Rinsho Shinkeigaku (Clinical Neurology)

The 43rd Annual Meeting of the Japanese Society of Neurology

Symposium VIII: How apply the information technology to neurology?
2) Search and appraisal of literatures and methods to use internets in Evidence Based Nuerology

Shinichiro Uchiyama, M.D.

Department of Neurology, Neurological Institute, Tokyo Women's Medical University

A national guideline for stroke management is currently being made on the basis of evidence collected from randomized controlled trials (RCTs) and other types of clinical studies, which have been searched using computer system, as well as systematic reviews by the Cochrane Collaboration. In this guideline, grades of recommendation will be determined according to the levels of evidence. In critical appraisal for clinical trials, evaluation of validity in the methodology of trials and in the analysis of treatment effects are crucial. In estimating the quality of metaanalysis, a pivotal issue is to check the possibility of selection bias in RCTs. Indices for the assessment of treatment effects include relative risk reduction (RRR), absolute risk reduction (ARR), and number needed to treat (NNT). Besides, cost-effectiveness, cost-benefit, and cost-utility are used in medical economics. Quality-adjusted life years (QALY) and disability-adjusted years (DALY) have recently been proposed by the World Health Organization as the indices for the effect on quality of life as well.

(CLINICA NEUROL, 42: 1182|1185, 2002)
key words: guideline, Cochrane Collaboration, critical appraisal, treatment effect

(Received: 31-May-02)