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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

Shuntaro Sato
September 25, 2021

 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

自己対照デザインの研究は、アウトカムが基準と曝露が基準のデザインに大別できます。このスライドではアウトカムが基準となるデザインとして、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・ケース・ケースタイムコントロールデザインを解説します。ケースクロスオーバーデザイン用のデータセット作成と解析用プログラムもついています。

Shuntaro Sato

September 25, 2021
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  1. Ξ΢τΧϜ͕ΞϯΧʔͱͳΔ

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

    View full-size slide

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

    View full-size slide

  3. έʔεΫϩεΦʔόʔσβΠϯͱ͸ʁ

    View full-size slide

  4. Ϟνϕʔγϣϯ
    4
    ৺ے伷࠹ʢ.*ʣͷൃ঱ʹӨڹ͢Δൃ঱௚લͷཁҼΛௐ΂͍ͨʂ
    ଟ͘ͷ.*͸ɺൃ঱લͷ਺͔࣌ؒΒ਺೔ͷ׆ಈ͕Ҿ͖ۚʹͳͬͯΔͩΖ͏ɻ
    έʔείϯτϩʔϧݚڀΛܭը͠Α͏ɻ
    Ͱ΋ɺίϯτϩʔϧ܈ͷ৘ใΛूΊΔͷେมͩΑͶʜɻ
    έʔείϯτϩʔϧݚڀͰ͸ɺ

    έʔεͱίϯτϩ—ϧͷݪूஂ͕ಉ͡ඞཁ͕͋Δ
    έʔεͱಉ͡ݪूஂ͸ʁ έʔεࣗ਎
    ݪूஂ
    έʔε
    ίϯτϩʔϧ
    έʔεΫϩεΦʔόʔσβΠϯ
    .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF
    ff
    FDUTPOUIFSJTLPGBDVUFFWFOUT

    "N+&QJEFNJPM+BO
    r
    $BTFDSPTTPWFSEFTJHO

    View full-size slide

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

    View full-size slide

  6. 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

    View full-size slide

  7. 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

    View full-size slide

  8. 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
    ࣌ؒ

    View full-size slide

  9. 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

    View full-size slide

  10. 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

    View full-size slide

  11. ݁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

    View full-size slide

  12. .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

    View full-size slide

  13. .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

    View full-size slide

  14. ݁Ռͷهࡌʢ.BDMVSFͷྫʣ
    14
    33.)
    13,517
    7,360
    = 1.8
    'PSUIFPOFIPVSQFSJPEBGUFSESJOLJOHDP
    ff
    FF

    UIFSBUFSBUJPJT QFSDFOU$*

    .BDMVSF.5IFDBTFDSPTTPWFSEFTJHOBNFUIPEGPSTUVEZJOHUSBOTJFOUF
    ff
    FDUTPOUIFSJTLPGBDVUFFWFOUT

    "N+&QJEFNJPM+BO
    r

    View full-size slide

  15. 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

    View full-size slide

  16. 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

    View full-size slide

  17. ౷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

    View full-size slide

  18. ౷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

    View full-size slide

  19. ౷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

    View full-size slide

  20. ݁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

    View full-size slide

  21. έʔεΫϩεΦʔόʔσβΠϯɿ
    ޷·͍͠৚݅ͱԾఆ

    View full-size slide

  22. ޷·͍͠৚݅
    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

    View full-size slide

  23. 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

    View full-size slide

  24. 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

    View full-size slide

  25. 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

    View full-size slide

  26. 26
    ɹ݁Ռʢ8BOH47ͷྫɿҰ෦ʣᶃ
    8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT

    XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ
    r
    έʔεΫϩεΦʔόʔσβΠϯͰղੳ
    ࢢൢޙ͙͢͸03ߴͯ͘ɺ

    ࣌ؒܦͭͱ௿͘ͳΔʁ

    View full-size slide

  27. ༀࡎӸֶͰى͜Γ΍͍͢όΠΞε
    27
    ৽نༀࡎ͸ɺമ࿐֬཰͕ҰఆͰ͸ͳ͍
    ࣌ؒ
    ༀࡎͷྲྀ௨ྔ

    ఆৗঢ়ଶ
    ༀࡎͷྲྀ௨ྔ͕ఆৗঢ়ଶʹࢸΔ·Ͱ͸ɺ

    έʔεΫϩεΦʔόʔσβΠϯ͔Β

    ಘͨਪఆ஋͸όΠΞε͞ΕΔ
    'JSTUXBWFCJBT
    ඇఆৗঢ়ଶ

    View full-size slide

  28. 28
    ूஂϨϕϧͷമ࿐܏޲͕มΘΔͱ͖ɺͲ͏͢Δ͔ʁ
    έʔελΠϜίϯτϩʔϧσβΠϯ
    $BTFUJNFDPOUSPMEFTJHO
    ඇఆৗঢ়ଶ

    View full-size slide

  29. έʔελΠϜίϯτϩʔϧσβΠϯ

    View full-size slide

  30. 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

    View full-size slide

  31. 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
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    য఺ظؒͷമ࿐Φοζൺ
    മ࿐֬཰্͕͕Δ
    മ࿐֬཰͕Լ͕Δ
    ௐ੔
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    ORCCO(controlss)
    ΞϦϐϓϥκʔϧ
    ΞϦϐϓϥκʔϧ
    ج४೔

    View full-size slide

  32. 32
    ɹ݁Ռʢ8BOH47ͷྫɿҰ෦ʣᶄ
    8BOH47 4DIOFFXFJTT4 .BDMVSF. (BHOF++ɹl'JSTUXBWFzCJBTXIFODPOEVDUJOHBDUJWFTBGFUZNPOJUPSJOHPGOFXMZNBSLFUFENFEJDBUJPOT

    XJUIPVUDPNFJOEFYFETFMGDPOUSPMMFEEFTJHOT"N+&QJEFNJPM4FQ
    r
    ࣌ؒΛ௨ͯ͠OVMM

    View full-size slide

  33. ౷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౰ੑ

    View full-size slide

  34. ౷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

    View full-size slide

  35. ౷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)

    View full-size slide

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

    View full-size slide

  37. έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯ

    View full-size slide

  38. 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

    View full-size slide

  39. 39
    ڏ݂ੑ೴ଔதൃ঱
    ΞϯΧʔ
    έʔεɾέʔελΠϜίϯτϩʔϧσβΠϯʢ8BOH4ͷྫʣᶄ




    έʔε




    ORCCO(cases)
    ORCCO(controls)
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    Ξ΢τΧϜൃ঱ͷΦοζൺ
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    য఺ظؒͷമ࿐Φοζൺ
    ௐ੔
    ORCCO(cases)
    ORCCO(controlss)
    ߅ਫ਼ਆපༀ
    ߅ਫ਼ਆපༀͰͳ͍ॲํༀ
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    ଞͷίϯτϩʔϧͱ͢Δༀࡎͷമ࿐܏޲͕ಉ͡
    Ծఆ
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    "ENJOJTUSBUJPO4USPLF+BO
    r
    w 03͸৚݅෇͖ϩδεςΟοΫճؼ෼ੳͰਪఆ
    w $*͸ϒʔτετϥοϓ๏Ͱਪఆ

    View full-size slide

  40. 40
    ɹ݁Ռʢ8BOH4ͷྫɿҰ෦ʣ
    8BOH4 -JOLMFUUFS$ %PSF% .PS7 #VLB4 .BDMVSF."HF
    BOUJQTZDIPUJDT BOEUIFSJTLPGJTDIFNJDTUSPLFJOUIF7FUFSBOT)FBMUI
    "ENJOJTUSBUJPO4USPLF+BO
    r
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    FYQPTVSFUPBOUJQTZDIPUJDTBOETUSPLFBGUFSBEKVTUJOHGPSUIFF
    ff
    FDUPG
    UJNFJOWBSJBOUXJUIJOQFSTPODPOGPVOEFSTBTXFMMBTFYQPTVSFUJNF
    USFOET5IFPEETPGTUSPLFXFSF $* r
    UJNFTHSFBUFS
    XIFOFYQPTFEUPBOUJQTZDIPUJDTGPSBUMFBTUPGUIFMBTUEBZTUIBO
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    TUSBUJ
    fi
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    ff
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    w ࣌ؒෆมͷަབྷҼࢠͱ

    മ࿐܏޲Λௐ੔ͨ͠ਪఆ
    w ͢΂ͯͷݚڀର৅ʹର͢Δਪఆ
    w ೥ྸ૚͝ͱʹਪఆɿޮՌम০ͷ֬ೝ

    View full-size slide

  41. 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

    View full-size slide

  42. έʔεΫϩεΦʔόʔσβΠϯɿ
    σʔλͷܗͱ3Λ࢖ͬͨ౷ܭղੳ

    View full-size slide

  43. ࢝఺ͱͳΔղੳ༻σʔλʢ.BDMVSFͷྫʣ
    43
    *% .*ൃ঱લͷ࠷ޙͷ

    ίʔώʔઁऔ
    ίʔώʔͷઁऔස౓ ࠷ޙͷമ࿐͕

    য఺ظؒ
    ࠷ޙͷമ࿐͕
    ࢀরظؒ
    ظ଴͞ΕΔ
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    ظ଴͞ΕΔ
    ࢀরظؒ
    ݚڀظؒ
    JE
    MBTU@FY@UJNF
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    5

    IPVST EBZ E
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    IPVST EBZ E
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    ff
    FDUTPOUIFSJTLPGBDVUFFWFOUT

    "N+&QJEFNJPM+BO
    r
    ೖྗ ೖྗ ೖྗ ܭࢉ ೖྗ

    View full-size slide

  44. ऴ఺ͱͳΔղੳ༻σʔλʢ.BDMVSFͷྫʣ
    44
    *% য఺ظؒ
    PSࢀরظؒ
    Ξ΢τΧϜͷൃ঱
    JE
    FYQPTVSF
    DBTF





















    ᶃ*%͝ͱͷFYQPTVSF
    ͕ରԠ͢Δظؒͷ਺͚ͩߦ͕͋Δ
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    ߦ
    ߦ
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    ᶅ֤JEɺ֤FYQPTVSFͷߦ໨ͷΈ

    ֤ظؒͷമ࿐ͷ༗ແʹରԠ͢ΔΑ͏ʹDBTFʹΛೖΕΔ
    Ξ΢τΧϜൃ঱͸ɺJE͝ͱʹճͷΈ͔ͩΒ
    ߦ
    ߦ

    View full-size slide

  45. ղੳ༻σʔλ࡞੒ίʔυᶃ
    45

    ४උ

    σʔλೖྗ

    View full-size slide

  46. ղੳ༻σʔλ࡞੒ίʔυᶄ
    46

    ੨͍෦෼ͷܭࢉ

    View full-size slide

  47. ղੳ༻σʔλ࡞੒ίʔυᶅ
    47

    ऴ఺σʔληοτΛ࡞੒
    ᶃ*%͝ͱͷFYQPTVSF
    ͕ରԠ͢Δظؒͷ਺͚ͩߦ͕͋Δ
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    ᶅ֤JEɺ֤FYQPTVSFͷߦ໨ͷΈ

    ֤ظؒͷമ࿐ͷ༗ແʹରԠ͢ΔΑ͏ʹDBTFʹΛೖΕΔ

    View full-size slide

  48. ౷ܭղੳίʔυ
    48

    View full-size slide

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

    View full-size slide

  50. ֶश͢ΔͨΊͷಓඪᶃɹʢ˒͸ಛʹ͓͢͢Ίʣ
    50

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  51. ֶश͢ΔͨΊͷಓඪᶄ
    51

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  52. ֶश͢ΔͨΊͷಓඪᶅ
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  53. ͝ਗ਼ௌ͋Γ͕ͱ͏͍͟͝·ͨ͠ɻ
    53
    έʔεΫϩεΦʔόʔ έʔελΠϜίϯτϩʔϧ έʔεɾέʔελΠϜίϯτϩʔϧ
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  54. ͓·͚
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  55. ަབྷ
    55
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  56. ߹ྲྀ఺όΠΞε
    56
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  57. മ࿐ͱΞ΢τΧϜͷ࣌ؒτϨϯυͱόΠΞεᶃ
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  58. മ࿐ͱΞ΢τΧϜͷ࣌ؒτϨϯυͱόΠΞεᶄ
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