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星野 絵里 ホシノ エリ

所属・職名:公衆衛生学  講師
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更新日: 20/09/03 05:16

研究者基本情報

学位

  • 医療経済・政策学 博士

研究活動情報

研究分野

  • ライフサイエンス / 医療管理学、医療系社会学

研究キーワード

    公共衛生学 , 医療社会学 , 公共経済

論文

  • A Cost Projection of Scheduled Physician Home-Visit Services in Japan: 2014 to 2064.
    Zoie Shui-Yee Wong PhD, Eri Hoshino PhD, Naoki Ikegami MD, MA, PhD
    Journal of aging & social policy 1-16 2020年06月 [査読有り]
    This study predicts the volume and spending on scheduled physician home-visit (SPHV) services over five decades. This model-based evaluation study considered the following scenarios in Japan: (1) change in services-delivery; (2) technology-assisted services; (3) a combination of (1) and (2). The model predicted that the volume and spending on SPHV will increase as the population and working-age population decline. Scenario analysis indicated that a combined strategy could reduce the relative rate of spending to less than 2.00 in 2064, indicating that home health-care service reforms through changes in services-delivery and cost-reduction through technology-assisted services are promising in countries facing aging population.
  • Direct and indirect costs of home healthcare in Japan: A cross-sectional study.
    Shiori Tomita, Eri Hoshino, Keisuke Kamiya, Osugi Yasuhiro, Mahbubur Rahman
    Health & social care in the community 28(3) 1109-1117 2020年05月 [査読有り]
    To tackle the rising healthcare expenditure in an ageing society in Japan, home healthcare has been promoted over the past several years. However, there is a dearth of literature on total costs incurring for home healthcare. In this study, we conducted a cross-sectional study among patients, who received home healthcare in the month of May, 2018. Direct healthcare costs and patients' clinical characteristics were collected from medical records and long-term care databases (n = 166). Indirect costs were estimated using a questionnaire survey which obtained information on job absenteeism and care time from the caregiver. A total of 112 patients responded to the survey. The median age was 82 years (interquartile range: 74-88). Total per-person per month home-care costs averaged USD 6,163 with direct costs (USD 2,547) and indirect costs (USD 3,596) accounted for 41.3% and 58.3% of the total costs, respectively. The largest components of direct costs were long-term care costs (48%) and medical costs (47%). Multivariable adjusted model showed that those with heavy healthcare were more likely to incur higher total as well as direct and indirect home healthcare cost (p<.05 for each). Patients aged >75 years (p = .041) were less likely and those who used oxygen at home were more likely to incur direct home healthcare cost (p = .001) than their counterpart. Our study findings show that indirect cost is a major contributor to total home healthcare costs in Japan. Also for patients who need heavy healthcare, both direct and indirect costs are large burden.
  • Enhanced outcomes for coronary artery disease obtained by a multidisciplinary heart team approach.
    Manabu Yamasaki, Kohei Abe, Rihito Horikoshi, Eri Hoshino, Hiromi Yanagisawa, Kunihiko Yoshino, Hiroyasu Misumi, Atsushi Mizuno, Nobuyuki Komiyama
    General thoracic and cardiovascular surgery 67(10) 841-848 2019年10月 [査読有り]
    BACKGROUND: We implemented our multidisciplinary heart team (MHT) approach since 2012 for patients with coronary artery disease (CAD) and assessed the effectiveness of it by comparing outcomes in patients treated before and after the introduction of the MHT approach. METHODS: Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for CAD were performed in 802 and 57 patients from 2009 to 2011 in Group NH, and were performed in 867 and 160 patients from 2012 to 2014 in Group H, respectively. The primary outcome was major adverse cardiovascular and cerebrovascular events (MACCE), defined as the composite of all-cause death, myocardial infarction, stroke, cardiac-related readmission and target vessel repeat revascularisation (TVR) for PCI or revascularisation on grafted vessels for CABG. RESULTS: MACCE occurred significantly more often in Group NH than in Group H at 3 years postoperatively (28.1% vs 21.1%) (log rank P = 0.001). Cox regression analysis showed that the MHT approach [hazard ratio (HR), 0.737; 95% confidence interval (CI), 0.60-0.91; P = 0.004] and ejection fraction (HR 0.976; 95% CI, 0.97-0.98; P < 0.0001) were associated with significantly lower rates of MACCE events, while SYNTAX score (HR 1.023; 95% CI 1.00-1.03, P < 0.0001) and EuroSCORE II (HR 1.014, 95% CI 0.60-0.91, P = 0.004) were associated with a higher rate of MACCE events. CONCLUSION: Our MHT approach was able to reduce the MACCE events of treatment for CAD. The dedicated MHT approach might be beneficial for patients with CAD.
  • Variation in somatic symptoms by patient health questionnaire-9 depression scores in a representative Japanese sample.
    Eri Hoshino, Sachiko Ohde, Mahbubur Rahman, Osamu Takahashi, Tsuguya Fukui, Gautam A Deshpande
    BMC public health 18(1) 1406-1406 2018年12月 [査読有り]
    BACKGROUND: This study aims to evaluate variation in somatic symptoms by age using patient health questionnaire-9 (PHQ) depression scores, which may be helpful in identifying depression. METHODS: The study evaluated a nationally representative cross-sectional sample of community-dwelling adults in Japan in 2013. We utilized the PHQ to identify risk for depression, with PHQ ≥ 10 defining at least moderate depression. Bivariate and factor analyses were used to capture underlying patterns in self-reported symptoms over a 30 day period; aged-stratified multivariate logistic regression was performed to further explore associations between age, symptoms, and depression. RESULTS: Of 3753 respondents, 296 (8, 95% CI 7.0-8.8) reported a PHQ ≥ 10; 42% of these were male and mean age was 51.7 years old (SD = 18.6). Multivariate analysis showed that presence of fatigue and malaise (OR = 1.7, 95% CI 1.3-2.4) was significantly associated with PHQ ≥ 10. After stratification by age, PHQ ≥ 10 was associated with gastrointestinal complaints among 18-39 year olds (OR = 1.7, 95% CI 1.0-2.9); fatigue and malaise (OR = 1.8, 95% CI 1.1-3.1) among 40-64 year olds; and fatigue and malaise (OR = 1.8, 95% CI 1.1-3.0) as well as extremity pain (OR = 1.7, 95% CI 1.0-2.8) in over 65 year olds. CONCLUSION: Age-related somatic symptom correlates of PHQ ≥ 10 differ across the lifespan. Predominantly gastrointestinal symptoms in younger patients, and generalized fatigue, malaise, and musculoskeletal pain in older groups were observed. In order for screening physicians to proactively identify depression, awareness of age-related somatic symptoms is warranted.
  • A prospective phase II study of combined androgen blockade in patients with androgen receptor-positive metastatic or locally advanced unresectable salivary gland carcinoma
    C. Fushimi, Yuichiro Tada, H. Takahashi, T. Nagao, H. Ojiri, T. Masubuchi, T. Matsuki, K. Miura, D. Kawakita, H. Hirai, E. Hoshino, S. Kamata, T. Saotome
    Annals of Oncology 29(4) 979-984 2018年04月 [査読有り]
    Background: There is no standard first-line chemotherapy for recurrent/metastatic (RM) or unresectable locally advanced (LA) salivary gland carcinoma (SGC). Patients and methods: We conducted a single institution, open-label, single arm, phase II trial of combined androgen blockade (CAB) for androgen receptor (AR)-positive SGC. Leuprorelin acetate was administered subcutaneously at a dose of 3.75mg every 4 weeks. Bicalutamide was administered orally at a daily dose of 80 mg. Patients were treated until progressive disease or unacceptable toxicities. Results: Thirty-six eligible patients were enrolled. Thirty-three patients had RM disease and three patients had LA disease. The pathological diagnoses were salivary duct carcinoma (34 patients, 94%) and adenocarcinoma, NOS (two patients, 6%). The best overall response rate was 41.7% [n=15, 95% confidence interval (CI), 25.5%-59.2%], the clinical benefit rate was 75.0% (n=27, 95% CI, 57.8%-87.9%). The median progression-free survival was 8.8 months (95% CI, 6.3-12.3 months) and the median overall survival was 30.5 months (95% CI, 16.8 months to not reached). Additional analyses between treatment outcomes and clinicopathological factors or biomarkers including AR positivity, human epidermal growth factor receptor 2 status, and its complex downstream signaling pathway gene mutations showed no statistically significant differences. Elevated grade 3 liver transaminases and increased serum creatinine were reported in two patients, respectively. Discontinuation of leuprorelin acetate or bicalutamide due to adverse event occurred in one patient. Conclusion: This study suggests that CAB has equivalent efficacy and less toxicity for patients with AR-positive RM or unresectable LA SGC compared with conventional chemotherapy, which warrants further study.
  • Current Vitamin D Status in Healthy Japanese Infants and Young Children.
    Satoshi Nakano, Mitsuyoshi Suzuki, Kei Minowa, Saeko Hirai, Noriyuki Takubo, Yuko Sakamoto, Muneaki Ishijima, Eri Hoshino, Akifumi Tokita, Toshiaki Shimizu
    Journal of nutritional science and vitaminology 64(2) 99-105 2018年 [査読有り]
    This study aimed to characterize serum 25-hydroxyvitamin D (25OH-D) values among Japanese children aged ≤48 mo. The study included 290 healthy infants and young children aged 0-48 mo (males/females=166/124) living in Shizuoka or Tokyo. The subjects were divided into three groups by age (Low Age: 0-5, Middle Age: 6-15, High Age: 16-48 mo). The vitamin D deficient state was defined as 25OH-D <12 ng/mL, the insufficient state as 12-20 ng/mL, and the sufficient state as >20 ng/mL. The seasonal variation of serum 25OH-D levels was also analyzed. The median serum 25OH-D levels in each group were: Low Age (n=50), 19 ng/mL; Middle Age (n=94), 30 ng/mL; and High Age (n=146), 30 ng/mL. The serum 25OH-D level was significantly lower in the Low Age group than in the other groups (p<0.01). Serum 25OH-D levels in summer and autumn (n=149) were significantly higher than in winter and spring (n=141) (33 vs. 25 ng/mL, p<0.01). In the Low Age group, there was a significant difference in serum 25OH-D levels between breast-fed infants (n=26) and formula-fed or mixed-fed infants (n=19) (12 vs. 32 ng/mL, p<0.01). However, there were no significant differences in 25OH-D levels between the two season classifications in either breast-fed or formula-fed and mixed-fed infants. Although clinical symptoms were not available, more than 75% of the breast-fed infants and 14.6% of infants and young children to whom food had been introduced were defined as having a vitamin D deficient or insufficient state. Breastfeeding seems one of the contributing factor to lower serum 25 OH-D levels among infants ≤5 mo of age.
  • Reassessing the Ecology of Medical Care in Japan.
    Tsuguya Fukui, Mahbubur Rahman, Sachiko Ohde, Eri Hoshino, Takeshi Kimura, Kevin Y Urayama, Fumio Omata, Gautam A Deshpande, Osamu Takahashi
    Journal of community health 42(5) 935-941 2017年10月 [査読有り]
    Studies on ecology of medical care can provide valuable information on how people seek healthcare in a specific geographic area. The objective of this study was to update a 2003 report on the ecology of medical care in Japan, identifying relevant changes in healthcare patterns. We collected information based on a prospective health diary recorded for a month in 2013 (n = 4548; 3787 adults and 797 children) using a population-weighted random sample from a nationally representative panel. We compared our overall and stratified findings with a similar study conducted in 2003. During a one-month period, per 1000 adults and children living in Japan, we estimated that 794 report at least one symptom, 447 use an over-the-counter (OTC) drug, 265 visit a physician's office, 117 seek help from a professional provider of complementary or alternative medicine (CAM), 70 visit a hospital outpatient clinic (60 community-based and 10 university-based), 6 are hospitalized, and 4 visit a hospital emergency department. After adjusting for demographic variables, we found that healthcare seeking behaviors were influenced by age, gender and area of living. Compared with the 2003 study, participants in this study had fewer symptoms, fewer physician and emergency room visits, and less OTC use, but reported higher frequency of CAM use (p < .01 for all). Compared with 2003, reported symptoms, physician visits and OTC use has decreased, while CAM use has increased. Our findings may be useful to policymakers in Japan in a context where healthcare expenditure and a rapidly aging population are two challenging issues.
  • An iPhone application using a novel stool color detection algorithm for biliary atresia screening.
    Eri Hoshino, Kuniyoshi Hayashi, Mitsuyoshi Suzuki, Masayuki Obatake, Kevin Y Urayama, Satoshi Nakano, Yasuyuki Taura, Masaki Nio, Osamu Takahashi
    Pediatric surgery international 33(10) 1115-1121 2017年10月 [査読有り]
    BACKGROUND: The stool color card has been the primary tool for identifying acholic stools in infants with biliary atresia (BA), in several countries. However, BA stools are not always acholic, as obliteration of the bile duct occurs gradually. This study aims to introduce Baby Poop (Baby unchi in Japanese), a free iPhone application, employing a detection algorithm to capture subtle differences in colors, even with non-acholic BA stools. METHODS: The application is designed for use by caregivers of infants aged approximately 2 weeks-1 month. Baseline analysis to determine optimal color parameters predicting BA stools was performed using logistic regression (n = 50). Pattern recognition and machine learning processes were performed using 30 BA and 34 non-BA images. Additional 5 BA and 35 non-BA pictures were used to test accuracy. RESULTS: Hue, saturation, and value (HSV) were the preferred parameter for BA stool identification. A sensitivity and specificity were 100% (95% confidence interval 0.48-1.00 and 0.90-1.00, respectively) even among a collection of visually non-acholic, i.e., pigmented BA stools and relatively pale-colored non-BA stools. CONCLUSIONS: Results suggest that an iPhone mobile application integrated with a detection algorithm is an effective and convenient modality for early detection of BA, and potentially for other related diseases.
  • 便色カードの「便色4番」に対する精密検査の妥当性についての検討
    大畠 雅之, 星野 絵里, 田浦 康明, 山根 裕介, 吉田 拓哉
    日本小児外科学会雑誌 52(3) 600-600 2016年05月
  • 健康日記を用いた近年の日本人における喘息症状の有症状率の調査
    次富 亮輔, 仁多 寅彦, 谷川 朋幸, 中岡 大士, 岡藤 浩平, 北村 淳史, 冨島 裕, 西村 直樹, 星野 絵里, 田村 友秀, 蝶名林 直彦
    日本呼吸器学会誌 5(増刊) 251-251 2016年03月
  • Pharmacist Educational Intervention in Intravenous Patient-Controlled Analgesia is Associated with Decreased Postoperative Pain
    Ikkou H, Masateru I, Eri H, Masanori S, Mariko K, Hirokazu I, Junko N, Hiromi Y, Ryuichi S, Ryohkan F
    Research & Reviews: Journal of Hospital and Clinical Pharmacy 2(4) 2016年 [査読有り]
  • 急性心不全において院内心不全増悪が院内死亡率に与える影響
    立石 遼, 黒田 俊介, 末永 祐哉, 星野 絵里, 鈴木 誠, 松村 昭彦, 橋本 裕二
    日本心臓病学会学術集会抄録 63回 405-405 2015年09月
  • 医学研究に必要な統計解析の基礎と実際
    星野 絵里, 飯山 達雄
    日本気管食道科学会会報 66(2) 160-165 2015年04月
  • The Causal Effect of Early Surgical Intervention on Biliary Atresia Patients Clinical Outcome Using Economic and Education Models
    Columbia University 2015年
  • Loop-mediated isothermal amplification method for diagnosing Pneumocystis pneumonia in HIV-uninfected immunocompromised patients with pulmonary infiltrates.
    Kei Nakashima, Masahiro Aoshima, Yoshihiro Ohkuni, Eri Hoshino, Kohei Hashimoto, Yoshihito Otsuka
    Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy 20(12) 757-61 2014年12月 [査読有り]
    Loop-mediated isothermal amplification (LAMP) is becoming an established nucleic acid amplification method offering rapid, accurate, and cost-effective diagnosis of infectious diseases. We retrospectively evaluated 78 consecutive HIV-uninfected patients who underwent LAMP method for diagnosing Pneumocystis pneumonia (PCP). Diagnosis of PCP was made by the detection of Pneumocystis jirovecii (P. jirovecii) with positive LAMP or conventional staining (CS) (Grocott methenamine silver staining or Diff-Quick™) on the basis of compatible clinical symptoms and radiologic findings. Additionally, we reviewed HIV-uninfected immunocompromised patients who underwent subcontract PCR as a historical control. LAMP was positive in 10 (90.9%) of 11 positive-CS patients. Among 13 negative-CS patients with positive LAMP, 11 (84.6%) had PCP, and the remaining 2 were categorized as having P. jirovecii colonization. LDH levels in negative-CS PCP were higher than in positive-CS PCP (p = 0.026). (1 → 3)-β-D-glucan levels in negative-CS PCP were lower than in positive-CS PCP (p = 0.011). The interval from symptom onset to diagnosis as PCP in LAMP group (3.45 ± 1.77 days; n = 22) was shorter than in subcontract PCR group (6.90 ± 2.28 days; n = 10; p < 0.001). As for patients without PCP, duration of unnecessary PCP treatment in LAMP group (2; 2-3 days; n = 10) was shorter than in subcontract PCR group (7; 7-12.25 days; n = 6; p = 0.003). LAMP showed higher sensitivity (95.4%) and positive predictive value (91.3%) than subcontract PCR did. Pneumocystis LAMP method is a sensitive and cost-effective diagnostic method and is easy to administer in general hospitals. In-house LAMP method would realize early diagnosis of PCP, resulting in improving PCP prognosis and reducing unnecessary PCP-specific treatment.
  • 随時尿から早朝尿への変更による尿蛋白陽性率の変化
    佐々木 美和, 馬嶋 健一郎, 星野 絵里, 小宮 雅明, 石井 那奈, 高橋 麻里子, 野口 瑞恵
    人間ドック 29(2) 305-305 2014年07月
  • 学会発表と論文化のあいだ 亀田総合病院における臨床研究支援ニーズに関する調査
    星野 絵里, 片多 史明
    医学教育 45(Suppl.) 161-161 2014年07月
  • 紫斑病性腎炎への腎生検と治療に関する多施設アンケート調査
    石原 正行, 齋藤 宏, 田中 絵里子, 田中 征治, 三浦 健一郎, 藤丸 季可, 星野 絵里, 中堅医のための小児腎勉強会
    日本小児腎臓病学会雑誌 27(1Suppl.) 114-114 2014年04月
  • Donepezil can improve ischemic muscle atrophy by activating angiomyogenic properties of satellite cells.
    Tatsuya Noguchi, Yoshihiko Kakinuma, Mikihiko Arikawa, Kayo Okazaki, Eri Hoshino, Tatsuo Iiyama, Toru Kubo, Hiroaki Kitaoka, Yoshinori Doi, Takayuki Sato
    Circulation journal : official journal of the Japanese Circulation Society 78(9) 2317-24 2014年 [査読有り]
    BACKGROUND: Saving more limbs of patients with peripheral arterial disease (PAD) from amputation by accelerating angiogenesis in affected limbs has been anticipated for years. We hypothesized that an anti-Alzheimer drug, donepezil (DPZ), can activate angiomyogenic properties of satellite cells, myogenic progenitors, and thus be an additional pharmacological therapy against PAD. METHODS AND RESULTS: In a murine hindlimb ischemia model, we investigated the angiogenic effects of a clinical dose of DPZ (0.2 mg·kg(-1)·day(-1)) and its combination with cilostazol, a platelet aggregation inhibitor and a conventional therapeutic drug against PAD. The combination therapy most effectively improved skin coldness and most effectively upregulated vascular endothelial growth factor (VEGF)-producing satellite cells in ischemic hindlimbs. Computed tomography revealed that DPZ remarkably attenuated ischemic muscle atrophy and induced super-restoration in affected hindlimbs. The in vitro study with human aortic endothelial cells showed that DPZ or its combination with cilostazol effectively upregulated the expression of pAkt, hypoxia inducible factor-1α, and VEGF protein. Likewise, in primary cultured satellite cells, DPZ, alone or in combination, upregulated the expression of VEGF, interleukin-1β, and fibroblast growth factor 2 protein. CONCLUSIONS: The present results suggest that a clinical dosage of DPZ accelerates angiomyogenesis by directly acting on both endothelial and satellite cells. Therefore, DPZ is a potential additional choice for conventional drug therapy against PAD.
  • Erratum: Serum level of soluble (pro)renin receptor is modulated in chronic kidney disease (Clinical and Experimental Nephrology DOI: 10.1007/s10157-013- 0803-y))
    Kazu Hamada, Yoshinori Taniguchi, Yoshiko Shimamura, Kosuke Inoue, Koji Ogata, Masayuki Ishihara, Taro Horino, Shimpei Fujimoto, Takashi Ohguro, Yukio Yoshimoto, Mika Ikebe, Kenji Yuasa, Eri Hoshino, Tatsuo Iiyama, Atsuhiro Ichihara, Yoshio Terada
    Clinical and Experimental Nephrology 17(6) 857 2013年12月 [査読有り]
  • Serum level of soluble (pro)renin receptor is modulated in chronic kidney disease.
    Kazu Hamada, Yoshinori Taniguchi, Yoshiko Shimamura, Kosuke Inoue, Koji Ogata, Masayuki Ishihara, Taro Horino, Shimpei Fujimoto, Takashi Ohguro, Yukio Yoshimoto, Mika Ikebe, Kenji Yuasa, Eri Hoshino, Tatsuo Iiyama, Atsuhiro Ichihara, Yoshio Terada
    Clinical and experimental nephrology 17(6) 848-56 2013年12月 [査読有り]
    BACKGROUND: Prorenin, the precursor of renin, binds to the (pro)renin receptor [(P)RR] and triggers intracellular signaling. The ligand binding sites of (P)RR are disconnected and are present in the soluble form of the receptor in serum. Given that the clinical significance of serum prorenin and soluble (P)RR in chronic kidney disease (CKD) is unclear, we investigated the relationship between serum prorenin, soluble (P)RR, and various clinical parameters in patients with CKD. METHODS: A total of 374 patients with CKD were enrolled. Serum samples were collected, and the levels of soluble (P)RR and prorenin were measured using ELISA kits. Serum creatinine (Cr), blood urea nitrogen (BUN), uric acid (UA), hemoglobin (Hb), soluble secreted α-Klotho, and the urine protein/Cr ratio were also measured. Similarly, clinical parameters were also evaluated using serum and urine sample collected after 1 year (n = 204). RESULTS: Soluble (P)RR levels were positively associated with serum Cr (P < 0.0001, r = 0.263), BUN (P < 0.0001, r = 0.267), UA (P < 0.005, r = 0.168) levels, CKD stage (P < 0.0001, r = 0.311) and urine protein/Cr ratio (P < 0.01, r = 0.157), and inversely with estimated glomerular infiltration rate (eGFR) (P < 0.0001, r = -0.275) and Hb (P < 0.005, r = -0.156). Soluble (P)RR levels were inversely associated with α-Klotho levels (P < 0.001, r = -0.174) but did not correlate with prorenin levels. With respect to antihypertensive drugs, soluble (P)RR levels were significantly lower in patients treated with an angiotensin II receptor blocker (ARB) than in those without ARB therapy (P < 0.005). Soluble (P)RR levels were significantly lower in CKD patients with diabetes mellitus or primary hypertension than in those without these conditions (P < 0.05). In contrast, serum levels of prorenin did not correlate with parameters related to renal function. Serum prorenin levels were significantly higher in CKD patients with diabetes mellitus than in nondiabetic patients (P < 0.05), but not in CKD patients with hypertension (P = 0.09). Finally, with respect to the relationship between basal soluble (P)RR levels and the progression rates of renal function, soluble (P)RR levels were positively associated with ΔCr (P < 0.05, r = 0.159) and inversely associated with ΔeGFR (P < 0.05, r = -0.148). CONCLUSION: Serum levels of soluble (P)RR correlated with the stage of CKD. Our findings suggest that soluble (P)RR may be involved in renal injury and influence the progression of CKD.
  • Radiographic progression of silicosis among Japanese tunnel workers in Kochi.
    Narongpon Dumavibhat, Tomomi Matsui, Eri Hoshino, Sasivimol Rattanasiri, Dittapol Muntham, Ryoji Hirota, Masamitsu Eitoku, Momo Imanaka, Basilua Andre Muzembo, Nlandu Roger Ngatu, Shinichi Kondo, Norihiko Hamada, Narufumi Suganuma
    Journal of occupational health 55(3) 142-8 2013年 [査読有り]
    OBJECTIVE: The aim of our study was to investigate the natural course of silicosis in terms of radiographic progression among Japanese tunnel workers. METHODS: Tunnel workers with silicosis were included in our study between January 2008 and June 2011. We retrospectively assessed workers' radiographs from their first through last visits to see whether there was progression. All films were interpreted by two physicians, who had been specially trained in using the ILO (2000) International Classification of Radiographs of Pneumoconioses (ILO/ICRP). We classified the radiographic findings according to the ILO/ICRP. Survival analysis was performed and then presented as time to progression. Subgroup analysis among the progressed group was performed to demonstrate duration of progression. RESULTS: A total of 65 patients, who were no longer exposed to silica for the duration of the study, were included. The mean age at the first visit was 58.60 ± 7.10 years. The incidence rate of progression was 42 per 1,000 person-years with a median time to progression of 17 years. Progression was demonstrated among 33 cases (51%). The mean durations of progression from category 1 to category 4 and category 2 to category 4 were 14.55 and 10.65 years, respectively. Most patients (86%) had radiographic change from category 1 or 2 directly to category 4. CONCLUSION: Silicosis progressed at a relatively high rate among tunnel workers without further silica exposure. The high probability of progression directly from category 1 to category 4 may lead to further investigation for the improvement of disease prevention.
  • 【諸外国の就学前教育・保育サービス 子どもの「育ち」を保障する社会のしくみ】 就学前児童の健康状態が教育に与える影響について 諸外国のデータを用いた実証研究のサーベイ
    中室 牧子, 星野 絵里
    海外社会保障研究(173) 61-70 2010年12月 [査読有り]
    就学前児童の健康状態が、その後の教育にどのような影響を与えるか調べた研究のうち、データを用いた実証研究の包括的サーベイを行った。先進国のみならず開発途上国のデータを用いた研究、中でも実験データや計量経済学的手法を用いて内生性バイアスをコントロールした研究に重点をおき、評価を行った。その結果、就学前児童に対する鉄分や蛋白質を含む食品の供与が教育成果の改善に高い効果を発揮していることが明らかになった。
  • ランダム化フィールド実験による教育プロジェクトの費用効果分析--ケニアを事例に
    小川 啓一, 中室 牧子, 星野 絵里
    国際教育協力論集 12(2) 29-42 2009年10月 [査読有り]
    Are there strategies to measure the unbiased impact of a particular project, program or policy in such a way as to prioritize public action and maximize the outcome? The decision to expand, reduce or maintain the size of a particular project is based on impact evaluation. How an evaluation can eliminate potential bias and assess the impact of intervention in an accurate fashion is extremely important for the implementation of project, program and policy by development communities and government officials.Randomized experiments are generally thought to be the "gold standard" in policy research. Experimental designs that involve randomly assigning participants to one or more treatment conditions and a no-treatment control group for comparison allow researchers to more confidently answer research questions about whether or not a certain policy or intervention has an influence on observed changes in the population of interest. Selection, or the possibility that an individual's unobserved characteristics are actually explaining the observed association between the intervention and the outcome, is largely ruled out in a randomized experiment.This paper introduces recent randomized experiments of eight educational projects in the primary education sub-sector in Kenya to demonstrate how this experimental design works to reduce potential bias. Further, using the average treatment effect on the treated (ATT) estimated by the experiments, this paper runs a cost-effectiveness analysis in terms of (i) quantitative measures expressed as gains in school attendance and (ii) qualitative measures expressed as gains in test scores.The analysis reveals that education projects diminishing the burden on parents of educational costs are more cost-effective than alternatives to improve quantitative measures at primary education in Kenya. On the other hand, those providing appropriate incentives for both students and teachers are more cost-effective to improving qualitative measures. We confirm the same result from the cost-effectiveness analyses using data obtained by randomized and quasi-experiments, in other developing countries.

講演・口頭発表等

  • 単・多変量解析の基礎から予測モデルの組み立てまで
    星野 絵里
    第6回日本頭頸外科学会 教育セミナー 2017年 [招待有り]
  • 臨床研究に必要な基礎知識
    星野 絵里
    南房総臨床薬学セミナー 2016年 [招待有り]
  • 臨床研究に必要な医学統計の基礎
    星野 絵里
    第5回日本頭頸外科学会;教育セミナー 2016年 [招待有り]
  • 医学研究に必要な統計解析の基礎と実際
    星野 絵里
    第66回日本気管食道科学会総会ならびに学術講演会 2014年 [招待有り]

MISC

  • iPhoneアプリ'Babyうんち'による胆道閉鎖症スクリーニングツールの開発
    平井 沙依子, 星野 絵里, 林 邦好, 浦山 ケビン, 中野 聡, 箕輪 圭, 鈴木 光幸, 田浦 康明, 大畠 雅之, 仁尾 正記, 高橋 理, 清水 俊明
    日本小児外科学会雑誌 54(7) 1409-1409 2018年12月
  • 尿中硫酸抱合型胆汁酸測定による新生児胆道閉鎖症早期スクリーニング 沖縄県におけるパイロットスタディ
    鈴木 健, 金城 僚, 鈴木 光幸, 大城 清哲, 仲間 司, 連 利博, 星野 絵里, 大畠 雅之, 秋山 卓士, 仁尾 正紀, 山城 雄一郎
    日本マス・スクリーニング学会誌 28(1) 83-91 2018年05月
    肝細胞内で産生された胆汁酸はタウリン、グリシン、硫酸などの抱合体として生体内に存在する。胆道系に閉塞がある場合、胆汁酸の大部分は硫酸抱合体となり尿中に排泄される。尿中硫酸抱合型胆汁酸(urinary sulfated bile acid:以下USBAと略す)測定法は、胆汁うっ滞の存在を検出する非侵襲的な検査である。本研究では2009年8月から2015年3月までの間に沖縄県で出生した新生児24,889名を対象として、胆道閉鎖症患児を早期発見するためにUSBA測定を行い、その実用性に関する検討を行った。その結果、3例の胆道閉鎖症(有病率1.2/1万人)を見出し、スクリーニング成績は感度100%、特異度96.2%、偽陽性率3.8%、陽性尤度比25.9%であった。葛西術施行日は平均41日齢(範囲:33-55日齢)で、同時期にUSBAスクリーニング外で発見された沖縄県内の胆道閉鎖症患児6例の平均72.8日齢(範囲:30-153日齢)よりも早期であった。現行の便色カードによる胆道閉鎖症スクリーニング検査の問題点を挙げ、USBAスクリーニングの活用法について考察する。(著者抄録)
  • 胆道閉鎖症スクリーニングツールとしてのiPhoneアプリ"Babyうんち"の現況と今後
    西山 樹, 星野 絵里, 浦山 ケビン, 中野 聡, 平井 沙依子, 箕輪 圭, 鈴木 光幸, 清水 俊明
    日本小児科学会雑誌 122(2) 275-275 2018年02月
  • 日本でのビタミンD欠乏状態の乳幼児の頻度
    平井 沙依子, 中野 聡, 箕輪 圭, 鈴木 光幸, 坂本 優子, 石島 旨章, 星野 絵里, 時田 章史, 清水 俊明
    外来小児科 20(4) 515-515 2017年12月

特許

  • 情報処理装置、情報処理システム及びプログラム
    星野絵里, 林邦好
    特願特願2016-190338
    特開特開2018-54443(P2018-54443A)

受賞

  • 2014年 第1回胆道閉鎖症関連疾患国際学会, ベルリン 最優秀発表賞 葛西手術の時期が胆道閉鎖症患者の短期成績に与える影響

競争的資金

  • 費用対効果を含む多様な価値基準を統合した新たな医療政策意思決定支援システムの開発
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間:2020年04月 - 2024年03月  
  • 認知症高齢者の徘徊対策のシステマティックレビューと費用対効果分析
    日本学術振興会:科学研究費助成事業 若手研究
    研究期間:2020年04月 - 2023年03月  
  • *便色判別プログラムを利用した胆道閉鎖症早期発見のためのフィールド実証研究
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間:2018年04月 - 2023年03月  
    胆道閉鎖症および胆汁鬱滞性肝疾患により発生する便色調異常を早期発見するためにAI技術を応用して開発された便色調判定プログラム(アプリ ケーション)を開発し、現在母子手帳に配布されている便色カラーカードより正確で確実な判定が期待できる。 今回開発したアプリケーションは新生児の1ヶ月健診を対象としており、アプリケーションを搭載された1台の機材で複数の児の便色を判定管理できることが特徴である。機材には安定性と操作性を考えてApple社製のiPadを準備した。iPadのカメラでオムツに付着した便を撮影し、判定はWiFiを通じて聖路加国際大学のサーバーコンピューターで解析した。判定は「異常なし」「要観察」「要注意」の3つで判定した。判定に最も影響を与えるのは撮影方法であると考え、「要観察」「要注意」と判定された場合は必ず2回目の撮影モードに入るように制定した。最終判定が「要注意」の場合は採血検査を行い、「要観察」場合は家族に便色に注意するように指導し、便色に不安のある場合は主幹施設で高知大学病院への専用回線接続を案内し便色判定を行った。 本研究の初年度半ばにはアプリケーションの開発が終了した。主幹施設を含めた新生児健診を行う公立病院での倫理申請許可を得て3施設で試験的運用を初年度後半から始めた。その後アプリケーションの不具合やシステムの不備や問題点を洗い出し改良と修正を行い初年度末には安定した運用が可能となっている。
  • AI搭載のスマホアプリによる胆汁うっ滞系小児慢性特定疾病のスクリーニング法の開発と実証研究
    三菱財団:社会福祉研究助成
    研究期間:2019年10月 - 2021年03月  
  • ICTを活用した胆道閉鎖症早期発見のための便色判定システム構築と費用対効果分析
    聖路加国際大学:若手研究(B)
    研究期間:2016年04月 - 2018年03月  

その他

  •  2017年4月20日付 日本経済新聞 ”スマホアプリも登場 赤ちゃんの便は「色」でチェック”
    https://style.nikkei.com/article/DGXKZO15520980Q7A420C1NZBP01?channel=DF130120166090
  •  “赤ちゃんのうんち×iPhone”で臨床研究
    http://techon.nikkeibp.co.jp/atcl/feature/15/327441/072200102/?ST=health
  •  2019年7月14日付 毎日新聞 "「うんちアプリ」で病気発見”
    https://mainichi.jp/articles/20190714/ddm/013/100/026000c
  •  ラジオNIKKEI 小児科診療 UP-to-DATE 2019
    9月17日 ”iPhoneを用いた胆道閉鎖症のスクリーニング”
  •  2019年2月27日付 産経新聞 ”命に関わる難病「胆道閉鎖症」 赤ちゃんの便色チェックが必須”
    https://www.sankeibiz.jp/econome/news/190227/ecb1902271330003-n1.htm
  •  2019年1月25日付 朝日新聞(ひと欄)”赤ちゃんのうんちから病気を見つけるアプリを開発”
    https://www.asahi.com/articles/DA3S13863625.html

教育活動情報

担当経験のある科目

  • 実践課題 (聖路加国際大学)
  • 疫学実習 (聖路加国際大学)
  • 臨床疫学 (聖路加国際大学)
  • 慢性疾患疫学 (聖路加国際大学)
  • 医療経済学 (聖路加国際大学)