スギヤマ　ヒトシ   杉山　斉    所属   川崎医療短期大学  教育部 医療介護福祉学科    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Concordance between practice and published evidence in the management of ANCA-associated vasculitis in Japan: a cross-sectional web-questionnaire survey.
掲載誌名	正式名：Mod Rheumatol.
掲載区分	国外
巻・号・頁	33(5),pp.990-997
著者・共著者	Yoshia Miyawaki, Takao Fujii, Keisuke Anan, Masanari Kodera, Masao Kikuchi, Ken-Ei Sada, Kenji Nagasaka, Masashi Bando, Hitoshi Sugiyama, Shinya Kaname, Masayoshi Harigai, Naoto Tamura
発行年月	2023/08/25
概要	Objectives: We conducted a descriptive study of the physicians’ evidence–practice gap for adults covered by the 2017 clinical practice guidelines for the management of antineutrophil cytoplasmic antibody-associated vasculitis in Japan. Methods: This web-based survey, conducted between January and February 2021, involved physicians who had treated at least five patients in the preceding year at a regional core hospital. The outcome was the physicians’ experience in treating patients with microscopic polyangiitis or granulomatosis with polyangiitis [prevalence with 95% confidence intervals (CIs)], defined as treating at least 60% of their patients with the recommended therapy during the year. A modified Poisson regression analysis was performed to explore the factors associated with concordance. Results: The 202 participants included 49 pulmonologists, 65 nephrologists, 61 rheumatologists, and other physicians. The concordance was 31.5% (95% CI, 25.1–38.5) of physicians who used cyclophosphamide or rituximab for the induction of remission. Rheumatology showed the highest concordance with published evidence (risk ratio=2.4; 95% CI, 1.10–5.22, p=.03). Conclusions: These results suggest an evidence–practice gap, which varies substantially among subspecialties. Further studies and a new promotional initiative are necessary to close this gap in clinical practice.
DOI	10.1093/mr/roac118
PMID	36181464