イシハマ　タカノリ   Takanori Ishihama   石濱　嵩統    所属   川崎医科大学  医学部 臨床医学　歯科総合口腔医療学    職種   臨床助教８年
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	The degree of agreement between score-based decision and clinician's discretion regarding the need for tracheotomy in oral cancer surgery: A retrospective analysis.
掲載誌名	正式名：Medicine 略　 称：Medicine (Baltimore) ISSNコード：15365964/00257974
掲載区分	国外
巻・号・頁	100(30),pp.e26712
著者・共著者	Atsushi Abe, Yu Ito, Hiroki Hayashi, Hiroshi Furuta, Takanori Ishihama, Moriyasu Adachi
発行年月	2021/07
概要	In oral cancer surgery, the decision to perform a tracheotomy is often determined by the surgeon. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy and examined the degree of agreement between the surgeon's decision and the indications of various scoring systems. We identified 110 patients who were surgically treated for oral cancer. Of these, 67 patients (44 men and 23 women) who underwent resection and reconstruction were retrospectively analyzed. To derive the score, we evaluated the endpoint of the airway management score using clinical records and images. We divided the patients into two groups based on the Cameron and Gupta scores (tracheotomy and no-tracheotomy groups) and evaluated the degree of agreement with the surgeon's decision by calculating the κ coefficient. The κ coefficients of the Gupta and Cameron scores were 0.61 (95% confidence interval [CI]: 0.40-0.82) and 0.60 (95% CI: 0.38-0.82), respectively. The clinical evaluation of the κ coefficient indicated that the Cameron and Gupta scores agreed fairly with the surgeon's decision. In this study, the Cameron and Gupta scores fairly agreed with the decision of experienced surgeons and were confirmed as acceptable guides for making clinical judgments.
DOI	10.1097/MD.0000000000026712
PMID	34397703