健康解析学講座

薬剤疫学分野 / デジタルヘルス学講座

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研究・業績

研究内容

活動内容

私たちの研究室では、大規模医療系データベースを用いた臨床疫学、薬剤疫学研究といった臨床研究を中心として活動しています。

研究は、主として臨床医や薬剤師などの医療者が、それぞれの現場での疑問(クリニカルクエスチョン)を実施可能な研究デザイン(リサーチクエスチョン)としてテーマを設定し、教員の指導を受けて研究を実施、論文発表していくことになります。また、将来この分野の顕著な研究者を志す若手学生のサポートも全力で行います。

臨床疫学、生物統計学に造詣の深い多くの教員によるメンター制度のもと、主とし医療職の資格を持つ大学院生に対して、各種の医療リアルワールドデータを用いて、医療上の各種の疑問を解決するための臨床研究や、自治体由来の母子保健・学校健診情報を用いた予防医療のための疫学研究を実施しています。

また、電子カルテ由来の診療情報のデータベース(RWDデータベース)の構築や分析、自治体由来の母子保健や学校健診のデータベース(SHRデータベース)の構築や分析還元の事業に関心がある方は、大学院生をしながら事業に携わることもできます。

これらの領域は、日本における既存の疾患別臨床医学、基礎医学、医療薬学の枠内では研究業績も人材もまだまだ欠如しているため、私達の教室の活動や出身者は、近い将来、各所から極めて望まれるものとなるでしょう。

これまでの大学院生、教室員のバックグラウンドは、小児科、循環器内科、呼吸器内科、糖尿病内科、消化器内科、腎臓内科、腫瘍内科、消化器外科、麻酔科、耳鼻咽喉科、眼科、救急診療、歯科、薬剤師、製薬企業(出向ふくむ)、新卒等です。

教室出身者からは、教授7名(札幌医科大学、岡山大学、京都大学、長崎大学、静岡社会健康医学大学院大学、慶應義塾大学、同志社大学、長浜バイオ大学)、准教授2名(滋賀医科大学、京都大学)、講師3名(鹿児島大学、大阪歯科大学、京都大学)、大規模病院での部長、ナショナルセンターでの室長等の指導者を全国に輩出しています。

<大規模医療データベースを用いた臨床疫学研究>

使用あるいは構築している医療系データベースは、電子カルテDB(2500万人)、診療報酬請求レセプト情報(1000万人)、DPC(3000万人)、調剤薬局情報統合(大手5社3500万処方箋相当)、母子保健情報(4万5000人)、学校健診情報(150自治体20万人)、介護入所時情報等です。

<母子保健、学校健診情報を活用した予防医療にむけて>

2015年より、教室では、(一社)健康・医療・教育情報評価推進機構(HCEI)およびリアルワールドデータ株式会社(RWD社)SHR事業部(旧:学校健診情報センター)との連携により、全国の自治体と連携し、学校健診情報(以下の図にあるように、全国約150自治体と正式に連携)を統合したデータベースを構築し、個人や地域に対する分析の還元と、パーソナルヘルスレコード(PHR)と呼ばれる、個人の携帯端末にて健診情報を保管できる仕組み(電子生涯健康手帳)の提供を実施しています。厚生労働省による項目標準化の開始に合わせて、2019年からは、乳幼児健診に関しても、データベースの構築および個人や地域に対する分析の還元を開始しました。

兵庫県神戸市などとの連携により、これまでも母子保健情報を活用した小児保健、予防医療の疫学研究を多数実施してきましたが、今後、全国規模で、-1歳から14歳までの15年間を紡いだデジタルコホートを用いた研究の展開を準備しています。

2018年の匿名医療加工情報に関する法律の施行にも関連して、今後は、人生の健康の歴史を紡ぐライフコースデータの研究基盤を用いた予防医学の研究も実施していきます。

所属するスタッフ、学生が現在実施している研究テーマの一部は以下の通りです。

<教室の直近の主な業績 (抜粋)> (下線はMCR履修生)

  1. Noda M, Yoshida S, Kawakami C, Takeuchi M, Kawakami K, Ito S: Japan Environment and Children’s Study Group. Association of pre-pregnancy physical activity with obesity in offspring: The Japan Environment and Children’s Study (JECS). Obesity 2022; 30: 1851-1862. doi: 10.1002/oby.23516.
  2. Endo K, Mizuno K, Seki T, Joo WJ, Takeda C, Takeuchi M, Kawakami K: Intensive care unit versus high-dependency care unit admission on mortality in patients with septic shock: A retrospective cohort study using Japanese claims data. Journal of Intensive Care 2022; 10: 35. doi: 10.1186/s40560-022-00627-2.
  3. Masuda S, Fukasawa T, Takeuchi M, Fujibayashi S, Otsuki B, Murata K, Shimizu T, Matsuda S, Kawakami K: Reoperation rates of microendoscopic discectomy compared with conventional open lumbar discectomy: A large database study. Clinical Orthopaedics and Related Research 2023; 481: 145-154. doi: 10.1097/CORR.0000000000002322.
  4. Takeda C, Yamashita Y, Takeuchi M, Yonekura H, Kawakami K, Dong L, Hamada M, Hirotsu A, Ono K, Fukuda K, Morimoto T, Kimura T, Mizota T: Incidence, clinical characteristics, and long-term prognosis of postoperative symptomatic venous thromboembolism: a retrospective cohort study. BMJ Open 2022; 12: e055090. doi:10.1136/bmjopen-2021-055090.
  5. Yoshida S, Takeuchi M, Tanaka-Mizuno S, Mizuno K, Nakashima M, Fukasawa T, Kawakami K: Clinical epidemiology and pharmacoepidemiology studies with real-world databases. Proceeding of Japanese Academy of Science Ser. B, Physical and Biological Sciences 2022; 98: 517-528. doi: 10.2183/pjab.98.026.
  6. Tsuchida T, Yoshida S, Takeuchi M, Kawakami C, Kawakami K, Ito S. A prospective cohort study of the association between the Apgar score and developmental status at 3 years of age: The Japan Environment and Children’s Study (JECS). European Journal of Pediatrics, doi.org/10.1007/s00431-021-04249-y, 2021.
  7. Takeuchi M, Shinkawa K, Yanagita M, Kawakami K. Prevalence, recognition and management of chronic kidney disease in Japan: population-based estimate using a healthcare database with routine health checkup data. Clinical Kidney Journal, doi: 10.1093/ckj/sfab016, 2021.
  8. Nakashima M, Takeuchi M, Kawakami K. Effectiveness of barrier agents for postoperative bowel obstruction in laparoscopic surgery: A retrospective cohort study. Surgery Today, doi.org/10.1007/s00595-021-02258-w, 2021.
  9. Tsuji T, Sato I, Kamimura Y, Ota H, Takeda C, Sobue K, Kawakami K. Trends and patterns in the practice of pediatric sedation during magnetic resonance imaging in Japan: A longitudinal descriptive study from 2012 to 2019. Pediatric Anesthesia, 32: 673-684, 2022.
  10. Masubuchi R, Noda M, Yoshida S Kawakami K. Longitudinal study of body mass index and percentage of overweight in Japanese children grouped by maturity. Endocrine Journal, doi: 10.1507/endocrj.EJ21-0434, 2021.
  11. Masato Takeuchi, Masahito Ogura, Takaaki Minoura, Nobuya Inagaki, and Koji Kawakami. Comparative effectiveness of SGLT2 inhibitors vs other classes of glucose-lowering medications on renal outcome in type 2 diabetes. Mayo Clinic Proceedings, 95(2):265-273, 2020.
  12. Woo Jin Joo, Kazuki Ide, Kei Nishiyama, Tomotsugu Seki, Hiroyuki Tanaka, Junpei Tsuchiya, Noritoshi Ito, Kosuke Yoshida, and Koji Kawakami. Prediction of the neurologic outcome using regional cerebral oxygen saturation in patients with extracorporeal cardiopulmonary resuscitation after out-of-hospital cardiac arrest: A multicentre retrospective cohort study. Acute Medicine & Surgery, in press, 2020.
  13. Keisuke Matsubayashi and Koji Kawakami. Syphilis testing among spouses of patients with syphilis in Japan: an epidemiological study using an administrative claims database. International Journal of STD & AIDS, 31: 214-220, 2020.
  14. Takeshi Kimura, Masato Takeuchi, and Koji Kawakami. Utilization and efficacy of palivizumab for children with Down syndrome. Pediatrics International, in press, 2020.
  15. Masanobu Ishii, Tomotsugu Seki, 他14名, on the behalf of JROAD Investigators. Short-term exposure to desert dust and the risk of acute myocardial infarction in Japan: A time-stratified case-crossover study. European Journal of Epidemiology, in press, 2020.
  16. Kayoko Mizuno, Masato Takeuchi, Yo Kishimoto, Koji Kawakami, and Koichi Omori. Indications and outcomes of pediatric tracheotomy: A descriptive study using a Japanese claims database. in press, BMJ Open, 2019.
  17. Masanobu Ishii, Tomotsugu Seki, 他14名, on the behalf of JROAD Investigators. Association of short-term exposure to air pollution with myocardial infarction with and without obstructive coronary artery disease. European Journal of Preventive Cardiology, in press, 2019.
  18. Hiroshi Yonekura, Kazuki Ide, Yuji Kanazawa, Chikashi Takeda, Yuki Nakamori, Yasunori Matsunari, Michihiro Sakai, Koji Kawakami, and Masataka Kamei. The use of preoperative haemostasis and ABO blood typing tests in children: A retrospective observational study using a nationwide claims database in Japan. BMJ Open, in press, 2019.
  19. Satomi Yoshida, Takeshi Kimura, Masahiro Noda, Masato Takeuchi, and Koji Kawakami. Association of maternal pre-pregnancy weight and early childhood weight with obesity in adolescence: A population-based longitudinal cohort study in Japan. Pediatric Obesity, in press, 2019.
  20. Maki Shinzawa, Shiro Tanaka, Hironobu Tokumasu, Daisuke Takada, Tatsuo Tsukamoto, Motoko Yanagita, and Koji Kawakami. Association of low birth weight with childhood proteinuria at age 3 years: A population-based retrospective cohort study. AJKD, 74:141-143, 2019.
  21. Masayuki Nakashima, Kazuki Ide, and Koji Kawakami. Laparoscopic versus open repair for inguinal hernia in children: a retrospective cohort study. Surgery Today, in press, 2019.
  22. Ryusuke Miki, Masato Takeuchi, Takumi Imai, Tomotsugu Seki, Shiro Tanaka, Masaki Nakamura, and Koji Kawakami. Association of intensive care unit admission and mortality in patients with acute myocardial infarction. Journal of Cardiology, 74:109-115, 2019.
  23. Woo Jin Joo, Kazuki Ide, Yohei Kawasaki, Chikashi Takeda, Tomotsugu Seki, Tomoko Usui, and Koji Kawakami. Effectiveness and safety of early enteral nutrition for patients who received targeted temperature management after out-of-hospital cardiac arrest. Resuscitation, 135: 191-196, 2019.
  24. Chikashi Takeda, Masato Takeuchi, Yohei Kawasaki, Hiroshi Yonekura, Isao Nahara, Aki Kuwauchi, Satomi Yoshida, Shiro Tanaka, and Koji Kawakami. Prophylactic sivelestat for esophagectomy and in-hospital mortality: a propensity score-matched analysis of claims database. Journal of Anesthesia, 33(2):230-237, 2019.
  25. Chikashi Takeda, Masato Takeuchi, Toshiyuki Mizota, Hiroshi Yonekura, Isao Nahara, Aki Kuwauchi, Woo Jin Joo, Yohei Kawasaki, and Koji Kawakami. Utilization of arterial pulse waveform analysis during non-cardiac surgery in Japan: A retrospective observational study using a nationwide claims database. Journal of Anesthesia, 33(1):159-162, 2019.
  26. Kayoko Mizuno, Masato Takeuchi, Yuji Kanazawa, Morimasa Kitamura, Kazuki Ide, Koichi Omori, and Koji Kawakami. Recurrent laryngeal nerve paralysis after thyroid cancer surgery and intraoperative nerve monitoring. Laryngoscope, 129(8):1954-1960, 2019.
  27. Motoko Nakayama, Shiro Tanaka, Shota Hamada, Takahiro Uchida, and Koji Kawakami. Recalls and premarket review systems for high-risk medical devices in Japan. Therapeutic Innovation & Regulatory Science, 53(6):775-780, 2019.
  28. Sumihiro Kawano, Masato Takeuchi, Shiro Tanaka, Takehiro Yamashita, Taiji Sakamoto, and Koji Kawakami. Current status of late and recurrent intraocular lens dislocation: Analysis of real-world data in Japan. Japanese Journal of Ophthalmology, 63(1):65-72, 2019.
  29. Hiroshi Yonekura, Kazuki Ide, Yoshika Onishi, Isao Nahara, Chikashi Takeda, and Koji Kawakami. Preoperative echocardiography for patients with hip fractures undergoing surgery: a retrospective cohort study using a nationwide database. Anesthesia & Analgesia, 128(2):213-220, 2019.
  30. Kota Nagai, Kazuki Ide, Yohei Kawasaki, Sachiko Tanaka-Mizuno, Kahori Seto, Shinji Iwane, Yuichiro Eguchi, and Koji Kawakami. Estimating the cost-effectiveness of screening for hepatitis C virus infection in Japan. Hepatology Research, in press, 2019.
  31. Tomotsugu Seki, Morio Aki, Hirotsugu Kawashima, Tomotaka Miki, Shiro Tanaka, Koji Kawakami, and Toshi A. Furukawa. Electronic health record nested pragmatic randomized controlled trial of a reminder system for serum lithium level monitoring in patients with mood disorder: KONOTORI study protocol. Trials, in press, 2019.
  32. Sachiko Kasamo, Masato Takeuchi, Masashi Ikuno, Yohei Kawasaki, Shiro Tanaka, Ryosuke Takahashi, and Koji Kawakami. Real-world pharmacological treatment patterns of patients with young-onset Parkinson’s disease: a medical claims database analysis. Journal of Neurology, 266:1944-1952, 2019.
  33. Masayuki Nakashima, Kazuki Ide, and Koji Kawakami. Standard initial dose and reduced initial dose regorafenib for colorectal cancer patients: A retrospective cohort study. Targeted Oncology, in press, 2019.
  34. Masahiro Iwasaku, Maki Shinzawa, Shiro Tanaka, and Koji Kawakami. Impact of underlying chronic adrenal insufficiency on clinical course of hospitalized patients with adrenal crisis: a nationwide cohort study. European Journal of Internal Medicine, 64:24-28, 2019.
  35. Shuhei Yamada, Izumi Sato, and Koji Kawakami. A descriptive epidemiological study on the treatment options for head and neck cancer: transition before and after approval of Cetuximab. Pharmacoepidemiology and Drug Safety, 28:330-336, 2019.
  36. Shin Kawasoe, Kazuki Ide, Tomoko Usui, Takuro Kubozono, Shiro Yoshifuku, Hironori Miyahara, Shigeho Maenohara, Mitsuru Ohishi, and Koji Kawakami. Distribution and characteristics of hypouricemia within the Japanese general population: A cross-sectional study. Medicina, 55, 61; doi:10.3390/medicina55030061, 2019.
  37. Takahiro Imanaka, Izumi Sato, Yohei Kawasaki, Yuji Kanazawa, and Koji Kawakami. An analysis of factors associated with compliance and dropout of sublingual immunotherapy on Japanese cedar pollinosis patients. International Forum of Allergy & Rhinology. DOI: 10.1002/alr.22308, 2019.
  38. Masato Takeuchi, Sayuri Nakano, Sachiko Tanaka-Mizuno, Chika Nishiyama, Yuko Doi, Masaru Arai, Yosuke Fujii, Toshiyuki Matsunaga, and Koji Kawakami. Adherence and concomitant medication use among patients on warfarin therapy: Insight from large pharmacy dispensing database in Japan. Biological and Pharmaceutical Bulletin, 42(3):389-393, 2019.
  39. Madoka Yamamoto-Sasaki, Satomi Yoshida, Masato Takeuchi, Sachiko Tanaka-Mizuno, Yusuke Ogawa, Toshiaki A. Furukawa, and Koji Kawakami. Association between antidepressant use during pregnancy and autism spectrum disorder in children: A retrospective cohort study based on Japanese claims data. Maternal Health, Neonatology and Perinatology, 5:1-7, 2019.