984c\u306f\u89e3\u6c7a\u3059\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\uff0c\u5f53\u9762\u305d\u308c\u304c\u5e83\u304f\u63d0\u8d77\u3055\u308c\u308b\u69d8\u5b50\u306f\u306a\u3055\u305d\u3046\u3060\uff0e<\/p>\n<p>\u3000\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u3068\u305d\u308c\u306b\u95a2\u9023\u3059\u308b\u30d0\u30a4\u30a2\u30b9\u3092\u6301\u3063\u305f\u81e8\u5e8a\u8a66\u9a13\u306f\u305d\u308c\u6545\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306e\u6839\u5e79\u3068\u306a\u308b\uff0e\u3053\u3053\u3067\u793a\u3057\u305f\u6240\u898b\u306f\u6b21\u306e\u3053\u3068\u3092\u793a\u5506\u3057\u3066\u3044\u308b\uff0e\u7c21\u7d20\u306a\u56f3\u5f62\u3068\u7d71\u8a08\u624b\u6cd5\u304c\u3053\u306e\u76ee\u7684\u306b\u306f\u6709\u7528\u3067\u3042\u308b\u3068\uff0e\u540c\u3058\u4ecb\u5165\u306b\u5bfe\u3059\u308b\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u5927\u898f\u6a21\u5358\u4e00\u8a66\u9a13\u3068\u306e\u4e21\u8005\u4e00\u5bfe\u306e\u3053\u306e\u65b9\u6cd5\u3092\u8a66\u9a13\u3059\u308b\u6642\u306b\u306f\uff0c\u6211\u3005\u306f\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u3088\u308a4\u5206\u306e3\u4ee5\u4e0a\u306e\u4e0d\u4e00\u81f4\u306e\u7d50\u679c\u306b\u975e\u5bfe\u79f0\u6027\u3092\u898b\u51fa\u3057\u305f\uff0e4\u756a\u76ee\u306f\u305f\u3063\u305f6\u3064\u306e\u8a66\u9a13\u306b\u57fa\u3065\u3044\u3066\u3044\u308b\u306e\u307f\u3067\uff0c\u3055\u3089\u306a\u308b\u8a66\u9a13\u306b\u3088\u308a\u66f4\u65b0\u3055\u308c\u305f\u6642\u306b\u306f\u975e\u5bfe\u79f0\u6027\u304c\u73fe\u308c\u3066\u304d\u305f\uff0e<\/p>\n<h3>\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u975e\u5bfe\u79f0\u6027\u306e\u30bd\u30fc\u30b9<\/h3>\n<p>\u3000\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306f\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u3068\u95a2\u9023\u3057\u3066\u304d\u305f\uff0e\u306b\u3082\u95a2\u308f\u3089\u305a\u51fa\u7248\u3055\u308c\u305f\u8a66\u9a13\u306b\u304a\u3044\u3066\u306f\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u95a2\u9023\u3057\u305f\u8a66\u9a13\u3092\u540c\u5b9a\u3059\u308b\u78ba\u7387\u3082\u307e\u305f\u305d\u308c\u3089\u306e\u7d50\u679c\u306b\u5f71\u97ff\u3055\u308c\u308b\uff0e\u82f1\u8a9e\u306e\u8a00\u8a9e\u30d0\u30a4\u30a2\u30b9\uff0c\u82f1\u8a9e\u4ee5\u5916\u306e\u8a00\u8a9e\u3067\u51fa\u7248\u3055\u308c\u305f\u96d1\u8a8c\u306b\u300e\u9670\u6027\u300f\u6240\u898b\u304c\u512a\u9047\u3057\u3066\u51fa\u7248\u3055\u308c\u308b\u3068\u3044\u3046\u3053\u3068\u3060\u304c\uff0c\u5730\u57df\u3068\u5305\u542b\u3092\u4f5c\u308a\u51fa\u3057\uff0c\u305d\u306e\u3088\u3046\u306a\u7814\u7a76\u3092\u542b\u3081\u308b\u53ef\u80fd\u6027\u304c\u4f4e\u304f\u306a\u308b\uff0e\u5f15\u7528\u30d0\u30a4\u30a2\u30b9\u306e\u7d50\u679c\u3068\u3057\u3066\u300e\u9670\u6027\u300f\u3068\u306a\u3063\u305f\u8a66\u9a13\u306f\u5f15\u7528\u3055\u308c\u308b\u983b\u5ea6\u304c\u3088\u308a\u4f4e\u304f\u306a\u308a\uff0c\u95a2\u9023\u3059\u308b\u8a66\u9a13\u3092\u691c\u7d22\u3059\u308b\u969b\u306b\u3088\u308a\u898b\u9003\u3055\u308c\u3084\u3059\u304f\u306a\u308b\uff0e\u300e\u967d\u6027\u300f\u8a66\u9a13\u306e\u7d50\u679c\u306f\u3057\u3070\u3057\u3070\u4e00\u5ea6\u306a\u3089\u305a\u5831\u544a\u3055\u308c\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff08\u8907\u6570\u306e\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\uff09\u306e\u305f\u3081\u306b\u914d\u7f6e\u3055\u308c\u308b\u78ba\u7387\u3092\u9ad8\u304f\u3059\u308b\uff0e\u3053\u308c\u3089\u306e\u30d0\u30a4\u30a2\u30b9\u306f\u5927\u898f\u6a21\u8a66\u9a13\u3088\u308a\u3082\u5c0f\u898f\u6a21\u8a66\u9a13\u306e\u65b9\u306b\u5f71\u97ff\u3092\u4e0e\u3048\u3066\u3044\u308b\u3088\u3046\u3067\u3042\u308b\uff0e<\/p>\n<p><em>Selection bias<\/em><\/p>\n<ul>\n<li>Publication bias<\/li>\n<li>Location biases<\/li>\n<\/ul>\n<p><em>True heterogeneity<\/em><\/p>\n<ul>\n<li>Size of effect differs according to study size<\/li>\n<\/ul>\n<p>Data iregularities<\/p>\n<ul>\n<li>Poor methodological design of small studies<\/li>\n<li>Inadequate analysis<\/li>\n<li>Fraud<\/li>\n<\/ul>\n<p><em>Artefactual<\/em><\/p>\n<ul>\n<li>Choice of effect measure<\/li>\n<\/ul>\n<p><em>Chance<\/em><\/p>\n<p>\u3000\u975e\u5bfe\u79f0\u6027\u306e\u4ed6\u306e\u6e90\u306f\u624b\u6cd5\u306e\u54c1\u8cea\u306e\u5dee\u304b\u3089\u751f\u3058\u308b\uff0e\u3088\u308a\u5c0f\u898f\u6a21\u306a\u8a66\u9a13\u306f\u4e00\u822c\u7684\u306b\u5927\u898f\u6a21\u8a66\u9a13\u3088\u308a\u3082\u65b9\u6cd5\u8ad6\u7684\u306b\u53b3\u3057\u3055\u306b\u6b20\u3051\u3066\u5b9f\u65bd\u3055\u308c\uff0c\u89e3\u6790\u3055\u308c\u308b\uff0e\u4f4e\u8cea\u306e\u7814\u7a76\u306f\u307e\u305f\u3088\u308a\u5927\u304d\u306a\u52b9\u679c\u3092\u8a3c\u660e\u3057\u304c\u3061\u3067\u3042\u308b\uff0e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u898b\u3089\u308c\u308b\u5bfe\u79f0\u6027\u306e\u7a0b\u5ea6\u306f\uff0c\u52b9\u679c\u3092\u6e2c\u5b9a\u3059\u308b\u305f\u3081\u306b\u5b9f\u65bd\u3055\u308c\u308b\u7d71\u8a08\u91cf\u306b\u4f9d\u5b58\u3059\u308b\u306e\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u30a4\u30d9\u30f3\u30c8\u767a\u751f\u7387\u306e\u9ad8\u3044\u30ea\u30b9\u30af\u306b\u304a\u3044\u3066\uff0c\u30aa\u30c3\u30ba\u6bd4\u306f\u30ea\u30b9\u30af\u6e1b\u5c11\u3084\u4e0a\u6607\u3092\u904e\u5927\u8a55\u4fa1\u3059\u308b\uff0e\u3053\u306e\u3053\u3068\u304b\u3089\uff0c\u5c0f\u898f\u6a21\u8a66\u9a13\u304c\u4e00\u8cab\u3057\u3066\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306b\u304a\u3044\u3066\u5b9f\u65bd\u3055\u308c\u308b\u3068\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u3092\u5c0e\u304f\u7d50\u679c\u3068\u306a\u308b\uff0e\u540c\u69d8\u306b\uff0c\u3082\u3057\u30a4\u30d9\u30f3\u30c8\u304c\u4e00\u5b9a\u306e\u7387\u3067\u767a\u751f\u3059\u308b\u306a\u3089\uff0c\u89b3\u5bdf\u671f\u9593\u304c\u5ef6\u9577\u3059\u308b\u306b\u3068\u3082\u306a\u3063\u3066\u76f8\u5bfe\u5371\u967a\u5ea6\u306f\u5358\u4e00\u306e\u5024\u306b\u5411\u304b\u3063\u3066\u79fb\u52d5\u3059\u308b\u7b48\u3067\u3042\u308b\uff0e\u5927\u898f\u6a21\u8a66\u9a13\u306b\u304a\u3044\u3066\u306f\u89b3\u5bdf\u671f\u9593\u306f\u5c0f\u898f\u6a21\u8a66\u9a13\u306e\u305d\u308c\u3088\u308a\u3082\u3057\u3070\u3057\u3070\u9577\u304f\u306a\u308b\uff0e\u6700\u7d42\u7684\u306b\u975e\u5bfe\u79f0\u306e\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306f\u5076\u7136\u306b\u3057\u304b\u767a\u751f\u3057\u306a\u304f\u306a\u308b\uff0e<\/p>\n<p>\u3000\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u793a\u3055\u308c\u305f\u8a66\u9a13\u306f\u4ecb\u5165\u306b\u304a\u3051\u308b\u5185\u5728\u3059\u308b\u540c\u3058\u52b9\u679c\u3092\u63a8\u5b9a\u3057\u306a\u3044\u304b\u3082\u3057\u308c\u305a\uff0c\u305d\u308c\u305e\u308c\u306e\u7d50\u679c\u306e\u9593\u306e\u305d\u306e\u3088\u3046\u306a\u7570\u8cea\u6027\u306f\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306e\u975e\u5bfe\u79f0\u6027\u306b\u81f3\u308b\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u4f8b\u3048\u3070\uff0c\u7d50\u5408\u3055\u308c\u305f\u8ee2\u5e30\u304c\u6b21\u3068\u307f\u306a\u3055\u308c\u305f\u3089\uff0c\u4ecb\u5165\u306b\u3088\u3063\u3066\u5f71\u97ff\u3092\u53d7\u3051\u308b\u7d50\u5408\u3055\u308c\u305f\u8ee2\u5e30\u306e\u8981\u7d20\u306e\u305f\u3081\uff0c\u9ad8\u30ea\u30b9\u30af\u306e\u60a3\u8005\u306b\u304a\u3044\u3066\u306e\u307f\uff0c\u304b\u306a\u308a\u306e\u5229\u76ca\u304c\u898b\u3089\u308c\u308b\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u30b3\u30ec\u30b9\u30c6\u30ed\u30fc\u30eb\u4f4e\u4e0b\u85ac\u306f\u51a0\u52d5\u8108\u75be\u60a3\u306b\u3088\u308b\u6b7b\u4ea1\u7387\u3092\u4f4e\u4e0b\u3055\u305b\uff0c\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306b\u304a\u3051\u308b\u5168\u6b7b\u4ea1\u7387\u306b\u5927\u304d\u306a\u52b9\u679c\u3092\u3082\u305f\u3089\u3057\u305f\uff0e\u305d\u306e\u60a3\u8005\u3068\u306f\u9ad8\u8102\u8840\u75c7\u3068\u540c\u5b9a\u3055\u308c\u305f\u7121\u75c7\u5019\u6027\u306e\u60a3\u8005\u3088\u308a\u3082\u51a0\u52d5\u8108\u75be\u60a3\u3068\u8a3a\u65ad\u306e\u78ba\u5b9a\u3057\u305f\u60a3\u8005\u3067\u3042\u308b\uff0e\u3053\u308c\u304c\u51a0\u52d5\u8108\u75be\u60a3\u306b\u3088\u308b\u4e00\u8cab\u3057\u305f\u6b7b\u4ea1\u30ea\u30b9\u30af\u4f4e\u4e0b\u304b\u3089\uff0c\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306b\u304a\u3051\u308b\u60a3\u8005\u306e\u5168\u6b7b\u56e0\u3092\u6e1b\u5c11\u3055\u305b\u308b\u3053\u3068\u3078\u3068\u6577\u884d\u3055\u308c\u308b\u3053\u3068\u306e\u6839\u62e0\u3067\u3042\u308a\uff0c\u5168\u6b7b\u4ea1\u306e\u3088\u308a\u5927\u304d\u306a\u5272\u5408\u304c\u51a0\u52d5\u8108\u75be\u60a3\u306b\u306a\u308b\u7b48\u3060\u3063\u305f\u60a3\u8005\u3067\u3042\u308b\uff0e\u4eee\u306b\u5c0f\u898f\u6a21\u8a66\u9a13\u304c\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u306b\u5b9f\u65bd\u3055\u308c\u308c\u3070\u30d5\u30a1\u30f3\u30cd\u30eb\u30d7\u30ed\u30c3\u30c8\u306b\u975e\u5bfe\u79f0\u6027\u3092\u751f\u3058\u308b\u7d50\u679c\u3068\u306a\u308b\u306f\u305a\u3067\u3042\u308b\uff0e<\/p>\n<p>\u3000\u3088\u308a\u5927\u898f\u6a21\u306a\u8a66\u9a13\u304c\u78ba\u7acb\u3059\u308b\u524d\u306b\u306f\u4e00\u822c\u306b\u5c0f\u898f\u6a21\u8a66\u9a13\u304c\u5b9f\u65bd\u3055\u308c\u308b\uff0e\u73fe\u5728\u306b\u81f3\u308b\u307e\u3067\uff0c\u5bfe\u7167\u7fa4\u306e\u6cbb\u7642\u6cd5\u306f\u5b9f\u9a13\u7684\u6cbb\u7642\u306e\u52b9\u80fd\u3092\u4f4e\u4e0b\u3055\u305b\u308b\u65b9\u6cd5\u3067\u6539\u5584\u3057\uff0c\u5909\u5316\u3057\u3066\u304d\u305f\uff0e\u5fc3\u7b4b\u6897\u585e\u306b\u5bfe\u3059\u308b\u30de\u30b0\u30cd\u30b7\u30a6\u30e0\u9759\u6ce8\u306e\u52b9\u679c\u3092\u8abf\u3079\u305f\u8a66\u9a13\u3067\u89b3\u5bdf\u3055\u308c\u305f\u7d50\u679c\u3068\u306e\u4e56\u96e2\u306e\u8aac\u660e\u3068\u3057\u3066\uff0c\u305d\u306e\u3088\u3046\u306a\u6a5f\u5e8f\u304c\u63d0\u6848\u3055\u308c\u3066\u304d\u305f\uff0e\u3053\u306e\u89e3\u91c8\u306f\u81e8\u5e8a\u8a66\u9a13\u306e\u30c7\u30fc\u30bf\u304b\u3089\u306f\u652f\u6301\u3055\u308c\u3066\u3044\u306a\u3044\u306e\u3060\u304c\uff0e\u7d50\u5c40\u306e\u3068\u3053\u308d\uff0c\u3042\u308b\u4ecb\u5165\u306f\u5927\u898f\u6a21\u8a66\u9a13\u306b\u304a\u3044\u3066\u306f\u3088\u308a\u5fb9\u5e95\u3055\u308c\u305a\u306b\u5b9f\u65bd\u3055\u308c\u308b\u306e\u304b\u3082\u3057\u308c\u305a\uff0c\u6545\u306b\u3088\u308a\u5c0f\u898f\u6a21\u306a\u8a66\u9a13\u307b\u3069\u6700\u3082\u967d\u6027\u306e\u7d50\u679c\u304c\u51fa\u308b\u3053\u3068\u3092\u8aac\u660e\u3057\u3066\u3044\u308b\u306e\u304b\u3082\u3057\u308c\u306a\u3044\uff0e\u6211\u3005\u306e\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3068\u5927\u898f\u6a21\u8a66\u9a13\u3068\u306e\u6bd4\u8f03\u3092\u8003\u616e\u3059\u308b\u3068\uff0c\u4ecb\u5165\u306e 1 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messages<\/h2>\n<ul>\n<li>Systematic reviews of randomised trials are the best strategy for appraising evidences; however, the findings of some meta-analyses were later contradicted by large trials<\/li>\n<li>Funnel plots, plots of the trials&#8217; effect estimates against sample size, are skewed and asymmetrical in the presence of publication bias and other biases<\/li>\n<li>Funnel plot asymmetry, measured by regression analyses, predicts discordance of results when meta-analyses are compared with single large trials<\/li>\n<li>Funnel plot asymmetry was found in 38% of meta-analyses published in leading general medicine journals and in 13% of reviews from Cochrane Database of Systematic Reviews<\/li>\n<li>Critical examination of systematic reviews for publication and related biases should be considered a routine procedure<\/li>\n<\/ul>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>\u3000\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u3084\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u306b\u304a\u3044\u3066\uff0c\u8907\u6570\u306e\u30b3\u30db\u30fc\u30c8\u8a66\u9a13\u3084\u7121\u4f5c\u70ba\u5316\u6bd4\u8f03\u8a66\u9a13\u306e\u30c7\u30fc\u30bf\u3092\u7d71\u5408\u3057\u305f\u308a\u7d2f\u7a4d\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3092\u884c\u3046\u306a\u3069\u3057\u3066\u3088\u308a\u7cbe\u5ea6\u306e\u9ad8\u3044\u89e3\u6790\u3092\u884c\u3044\u307e\u3059\uff0e\u3057\u304b\u3057\u306a\u304c\u3089\u305d\u3053\u306b\u306f\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u3068\u3044\u3046\u504f\u308a\u3092\u907f\u3051\u308b &hellip; <a href=\"https:\/\/www.fujiitoshiki.com\/improvesociety\/?p=3651\" class=\"more-link\"><span class=\"screen-reader-text\">&#8220;\u51fa\u7248\u30d0\u30a4\u30a2\u30b9\u306e\u6709\u7121\u3092funnel plot\u306b\u3088\u308a\u78ba\u8a8d\u3059\u308b&#8221; 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