自己対照デザイン：ケースクロスオーバーデザイン・ケースタイムコントロールデザイン

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Ξ΢τΧϜ͕ΞϯΧʔͱͳΔ   ࣗݾରরσβΠϯ ྟচӸֶݚڀʹ͓͚Δใࠂͷ࣭޲্ͷͨΊͷ౷ܭֶͷݚڀձ ୈճݚڀूձ ࠤ౻ढ़ଠ࿕ ௕࡚େֶපӃྟচݚڀηϯλʔ TIVOUBSPTBUP!OBHBTBLJVBDKQ

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2 Ξ΢τΧϜ͕ΞϯΧʔͷࣗݾରরσβΠϯͷུ֓ έʔεΫϩεΦʔόʔσβΠϯ έʔελΠϜίϯτϩʔϧσβΠϯ έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯ ಘΒΕΔޮՌ ৚݅ͱԾఆ όΠΞε ऑΈ ऑΈ ౷ܭղੳʢέʔεΫϩεΦʔόʔͱέʔελΠϜίϯτϩʔϧʣ ඞཁͳσʔληοτͷܗ ౷ܭղੳํ๏ 0WFSWJFX ܭࢉํ๏ ಘΒΕΔޮՌ ܭࢉํ๏ ಘΒΕΔޮՌ ܭࢉํ๏

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έʔεΫϩεΦʔόʔσβΠϯͱ͸ʁ

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Ϟνϕʔγϣϯ 4 ৺ے伷࠹ʢ.*ʣͷൃ঱ʹӨڹ͢Δൃ঱௚લͷཁҼΛௐ΂͍ͨʂ ଟ͘ͷ.*͸ɺൃ঱લͷ਺͔࣌ؒΒ਺೔ͷ׆ಈ͕Ҿ͖ۚʹͳͬͯΔͩΖ͏ɻ έʔείϯτϩʔϧݚڀΛܭը͠Α͏ɻ Ͱ΋ɺίϯτϩʔϧ܈ͷ৘ใΛूΊΔͷେมͩΑͶʜɻ έʔείϯτϩʔϧݚڀͰ͸ɺ   έʔεͱίϯτϩϧͷݪूஂ͕ಉ͡ඞཁ͕͋Δ έʔεͱಉ͡ݪूஂ͸ʁ έʔεࣗ਎ ݪूஂ έʔε ίϯτϩʔϧ έʔεΫϩεΦʔόʔσβΠϯ .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r $BTFDSPTTPWFSEFTJHO

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έʔεΫϩεΦʔόʔσβΠϯͷԿ͕͏Ε͍͔͠ʁ 5 w έʔεͷ৘ใ͚ͩूΊΕ͹ྑ͍ w ࣌ؒͰมಈ͠ͳ͍ҼࢠΛແࢹͰ͖Δ w ະ஌ɾະଌఆͰ͋ͬͯ΋ʢFHҨ఻৘ใʣ

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Maclure M.   The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol. 1991 Jan 15;133(2):144–53. έʔεΫϩεΦʔόʔσβΠϯɿ۩ମྫᶃ

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7 .*ൃ঱ ΞϯΧʔ 32 ίʔώʔͷઁऔ͸ɺ.*ൃ঱ͷҾ͖ۚʹͳΔ͔ʁ ର৅ूஂ .*ൃ঱ͨ͠ਓ Ξ΢τΧϜʢΞϯΧʔʣ ৺ے伷࠹ʢ.*.ZPDBSEJBM*OGBSDUJPOʣ മ࿐ ίʔώʔઁऔ য఺ظؒʢ'PDBMXJOEPXʣ .*ൃ঱௚લͷ࣌ؒ ࢀরظؒʢ3FGFSFOUXJOEPXʣ աڈ೥ؒʢ.*ൃ঱௚લͷ࣌ؒΛআ͘ʣ ղੳ୯Ґ ࣌ؒ ϝϞ ΠϯλϏϡʔௐࠪʢ.*ൃ঱ޙɺதԝ஋೔Ͱฉ͖औΓʣ য఺ظؒ ࢀরظؒ ࣌ؒ ʜ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ؍࡯ظؒʢ೥ؒʣ έʔεΫϩεΦʔόʔσβΠϯʢ.BDMVSFͷྫʣ

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σʔλʢ.BDMVSFͷྫʣ 8 *% .*ൃ঱લͷ࠷ޙͷ   ίʔώʔઁऔ ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕   য఺ظؒࢀরظؒ ظ଴͞ΕΔ য఺ظؒࢀরظؒ IPVST EBZ NJOVUFT EBZ IPVST NPOUI IPVST EBZ IPVST EBZ IPVST NPOUI IPVST EBZ IPVST EBZ IPVST EBZ IPVST EBZ .BDMVSF ͷදΛվม ೔ճҿΉ͔Β   ೥ؒͰɺظ଴͞ΕΔয఺ظؒʢ࣌ؒʣ͸ճº೔࣌ؒ ظ଴͞ΕΔࢀরظؒʢ࣌ؒʣ͸೔º࣌ؒ࣌ؒ ࣌ؒ .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r ࣌ؒ

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σʔλͷΠϝʔδʢ*%ʣ 9 .*ൃ঱ য఺ظؒ ࢀরظؒ ࣌ؒ ʜ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ຖ೔ճҿΉਓ *% .*ൃ঱લͷ࠷ޙͷ   ίʔώʔઁऔ ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕   য఺ظؒࢀরظؒ ظ଴͞ΕΔ য఺ظؒࢀরظؒ IPVST EBZ য఺ظؒ ࢀরظؒ ࠷ޙͷമ࿐ظؒ 1FSTPOUJNF º

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σʔλͷΠϝʔδʢ*%ʣ 10 .*ൃ঱ য఺ظؒ ࢀরظؒ ࣌ؒ ʜ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ϲ݄ʹճҿΉਓ *% .*ൃ঱લͷ࠷ޙͷ   ίʔώʔઁऔ ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕   য఺ظؒࢀরظؒ ظ଴͞ΕΔ য఺ظؒࢀরظؒ IPVST NPOUI য఺ظؒ ࢀরظؒ ࠷ޙͷമ࿐ظؒ 1FSTPOUJNF º

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݁Ռʢ.BDMVSFͷྫʣ 11 *% .*ൃ঱લͷ࠷ޙͷ   ίʔώʔઁऔ ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕   য఺ظؒࢀরظؒ ظ଴͞ΕΔ য఺ظؒࢀরظؒ IPVST EBZ NJOVUFT EBZ IPVST NPOUI IPVST EBZ IPVST EBZ IPVST NPOUI IPVST EBZ IPVST EBZ IPVST EBZ IPVST EBZ 33.) 13,517 7,355 = 1.8 য఺ظؒʹ മ࿐͕͋ͬͨέʔεͷ   ظ଴ࢀরظؒͷ࿨ ࢀরظؒʹ മ࿐͕͋ͬͨέʔεͷ   ظ଴য఺ظؒͷ࿨ .BOUFM)BFOT[FMਪఆྔ 3BUFSBUJP .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r ίʔώʔઁऔ࣌ؒҎ಺ͷ.*ൃ঱཰ൺ

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.BOUFM)BFO[FMਪఆྔʢ3BUFSBUJPʣᶃ 12 য఺ظؒ ࢀরظؒ 5PUBM ࠷ޙͷമ࿐ظؒ "J "J 1FSTPOUJNF 5J 5J 5J RRMH = ∑N i=1 A1i T0i /T+i ∑N i=1 A0i T1i /T+i αϯϓϧαΠζ/ Ұͭͷ૚͸ɺҰਓͷݸମͰ׬݁ .BOUFM)BFOT[FMਪఆྔ ҰਓͻͱΓͷݸମΛ૚ͱߟ͑ͯɺ৘ใΛ଍͠ࠐΜͰ͍͘ ݸମ಺ͰɺϚονϯά͍ͯ͠ΔΠϝʔδ

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.BOUFM)BFO[FMਪఆྔʢ3BUFSBUJPʣᶄ 13 *% য఺ظؒ ࢀরظؒ ࠷ޙͷമ࿐ظؒ 1FSTPOUJNF *% য఺ظؒ ࢀরظؒ ࠷ޙͷമ࿐ظؒ 1FSTPOUJNF য఺ظؒ ࢀরظؒ 5PUBM ࠷ޙͷമ࿐ظؒ "J "J 1FSTPOUJNF 5J 5J 5J RRMH = ∑N i=1 A1i T0i /T+i ∑N i=1 A0i T1i /T+i RRMH = 1 ⋅ 5116/8776 + 0 ⋅ 8730/8776 0 ⋅ 3650/8776 + 1 ⋅ 36/8776 *% *% = 142

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݁Ռͷهࡌʢ.BDMVSFͷྫʣ 14 33.) 13,517 7,360 = 1.8 'PSUIFPOFIPVSQFSJPEBGUFSESJOLJOHDP ff FF   UIFSBUFSBUJPJT QFSDFOU$* .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r

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Mittleman MA, Lewis RA, Maclure M, Sherwood JB, Muller JE. Triggering myocardial infarction by marijuana. Circulation.   2001 Jun 12;103(23):2805–9. έʔεΫϩεΦʔόʔσβΠϯɿ۩ମྫᶄ

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16 .*ൃ঱ ΞϯΧʔ 32 େຑͷ࢖༻͸ɺ.*ൃ঱ͷҾ͖ۚʹͳΔ͔ʁ ର৅ूஂ .*ൃ঱ͨ͠ਓ Ξ΢τΧϜʢΞϯΧʔʣ ৺ے伷࠹ʢ.*.ZPDBSEJBM*OGBSDUJPOʣ മ࿐ େຑͷ࢖༻ য఺ظؒʢ'PDBMXJOEPXʣ .*ൃ঱௚લͷ࣌ؒ ࢀরظؒʢ3FGFSFOUXJOEPXʣ աڈ೥ؒʢ.*ൃ঱௚લͷ࣌ؒΛআ͘ʣ ղੳ୯Ґ ࣌ؒ ϝϞ ΠϯλϏϡʔௐࠪʢ.*ൃ঱ޙɺதԝ஋೔Ͱฉ͖औΓʣ য఺ظؒ ࢀরظؒ ࣌ؒ ʜ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ࣌ؒ ؍࡯ظؒʢ೥ؒʣ έʔεΫϩεΦʔόʔσβΠϯʢ.BDMVSFͷྫʣ

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౷ܭղੳํ๏ͷهࡌʢ.JUUMFNBOͷྫʣᶃ 17 5IFSBUJPPGUIFPCTFSWFEFYQPTVSFGSFRVFODZJOUIFIB[BSEQFSJPEUPUIF FYQFDUFEGSFRVFODZ GSPNUIFDPOUSPMJOGPSNBUJPO XBTVTFEUPDBMDVMBUF FTUJNBUFTPGUIFPEETSBUJPBTBNFBTVSFPGSFMBUJWFSJTL .JUUMFNBO." -FXJT3" .BDMVSF. 4IFSXPPE+# .VMMFS+& 5SJHHFSJOHNZPDBSEJBMJOGBSDUJPOCZNBSJKVBOB$JSDVMBUJPO+VO r য఺ظؒʢGPDBMXJOEPXʣ 5IFBOBMZTJTPGDBTFDSPTTPWFSEBUBJTBOBQQMJDBUJPOPGTUBOEBSENFUIPETGPS TUSBUJ fi FEEBUBBOBMZTJT*OUIJTBOBMZTJT UIFTUSBUJGZJOHWBSJBCMFJTUIFJOEJWJEVBM QBUJFOU BTJOBDSPTTPWFSFYQFSJNFOU έʔεΫϩεΦʔόʔσβΠϯͷઆ໌ "TTPDJBUJPONFBTVSFͷઆ໌

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౷ܭղੳํ๏ͷهࡌʢ.JUUMFNBOͷྫʣᶄ 18 .JUUMFNBO." -FXJT3" .BDMVSF. 4IFSXPPE+# .VMMFS+& 5SJHHFSJOHNZPDBSEJBMJOGBSDUJPOCZNBSJKVBOB$JSDVMBUJPO+VO r 5IFBNPVOUPGQFSTPOUJNFFYQPTFEUPNBSJKVBOBXBTFTUJNBUFECZNVMUJQMZJOH UIFSFQPSUFEVTVBMBOOVBMGSFRVFODZPGFYQPTVSFCZUIFEVSBUJPOPGJUT IZQPUIFTJ[FEQIZTJPMPHJDBMF ff FDU IPVS 6OFYQPTFEQFSTPOUJNFXBTUIFO DBMDVMBUFECZTVCUSBDUJOHUIFFYQPTFEQFSTPOUJNFJOIPVSTGSPNUIFOVNCFSPG IPVSTJOBZFBS ظ଴͞ΕΔয఺ظؒͱࢀরظؒͷઆ໌ ؍࡯ظؒʢ࣌ؒʣ͔Βظ଴য఺ظؒΛҾ͘ େຑͷޮՌ͕͋ΒΘΕΔͩΖ͏࣌ؒ

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౷ܭղੳํ๏ͷهࡌʢ.JUUMFNBOͷྫʣᶅ 19 .JUUMFNBO." -FXJT3" .BDMVSF. 4IFSXPPE+# .VMMFS+& 5SJHHFSJOHNZPDBSEJBMJOGBSDUJPOCZNBSJKVBOB$JSDVMBUJPO+VO r 5IFEBUBXFSFBOBMZ[FEVTJOHNFUIPETGPSDPIPSUTUVEJFTXJUITQBSTFEBUBJO FBDITUSBUVN ༻ҙͨ͠σʔλͷղੳํ๏ͷઆ໌ w .BOUFM)BFOT[FMਪఆྔ w ৚݅෇͖࠷໬ਪఆྔ Λܭࢉ͢Δ

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݁Ռͷهࡌʢ.JUUMFNBOͷྫʣ 20 .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r ױऀഎܠͷཁ໿ େຑͷ࢖༻ස౓ "TTPDJBUJPONFBTVSFͷ݁Ռ 0OUIFCBTJTPGBDBTFDSPTTPWFSBOBMZTJTUIBUDPOUSPMMFEGPSEJ ff FSFODFTCFUXFFO QBUJFOUT XFGPVOEUIBUXJUIJOIPVSBGUFSTNPLJOHNBSJKVBOB UIFSJTLPGNZPDBSEJBM JOGBSDUJPOPOTFUXBTFMFWBUFEGPME DPO fi EFODFJOUFSWBM UP1 DPNQBSFEXJUIQFSJPETPGOPOVTF *OUIFTFDPOEIPVSBGUFSTNPLJOH UIFSFMBUJWFSJTLXBT DPO fi EFODFJOUFSWBM UP1 TVHHFTUJOHBSBQJEEFDMJOFJOUIFDBSEJBDF ff FDUTPGNBSJKVBOB 'JHVSF

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έʔεΫϩεΦʔόʔσβΠϯɿ ޷·͍͠৚݅ͱԾఆ

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޷·͍͠৚݅ 22 ᶄമ࿐͸ɺஅଓతͰ͋Γɺ૝ఆ͞ΕΔ༠ಋظ͕ؒ୹͍ ᶃΞ΢τΧϜ͸ɺٸͳൃ঱ *OEVDUJPOQFSJPE Ξ΢τΧϜ ൃ঱ മ࿐ മ࿐ ༠ಋظؒ ༠ಋظؒ ࣌ؒ w )BTIFNJ/B[BSJ44 .BOTPVSOJB."$BTFDSPTTPWFSBOEDBTFUJNFDPOUSPMTUVEJFTDPODFQUT EFTJHO BOEBOBMZTJT+&QJEFNJPM#JPTUBU 0DU r w (SFFOMBOE4$POGPVOEJOHBOEFYQPTVSFUSFOETJODBTFDSPTTPWFSBOEDBTFUJNFDPOUSPMEFTJHOT&QJEFNJPMPHZ.BZ r w -BTI5- 7BOEFS8FFMF5+ )BOFVTF4 3PUINBO,+.PEFSOFQJEFNJPMPHZ GPVSUIFEJUJPO8PMUFST,MVXFS

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Ծఆ 23 ᶃമ࿐ͷ෼෍͕ɺݚڀظؒத͸Ұఆ ຖ೔ճҿΉਓ ϲ݄ʹճҿΉਓ ᶃ`മ࿐֬཰͕ɺΞ΢τΧϜൃ঱ʹରͯ͠ɺ৚݅෇͖ಠཱ ˠଌఆ͞Εͨɺ࣌ؒมಈͷަབྷҼࢠ͸ௐ੔͠ͳ͚Ε͹ͳΒͳ͍ w .JUUMFNBO." .PTUPGTLZ&&YDIBOHFBCJMJUZJOUIFDBTFDSPTTPWFSEFTJHO*OU+&QJEFNJPM0DU r w (SFFOMBOE4$POGPVOEJOHBOEFYQPTVSFUSFOETJODBTFDSPTTPWFSBOEDBTFUJNFDPOUSPMEFTJHOT&QJEFNJPMPHZ.BZ r w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG0VUDPNF&WFOUTXJUI "CSVQU0OTFU&QJEFNJPMPHZ/PW r w -BTI5- 7BOEFS8FFMF5+ )BOFVTF4 3PUINBO,+.PEFSOFQJEFNJPMPHZ GPVSUIFEJUJPO8PMUFST,MVXFS ˠ৚݅෇͖ϩδεςΟοΫճؼϞσϧ͕ඞཁ

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Wang SV, Schneeweiss S, Maclure M, Gagne JJ.   “First-wave” bias when conducting active safety monitoring of newly marketed medications   with outcome-indexed self-controlled designs.   Am J Epidemiol. 2014 Sep 15;180(6):636–44. έʔεΫϩεΦʔόʔσβΠϯɿ۩ମྫ

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25 .*ൃ঱ ΞϯΧʔ 32 ৽نൢച͞ΕͨΞϦϐϓϥκʔϧ   ʢ߅ਫ਼ਆපༀʣͷ෰༻͸ɺ   .*ൃ঱ͷҾ͖ۚʹͳΔ͔ʁ ɹࢢൢޙͷ෭࡞༻ௐࠪ ର৅ूஂ w .*ൃ঱ͨ͠ਓ w .*ൃ঱ͷϦεΫ͸͋Δະൃ঱ऀ Ξ΢τΧϜ ৺ے伷࠹   ʢ.*.ZPDBSEJBM*OGBSDUJPOʣ മ࿐ ΞϦϐϓϥκʔϧ෰༻ য఺ظؒ .*ൃ঱೔ͷલ೔ʢ೔ؒʣ ࢀরظؒ .*ൃ঱೔ͷલʙ೔ʢ೔ؒʣ ղੳ୯Ґ ਓ ϝϞ OBUJPOBM.FEJDBJE"OBMZUJDF9USBDU อݥͷσʔλʢʙ೥ʣ σβΠϯʢ8BOH47ͷྫɿҰ෦ʣ ৽نൃച   ʢʣ ճ໨ௐࠪ ճ໨ௐࠪ ճ໨ௐࠪ ճ໨ௐࠪ ʜ ʜ ܧଓతͳϞχλϦϯά 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r

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26 ɹ݁Ռʢ8BOH47ͷྫɿҰ෦ʣᶃ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r έʔεΫϩεΦʔόʔσβΠϯͰղੳ ࢢൢޙ͙͢͸03ߴͯ͘ɺ   ࣌ؒܦͭͱ௿͘ͳΔʁ

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ༀࡎӸֶͰى͜Γ΍͍͢όΠΞε 27 ৽نༀࡎ͸ɺമ࿐֬཰͕ҰఆͰ͸ͳ͍ ࣌ؒ ༀࡎͷྲྀ௨ྔ ఆৗঢ়ଶ ༀࡎͷྲྀ௨ྔ͕ఆৗঢ়ଶʹࢸΔ·Ͱ͸ɺ   έʔεΫϩεΦʔόʔσβΠϯ͔Β   ಘͨਪఆ஋͸όΠΞε͞ΕΔ 'JSTUXBWFCJBT ඇఆৗঢ়ଶ

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28 ूஂϨϕϧͷമ࿐܏޲͕มΘΔͱ͖ɺͲ͏͢Δ͔ʁ έʔελΠϜίϯτϩʔϧσβΠϯ $BTFUJNFDPOUSPMEFTJHO ඇఆৗঢ়ଶ

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έʔελΠϜίϯτϩʔϧσβΠϯ

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30 .*ൃ঱ ΞϯΧʔ 32 ৽نൢച͞ΕͨΞϦϐϓϥκʔϧ   ʢ߅ਫ਼ਆපༀʣͷ෰༻͸ɺ   .*ൃ঱ͷҾ͖ۚʹͳΔ͔ʁ ɹࢢൢޙͷ෭࡞༻ௐࠪ ର৅ूஂ w .*ൃ঱ͨ͠ਓ w .*ൃ঱ͷϦεΫ͸͋Δະൃ঱ऀ Ξ΢τΧϜ ৺ے伷࠹   ʢ.*.ZPDBSEJBM*OGBSDUJPOʣ മ࿐ ΞϦϐϓϥκʔϧ෰༻ য఺ظؒ .*ൃ঱೔ͷલ೔ʢ೔ؒʣ ࢀরظؒ .*ൃ঱೔ͷલʙ೔ʢ೔ؒʣ ղੳ୯Ґ ਓ ϝϞ OBUJPOBM.FEJDBJE"OBMZUJDF9USBDU อݥͷσʔλʢʙ೥ʣ σβΠϯʢ8BOH47ͷྫɿҰ෦ʣ ৽نൃച   ʢʣ ճ໨ௐࠪ ճ໨ௐࠪ ճ໨ௐࠪ ճ໨ௐࠪ ʜ ʜ ܧଓతͳϞχλϦϯά 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r

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31 .*ൃ঱ ΞϯΧʔ έʔελΠϜίϯτϩʔϧσβΠϯʢ8BOH47ͷྫʣ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r έʔε ίϯτϩʔϧ ONBUDI w ೥ྸɺੑผͰέʔεͱϚονϯά w Ϛονϯάର৅ͷέʔεͷΞ΢τΧϜൃ঱೔ʢج४೔ʣʹ.*ͷϦεΫ͕͋Δ w ج४೔͔Β೔Ҏ্લ͔ΒҩྍอݥʹՃೖ͍ͯ͠Δ w য఺ظؒͱࢀরظؒ͸ɺϚονϯάͨ͠έʔεͱἧ͑Δ ORCCO(cases) ORCCO(controls) മ࿐ޙͷ   Ξ΢τΧϜൃ঱ͷΦοζൺ ࢀরظؒʹର͢Δ   য఺ظؒͷമ࿐Φοζൺ മ࿐֬཰্͕͕Δ മ࿐֬཰͕Լ͕Δ ௐ੔ ORCCO(cases) ORCCO(controlss) ΞϦϐϓϥκʔϧ ΞϦϐϓϥκʔϧ ج४೔

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32 ɹ݁Ռʢ8BOH47ͷྫɿҰ෦ʣᶄ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r ࣌ؒΛ௨ͯ͠OVMM

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౷ܭղੳํ๏ͷهࡌʢ8BOH47ͷྫʣᶃ 33 'PSFBDIFYBNQMF XFDPOEVDUFEDBTFDSPTTPWFSTUVEJFTUIBUDPNQBSFEUIF FYQPTVSFPEETEVSJOHBOJOEFYXJOEPXPGEBZTQSJPSUPUIFEBUFPG PVUDPNFUPUIFFYQPTVSFPEETEVSJOHBSFGFSFODFXJOEPXPGrEBZT QSJPSUPUIFEBUFPGUIFPVUDPNF 1BUJFOUTXFSFJODMVEFEJGUIFZFYQFSJFODFEUIFFWFOUPGJOUFSFTUGPMMPXJOHB XBTIPVUQFSJPEPGBUMFBTUEBZTEVSJOHXIJDIUIFQBUJFOUTXFSF FOSPMMFEJOUIFIFBMUIDBSFQMBOBOEEJEOPUIBWFUIFPVUDPNFPGJOUFSFTU B EBZHBQJOFOSPMMNFOUXBTBMMPXFE ʙ8FUIFOEF fi OFEBOJOEJWJEVBMBT FYQPTFEEVSJOHUIFJOEFYPSSFGFSFODFXJOEPXJGUIFSFXFSF BUNJOJNVN EBZTTVQQMZPGNFEJDBUJPOBWBJMBCMFEVSJOHUIBUUJNFXJOEPX έʔεɾΫϩεΦʔόʔσβΠϯͷઆ໌ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r w "TTPDJBUJPONFBTVSF w য఺ظؒͱࢀরظؒ w য఺ظؒͱࢀরظؒͷଥ౰ੑ

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౷ܭղੳํ๏ͷهࡌʢ8BOH47ͷྫʣᶄ 34 'PSFBDIFYBNQMF XFVTFEOWBSJBCMFSBUJPNBUDIJOHPGDBTFTUPTBNQMFT PGQFSTPOUJNFBNPOHDPOUSPMT*OEJWJEVBMTXFSFFMJHJCMFBTDPOUSPMTGPSB DBTFJGUIFZXFSFBUSJTLGPSUIFPVUDPNFPOUIFDBTFTJOEFYEBUFBOEXFSF FOSPMMFEJOUIFIFBMUIQMBOGPSBUMFBTUEBZTQSJPSUPUIFJOEFYEBUF B EBZHBQJOFOSPMMNFOUXBTBMMPXFE 5IFTBNQMFEDPOUSPMQFSTPOUJNF XBTNBUDIFEUPUIFDBTFPOBHF TBNFZFBSPGCJSUI DBMFOEBSUJNF TBNF JOEFYEBUF BOETFY5IFEF fi OJUJPOTPGJOEFYXJOEPXT SFGFSFODFXJOEPXT BOEFYQPTVSFTXFSFUIFTBNFGPSDBTFTBOENBUDIFEDPOUSPMQFSTPOUJNF έʔελΠϜίϯτϩʔϧσβΠϯͷઆ໌ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r w OϚονϯά w ίϯτϩʔϧͷ   য఺ظؒͱࢀরظؒ w ίϯτϩʔϧͷద֨ج४ w Ϛονϯάม਺ ܧଓతϞχλϦϯάͷઆ໌

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౷ܭղੳํ๏ͷهࡌʢ8BOH47ͷྫʣᶅ 35 5IFDBTFDSPTTPWFSQBSBNFUFSPGJOUFSFTUJTUIFFYQPTVSFPEETSBUJP &03 GPSUIFOFXMZNBSLFUFENFEJDBUJPOEVSJOHUIFJOEFYQFSJPEWFSTVTUIF SFGFSFODFQFSJPE5IFQBSBNFUFSPGJOUFSFTUGPSUIFDBTFUJNFDPOUSPM FTUJNBUFJTUIF&03GPSUIFOFXMZNBSLFUFENFEJDBUJPOBNPOHDBTFTBGUFS BEKVTUNFOUGPSUIF&03GPSUIFOFXMZNBSLFUFENFEJDBUJPOBNPOH NBUDIFEDPOUSPMQFSTPOUJNF &TUJNBOEͷઆ໌ 8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT   XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ r w έʔεΫϩεΦʔόʔͷ   &TUJNBOE w έʔελΠϜίϯτϩʔϧͷ   &TUJNBOE ORCCO(cases) ORCCO(controlss)

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36 έʔελΠϜίϯτϩʔϧσβΠϯͷ՝୊ έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯ $BTFDBTFUJNFDPOUSPMEFTJHO w έʔεͷσʔλ͔͠ͳ͍ w Ϛονϯάͯ͠΋ɺέʔεͱίϯτϩʔϧͰഎܠ৘ใͷͣΕ͸͋Δ

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έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯ

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38 32 ߅ਫ਼ਆපༀͷ෰༻͸ɺ   ڏ݂ੑ೴ଔதൃ঱ͷҾ͖ۚʹͳΔ͔ʁ ର৅ूஂ ڏ݂ੑ೴ଔத͕ൃ঱ͨ͠ਓ Ξ΢τΧϜ ڏ݂ੑ೴ଔத മ࿐ ߅ਫ਼ਆපༀ෰༻ য఺ظؒ ڏ݂ੑ೴ଔதൃ঱೔ͷલ೔ʢ೔ؒʣ ࢀরظؒ ڏ݂ੑ೴ଔதൃ঱೔ͷલʙ೔ʢ೔ؒʣ ղੳ୯Ґ ਓ ϝϞ ୀ໾܉ਓ݈߁ிͷσʔλʢʙ೥ʣ έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯʢ8BOH4ͷྫɿҰ෦ʣᶃ 8BOH4 -JOLMFUUFS$ %PSF% .PS7 #VLB4 .BDMVSF."HF BOUJQTZDIPUJDT BOEUIFSJTLPGJTDIFNJDTUSPLFJOUIF7FUFSBOT)FBMUI "ENJOJTUSBUJPO4USPLF+BO r

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39 ڏ݂ੑ೴ଔதൃ঱ ΞϯΧʔ έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯʢ8BOH4ͷྫʣᶄ έʔε ORCCO(cases) ORCCO(controls) മ࿐ޙͷ   Ξ΢τΧϜൃ঱ͷΦοζൺ ࢀরظؒʹର͢Δ   য఺ظؒͷമ࿐Φοζൺ ௐ੔ ORCCO(cases) ORCCO(controlss) ߅ਫ਼ਆපༀ ߅ਫ਼ਆපༀͰͳ͍ॲํༀ ؔ৺ͷ͋Δༀࡎͷമ࿐܏޲ͱ ଞͷίϯτϩʔϧͱ͢Δༀࡎͷമ࿐܏޲͕ಉ͡ Ծఆ 8BOH4 -JOLMFUUFS$ %PSF% .PS7 #VLB4 .BDMVSF."HF BOUJQTZDIPUJDT BOEUIFSJTLPGJTDIFNJDTUSPLFJOUIF7FUFSBOT)FBMUI "ENJOJTUSBUJPO4USPLF+BO r w 03͸৚݅෇͖ϩδεςΟοΫճؼ෼ੳͰਪఆ w $*͸ϒʔτετϥοϓ๏Ͱਪఆ

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40 ɹ݁Ռʢ8BOH4ͷྫɿҰ෦ʣ 8BOH4 -JOLMFUUFS$ %PSF% .PS7 #VLB4 .BDMVSF."HF BOUJQTZDIPUJDT BOEUIFSJTLPGJTDIFNJDTUSPLFJOUIF7FUFSBOT)FBMUI "ENJOJTUSBUJPO4USPLF+BO r 8FQSFTFOUFTUJNBUFTGPSUIFTUSFOHUIPGUIFSFMBUJPOTIJQCFUXFFO FYQPTVSFUPBOUJQTZDIPUJDTBOETUSPLFBGUFSBEKVTUJOHGPSUIFF ff FDUPG UJNFJOWBSJBOUXJUIJOQFSTPODPOGPVOEFSTBTXFMMBTFYQPTVSFUJNF USFOET5IFPEETPGTUSPLFXFSF $* r UJNFTHSFBUFS XIFOFYQPTFEUPBOUJQTZDIPUJDTGPSBUMFBTUPGUIFMBTUEBZTUIBO XIFOUIFSFXFSFEBZTPGBOUJQTZDIPUJDFYQPTVSFXJUIJOEBZT"HF TUSBUJ fi FEFTUJNBUFTTVHHFTUBHSFBUFSUSJHHFSJOHF ff FDUPGBOUJQTZDIPUJDT POTUSPLFXJUIJODSFBTJOHBHF w ࣌ؒෆมͷަབྷҼࢠͱ   മ࿐܏޲Λௐ੔ͨ͠ਪఆ w ͢΂ͯͷݚڀର৅ʹର͢Δਪఆ w ೥ྸ૚͝ͱʹਪఆɿޮՌम০ͷ֬ೝ

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σβΠϯͷ·ͱΊ 41 έʔεΫϩεΦʔόʔ έʔελΠϜίϯτϩʔϧ έʔεɾέʔελΠϜίϯτϩʔϧ ࢖༻͢Δ ৘ใ έʔεʢΞ΢τΧϜൃ঱ྫͷΈʣ w έʔεʢΞ΢τΧϜൃ঱ྫʣ w ίϯτϩʔϧ   ʢΞ΢τΧϜඇൃ঱ྫʣ έʔεʢΞ΢τΧϜൃ঱ྫͷΈʣ ղੳํ๏ w .BOUFM)BFOT[FMਪఆ w ৚݅෇͖ϙΞιϯճؼ w ৚݅෇͖ϩδεςΟοΫճؼ w Ϛονϯά w ৚݅෇͖ϩδεςΟοΫճؼ ৚݅෇͖ϩδεςΟοΫճؼ Ծఆ w മ࿐܏޲͕Ұఆ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ w έʔεͱ   ίϯτϩʔϧͷമ࿐܏޲͕ಉ͡ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ w έʔεͱରԠ͢Δέʔε಺ͷ   ίϯτʔϧͷമ࿐܏޲͕ಉ͡ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ ௕ॴ Ξ΢τΧϜൃ঱ྫͷ৘ใͷΈͰྑ͍ മ࿐܏޲Λௐ੔Ͱ͖Δ w മ࿐܏޲Λௐ੔Ͱ͖Δ w Ξ΢τΧϜൃ঱ྫͷ৘ใͷΈͰྑ͍ ୹ॴ മ࿐܏޲͕ఆৗঢ়ଶͰͳ͚Ε͹ͳΒͳ͍ ద੾ͳίϯτϩʔϧͷ৘ใ͕ඞཁ ద੾ͳέʔε಺ͷίϯτʔϧͷ৘ใ͕ඞ ཁ

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έʔεΫϩεΦʔόʔσβΠϯɿ σʔλͷܗͱ3Λ࢖ͬͨ౷ܭղੳ

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࢝఺ͱͳΔղੳ༻σʔλʢ.BDMVSFͷྫʣ 43 *% .*ൃ঱લͷ࠷ޙͷ   ίʔώʔઁऔ ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕   য఺ظؒ ࠷ޙͷമ࿐͕ ࢀরظؒ ظ଴͞ΕΔ য఺ظؒ ظ଴͞ΕΔ ࢀরظؒ ݚڀظؒ JE MBTU@FY@UJNF GSFR@FY GSFR@FY@VOJU GPDBM@FY SFG@FY 5@GPDBM 5@SFG 5 IPVST EBZ E NJOVUFT EBZ E IPVST NPOUI N IPVST EBZ E IPVST EBZ E IPVST NPOUI N IPVST EBZ E IPVST EBZ E IPVST EBZ E IPVST EBZ E .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT   "N+&QJEFNJPM+BO r ೖྗ ೖྗ ೖྗ ܭࢉ ೖྗ

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ऴ఺ͱͳΔղੳ༻σʔλʢ.BDMVSFͷྫʣ 44 *% য఺ظؒ PSࢀরظؒ Ξ΢τΧϜͷൃ঱ JE FYQPTVSF DBTF ᶃ*%͝ͱͷFYQPTVSF ͕ରԠ͢Δظؒͷ਺͚ͩߦ͕͋Δ ߦ ߦ ߦ ߦ ᶄDBTFʹ͸ɺ·ͣ͢΂ͯΛೖΕΔ ᶅ֤JEɺ֤FYQPTVSFͷߦ໨ͷΈ   ֤ظؒͷമ࿐ͷ༗ແʹରԠ͢ΔΑ͏ʹDBTFʹΛೖΕΔ Ξ΢τΧϜൃ঱͸ɺJE͝ͱʹճͷΈ͔ͩΒ ߦ ߦ

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ղੳ༻σʔλ࡞੒ίʔυᶃ 45 ४උ σʔλೖྗ

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ղੳ༻σʔλ࡞੒ίʔυᶄ 46 ੨͍෦෼ͷܭࢉ

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ղੳ༻σʔλ࡞੒ίʔυᶅ 47 ऴ఺σʔληοτΛ࡞੒ ᶃ*%͝ͱͷFYQPTVSF ͕ରԠ͢Δظؒͷ਺͚ͩߦ͕͋Δ ᶄDBTFʹ͸ɺ·ͣ͢΂ͯΛೖΕΔ ᶅ֤JEɺ֤FYQPTVSFͷߦ໨ͷΈ   ֤ظؒͷമ࿐ͷ༗ແʹରԠ͢ΔΑ͏ʹDBTFʹΛೖΕΔ

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౷ܭղੳίʔυ 48

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έʔελΠϜίϯτϩʔϧσβΠϯɿ σʔλͷܗͱ3Λ࢖ͬͨ౷ܭղੳ ࣗ৴͕ͳ͍ͷͰɺޙ΄Ͳ഑෍౳͍ͤͯͩ͘͞͞

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ֶश͢ΔͨΊͷಓඪᶃɹʢ˒͸ಛʹ͓͢͢Ίʣ 50 ֓؍Λ͔ͭΉʢೖ໳ʣ w ˒$BEBSFUUF4. .BDMVSF. %FMBOFZ+"$ 8IJUBLFS)+ )BZFT,/ 8BOH47 FUBM$POUSPMZPVSTFMG*41&FOEPSTFE HVJEBODFJOUIFBQQMJDBUJPOPGTFMGDPOUSPMMFETUVEZEFTJHOTJOQIBSNBDPFQJEFNJPMPHZ1IBSNBDPFQJEFNJPM%SVH4BG +VO rɹʲༀࡎӸֶͷཱ৔͔Βͷ·ͱΊʳ w -BTI5- 7BOEFS8FFMF5+ )BOFVTF4 3PUINBO,+.PEFSOFQJEFNJPMPHZ GPVSUIFEJUJPO8PMUFST,MVXFSɹʲϖ ʔδͰ·ͱ·͍ͬͯΔʳ w ˒$BSSBDFEP.BSUÍOF[& 5BSBDJEP. 5PCJBT" 4BF[. 'JHVFJSBT"$BTFDSPTTPWFSBOBMZTJTPGBJSQPMMVUJPOIFBMUI F ff FDUTBTZTUFNBUJDSFWJFXPGNFUIPEPMPHZBOEBQQMJDBUJPO&OWJSPO)FBMUI1FSTQFDU"VH rɹ ʲͲ͏ͳྖҬͰ࢖ΘΕ͍ͯΔ͔ɺͳΜͱͳ͘௫Ήʳ w ˒)BTIFNJ/B[BSJ44 .BOTPVSOJB."$BTFDSPTTPWFSBOEDBTFUJNFDPOUSPMTUVEJFTDPODFQUT EFTJHO BOEBOBMZTJT +&QJEFNJPM#JPTUBU0DU rɹʲํ๏࿦ͷ·ͱΊͱͯ͠Θ͔Γ΍͘͢ஸೡɻ؆୯͕ͩ਺ࣜ΋σʔλͷܗ΋ࡌͬ ͍ͯΔɻͨͩ͜͠ͷ··Ͱ͸ղੳͰ͖ͳ͍ʳ w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG 0VUDPNF&WFOUTXJUI"CSVQU0OTFU&QJEFNJPMPHZ/PW rɹʲෳ਺ͷσβΠϯͷํ๏࿦ϨϏϡʔͱͯ͠͸ ࠷΋ৄ͍͠ɻ͔͠͠೉͍͠ɻ֤࿦Λษڧ͠ͳ͕ΒɺԿ౓΋ৼΓฦΔ΂͠ʳ

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ֶश͢ΔͨΊͷಓඪᶄ 51 έʔεΫϩεΦʔόʔσβΠϯ w ˒4IJPTBLBJ, ,BHJNVSB5$BTF$SPTTPWFS4UVEZ+BQBOFTF+PVSOBMPG1IBSNBDPFQJEFNJPMPHZ:BLV[BJFLJHBLV rɹʲ೔ຊޠจݙʳ w ˒.BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF ff FDUTPOUIFSJTLPGBDVUFFWFOUT"N+ &QJEFNJPM+BO rɹʲΞ΢τΧϜ͕ΞϯΧʔͷࣗݾରরσβΠϯͷىݯͱͳΔ࿦จɻදͷ਺஋ʹͱ͜ΖͲ ͜Ζϛε͕͋ΔͷͰ஫ҙʳ w .JUUMFNBO." -FXJT3" .BDMVSF. 4IFSXPPE+# .VMMFS+&5SJHHFSJOHNZPDBSEJBMJOGBSDUJPOCZNBSJKVBOB $JSDVMBUJPO+VO rɹʲέʔεΫϩεΦʔόʔσβΠϯΛ࢖ͬͨݚڀͷ۩ମྫɻΘ͔Γ΍͍͢ʳ w .JUUMFNBO." .PTUPGTLZ&&YDIBOHFBCJMJUZJOUIFDBTFDSPTTPWFSEFTJHO*OU+&QJEFNJPM0DU rɹ ʲόΠΞεͷߏ଄Λཧղ͢Δɻ%"(Λ͍ࣔͯ͠ΔͷͰཧղ͠΍͍͢ʳ w ;IBOH;$BTFDSPTTPWFSEFTJHOBOEJUTJNQMFNFOUBUJPOJO3"OO5SBOTM.FE4FQ ɹʲ3Λ࢖ͬͨղੳ νϡʔτϦΞϧ࿦จɻίʔυ͸ݹ͘ɺ෼͔ΓͮΒ͍ɻ͜ͷࢿྉͷίʔυݟͯʳ

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ֶश͢ΔͨΊͷಓඪᶅ 52 έʔελΠϜίϯτϩʔϧσβΠϯ w ˒8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++l'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZ NBSLFUFENFEJDBUJPOTXJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ rɹ ʲέʔεΫϩεΦʔόʔͷऑΈΛཧղ্ͨ͠ͰɺέʔελΠϜίϯτϩʔϧσβΠϯͷϞνϕʔγϣϯ͕෼͔Δ۩ମྫɻʳ w 4VJTTB45IFDBTFUJNFDPOUSPMEFTJHO&QJEFNJPMPHZ.BZ rɹʲέʔελΠϜίϯτϩʔϧσβΠϯͷى ݯͱͳΔ࿦จʳ w (SFFOMBOE4$POGPVOEJOHBOEFYQPTVSFUSFOETJODBTFDSPTTPWFSBOEDBTFUJNFDPOUSPMEFTJHOT&QJEFNJPMPHZ .BZ rɹʲ(SFFMBOE͔ΒέʔελΠϜίϯτϩʔϧσβΠϯ͕͏·͍͔͘ͳ͍ྫͷఏࣔʳ w 4VJTTB45IFDBTFUJNFDPOUSPMEFTJHOGVSUIFSBTTVNQUJPOTBOEDPOEJUJPOT&QJEFNJPMPHZ+VM rɹ ʲ(SFFOMBOEͷ࿦จʹର͢Δ4VJTTBͷ੾Γฦ͠࿦จʳ έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯ w ˒8BOH4 -JOLMFUUFS$ %PSF% .PS7 #VLB4 .BDMVSF."HF BOUJQTZDIPUJDT BOEUIFSJTLPGJTDIFNJDTUSPLFJOUIF 7FUFSBOT)FBMUI"ENJOJTUSBUJPO4USPLF+BO rʲέʔεɾέʔελΠϜίϯτϩʔϧσβΠϯͷ۩ମྫɻ୹͘ ͯαΫοͱಡΊΔʳ w 8BOH4 -JOLMFUUFS$ .BDMVSF. %PSF% .PS7 #VLB4 FUBM'VUVSFDBTFTBTQSFTFOUDPOUSPMTUPBEKVTUGPSFYQPTVSF USFOECJBTJODBTFPOMZTUVEJFT&QJEFNJPMPHZ+VM rɹʲέʔεɾέʔελΠϜίϯτϩʔϧσβΠϯͷى ݯͱͳΔ࿦จʳ

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͝ਗ਼ௌ͋Γ͕ͱ͏͍͟͝·ͨ͠ɻ 53 έʔεΫϩεΦʔόʔ έʔελΠϜίϯτϩʔϧ έʔεɾέʔελΠϜίϯτϩʔϧ ࢖༻͢Δ ৘ใ έʔεʢΞ΢τΧϜൃ঱ྫͷΈʣ w έʔεʢΞ΢τΧϜൃ঱ྫʣ w ίϯτϩʔϧ   ʢΞ΢τΧϜඇൃ঱ྫʣ έʔεʢΞ΢τΧϜൃ঱ྫͷΈʣ ղੳํ๏ w .BOUFM)BFOT[FMਪఆ w ৚݅෇͖ϙΞιϯճؼ w ৚݅෇͖ϩδεςΟοΫճؼ w Ϛονϯά w ৚݅෇͖ϩδεςΟοΫճؼ ৚݅෇͖ϩδεςΟοΫճؼ Ծఆ w മ࿐܏޲͕Ұఆ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ w έʔεͱ   ίϯτϩʔϧͷമ࿐܏޲͕ಉ͡ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ w έʔεͱରԠ͢Δέʔε಺ͷ   ίϯτʔϧͷമ࿐܏޲͕ಉ͡ w മ࿐ͱΞ΢τΧϜൃ঱͕৚݅෇͖ಠཱ ௕ॴ Ξ΢τΧϜൃ঱ྫͷ৘ใͷΈͰྑ͍ മ࿐܏޲Λௐ੔Ͱ͖Δ w മ࿐܏޲Λௐ੔Ͱ͖Δ w Ξ΢τΧϜൃ঱ྫͷ৘ใͷΈͰྑ͍ ୹ॴ മ࿐܏޲͕ఆৗঢ়ଶͰͳ͚Ε͹ͳΒͳ͍ ద੾ͳίϯτϩʔϧͷ৘ใ͕ඞཁ ద੾ͳέʔε಺ͷίϯτʔϧͷ৘ใ͕ඞ ཁ

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͓·͚ έʔεΫϩεΦʔόʔσβΠϯɿ όΠΞε

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ަབྷ 55 ੑަব େຑ ৺ے伷࠹ ަབྷҼࢠ മ࿐ม਺ Ξ΢τΧϜ ᄶଉ૿ѱ ᄶଉͷༀ ࢮ๢ ަབྷҼࢠ മ࿐ม਺ Ξ΢τΧϜ w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG0VUDPNF&WFOUTXJUI "CSVQU0OTFU&QJEFNJPMPHZ/PW r ᄶଉ૿ѱ ӡಈ ৺ے伷࠹ ަབྷҼࢠ മ࿐ม਺ Ξ΢τΧϜ ੑަব͸େຑͷ࢖༻Λଅ͠ɺ ৺ے伷࠹ͷϦεΫΛߴΊΔ͔΋͠Εͳ͍ ᄶଉ૿ѱ͸ༀͷ࢖༻Λଅ͠ɺ ࢮ๢ͷϦεΫΛߴΊΔ͔΋͠Εͳ͍ ᄶଉ૿ѱ͸ӡಈͷ཈੍ʹಇ͖ɺ ৺ے伷࠹ͷϦεΫΛߴΊΔ͔΋͠Εͳ͍

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߹ྲྀ఺όΠΞε 56 ҧ๏ༀ෺   ࢖༻ ৺ے伷࠹ ࢀՃऀ മ࿐ม਺ Ξ΢τΧϜ w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG0VUDPNF&WFOUTXJUI "CSVQU0OTFU&QJEFNJPMPHZ/PW r બ୒ w ҧ๏ༀ෺࢖༻͸ݴ͍ʹ͍͘ͷͰࢀՃऀ͸ߜΒΕΔ w ৺ے伷࠹ͷױऀ͔͠ࢀՃ͠ͳ͍ ӡಈ ৺ے伷࠹ ੜଘ മ࿐ม਺ Ξ΢τΧϜ બ୒ w ӡಈ͢Δਓ͸ɺ͠ͳ͍ਓΑΓࢮ๢֬཰͸௿͍ w ৺ے伷࠹Λܦݧ͠ੜଘͨ͠ױऀ͔͠ࢀՃ͠ͳ͍

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മ࿐ͱΞ΢τΧϜͷ࣌ؒτϨϯυͱόΠΞεᶃ 57 w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG0VUDPNF&WFOUTXJUI "CSVQU0OTFU&QJEFNJPMPHZ/PW r ࣌ؒ େຑ ৺ے伷࠹ ࢀরظؒ w മ࿐֬཰͕࣌ؒͰมಈ͢Δ৔߹ɺ w ࣌ؒ͸େຑͷ࢖༻ʹӨڹ w ৺ے伷࠹ൃ঱ྫͷࢀরظؒΛબ୒ w બ୒͞Εͨࢀরظؒ͸࣌ؒʹΑͬͯ   മ࿐֬཰͕มΘ͍ͬͯΔ w ߹ྲྀ఺όΠΞεͷൃੜ ࣌ؒ ௟௧ༀ ৺ے伷࠹ ࢀরظؒ w മ࿐֬཰͕࣌ؒͰมಈͤͣɺ   Ξ΢τΧϜൃ঱֬཰͕࣌ؒʹΑΓมಈ͢Δ w ॲํᝦͷ͍Βͳ͍௟௧ༀͷ࢖༻֬཰͸҆ఆ͠ ͍ͯΔ w ͕࣌ؒܦͯ͹ܦͭ΄Ͳɺ.*ͷϦεΫ͸্͕Δ w ৺ے伷࠹ൃ঱ྫͷࢀরظؒΛબ୒ w ަབྷ΋߹ྲྀ఺όΠΞε΋ൃੜͤͣ

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മ࿐ͱΞ΢τΧϜͷ࣌ؒτϨϯυͱόΠΞεᶄ 58 w .PTUPGTLZ& $PVMM#" .JUUMFNBO.""OBMZTJTPG0CTFSWBUJPOBM4FMGNBUDIFE%BUBUP&YBNJOF"DVUF5SJHHFSTPG0VUDPNF&WFOUTXJUI "CSVQU0OTFU&QJEFNJPMPHZ/PW r ࣌ؒ ίʔώʔ ৺ے伷࠹ ࢀরظؒ w മ࿐֬཰΋Ξ΢τΧϜൃ঱֬཰΋   ࣌ؒʹΑΓมಈ͢Δ w .*ͷ֓೔पظͷϐʔΫ͸ே w ίʔώʔ΋ேଟ͘ҿΉ܏޲͕͋Δ w ࢀরظؒ͸ɺίʔώʔઁऔ֬཰͕௿͍͔΋͠ Εͳ͍ w ަབྷ΋߹ྲྀ఺όΠΞε΋ൃੜ