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Article: Medical Big Data for Research Use: Current Status and Related Issues.

Ishikawa, Koichi Benjamin

Japan Medical Association journal : JMAJ

2016 Volume 59, Issue 2-3, Page(s) 110–124

Abstract: Advances in the computerization of information and development of technology have mitigated restrictions on handling of a large amount of information. This has resulted in growth of expectations for the use of large-scale databases, or so-called "big ... ...

Abstract	Advances in the computerization of information and development of technology have mitigated restrictions on handling of a large amount of information. This has resulted in growth of expectations for the use of large-scale databases, or so-called "big data." This is also the case in the field of healthcare. Projects that involve building of the national receipt database (NDB) of medical fee bill (receipt) information and special health check-up information based on the Act on Assurance of Medical Care for Elderly People and the development of medical information databases have been pursued by the national government, and considerable attention has also been focused on researches conducted through the secondary uses of publicly collected data. Aside from these trends, there are numerous projects which collect diagnosis procedure combination (DPC) data to build large-scale databases for research purposes. Following to the ethics guidelines for epidemiologic studies, they collect and analyze anonymized DPC data from cooperating institutions. This communication concentrates on the use of DPC data, and outlines the scale of data currently available for research use. Examples on the use of DPC data will be shown for analysis on the current status of clinical practice from the microscopic perspective and macroscopic analysis of community medical care provision. Additionally, potential for extending studies to long-term outcomes research, limitations and issues related to the use of medical big data will also be discussed.
Language	English
Publishing date	2016-09-01
Publishing country	Japan
Document type	Journal Article
ZDB-ID	2052217-4
ISSN	1346-8650
ISSN	1346-8650
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Article ; Online: Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stroke After Inpatient Rehabilitation: A Retrospective Nationwide Cohort Study in Japan.

Yamaura, Reiko / Kaneko, Tetsuji / Ishikawa, Koichi Benjamin / Ikeda, Shunya / Fushimi, Kiyohide / Yamazaki, Tsutomu

Archives of rehabilitation research and clinical translation

2022 Volume 4, Issue 4, Page(s) 100229

Abstract: Objective: To describe characteristics of patient with severe stroke (FIM motor score [FIM motor] 20-49 at admission) and examine association between pre-specified factors (age, sex, modified Rankin Scale before stroke onset, body mass index, FIM motor, ...

Abstract	Objective: To describe characteristics of patient with severe stroke (FIM motor score [FIM motor] 20-49 at admission) and examine association between pre-specified factors (age, sex, modified Rankin Scale before stroke onset, body mass index, FIM motor, and FIM cognitive) and time to achieve FIM motor ≥70, that is, self-independent level. Design: Retrospective cohort study using a large database in Japan. Setting: Rehabilitation wards. Participants: Patients with severe stroke (N=1422) who received inpatient rehabilitation were included (median age: 76 years; interquartile range [IQR]: 68.0-84.0). A total of 54.6% were men, and 65.8% were ischemic stroke. Interventions: Not applicable. Main outcome measures: Time to achieve FIM motor ≥70. Results: After inpatient rehabilitation, 40.4% (N=575) achieved FIM motor ≥70 (admission FIM motor 20-29, 30-39 and 40-49: 18.6%, 33.6%, and 47.8%, respectively). Patients who achieved FIM motor ≥70 stayed median 81.0 days [IQR, 51.0-120.0]) and received median: 6.94 units per day [IQR, 5.48-7.78], 1 unit=20 minutes). Adjusted Fine-Gray regression revealed that shorter time to achieve FIM motor ≥70 was associated with higher admission FIM motor (hazard ratio [HR] 2.87 [95% confidence interval [CI] 2.27-3.62]: 20-29 vs 40-49), higher admission FIM cognitive (HR 1.81 [95% CI: 1.39-2.35]: 5-14 vs 25-35), and younger (HR 3.20 [95% CI: 2.32-4.42]: ≥85 years vs 20-69 years). Conclusions: Most patients with severe stroke did not achieve FIM motor ≥70 after inpatient rehabilitation. Older patients and patients with lower admission FIM motor require more attention. They should be prioritized for state-of-the-art rehabilitation therapy.
Language	English
Publishing date	2022-09-07
Publishing country	United States
Document type	Journal Article
ISSN	2590-1095
ISSN (online)	2590-1095
DOI	10.1016/j.arrct.2022.100229
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Article ; Online: Clarification of Factors Determining Discharge Destination Among Elderly Patients After Stroke With Low Levels of Independence in Activities of Daily Living

Yasushi Onishi, MD / Shinji Kimura, MD, PhD / Koichi Benjamin Ishikawa, PhD / Shunya Ikeda, MD, PhD

Archives of Rehabilitation Research and Clinical Translation, Vol 4, Iss 4, Pp 100226- (2022)

A Retrospective Study

2022

Abstract: Objective: To determine factors influencing discharge destination of elderly patients after stroke with low levels of independence in activities of daily living (ADL). Design: Cross-sectional study. Setting: A community-based public hospital in a rural ... ...

Abstract	Objective: To determine factors influencing discharge destination of elderly patients after stroke with low levels of independence in activities of daily living (ADL). Design: Cross-sectional study. Setting: A community-based public hospital in a rural area in Japan. Participants: A total of 67 patients with low daily function among 205 elderly patients with stroke screened for eligibility (N=67). Interventions: Not applicable. Main Outcome Measures: Motor component of functional independence measure (M-FIM) at discharge and discharge destination—home or long-term care facility (LCF). Results: Among the 205 eligible patients, 147 were discharged home and 58 were discharged to LCFs. Patients with an M-FIM score of ≤30 at discharge were defined as patients deemed difficult to discharge home because of low independence levels in ADL. Of the 147 patients discharged home, 24 (16.3%) had M-FIM scores of ≤30. Of the 58 patients discharged to LCFs, 43 (74.1%) had M-FIM scores of ≤30. Patients with an M-FIM score of ≤30 at discharge significantly tended to be discharged home if they obtained oral intake vs tube feeding as a nutritional method (P=.047) and higher cognitive component of FIM scores at discharge (P=.002). All six patients who lived alone among patients with an M-FIM score of ≤30 were discharged to LCFs. Two patients on tube feeding were discharged home. Conclusions: Nutritional method, cognitive function at discharge, and the prestroke living situation with or without household caregivers are important factors of discharge among elderly patients after stroke with low independence levels in ADL. However, only a small number of severely disabled patients were successfully discharged home.
Keywords	Activities of daily living ; Aged ; Long-term care ; Patient discharge ; Rehabilitation ; Stroke ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
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Article ; Online: Cost of postoperative complications of lower anterior resection for rectal cancer: a nationwide registry study of 15,187 patients.

Kumamaru, Hiraku / Kakeji, Yoshihiro / Fushimi, Kiyohide / Ishikawa, Koichi Benjamin / Yamamoto, Hiroyuki / Hashimoto, Hideki / Ono, Minoru / Iwanaka, Tadashi / Marubashi, Shigeru / Gotoh, Mitsukazu / Seto, Yasuyuki / Kitagawa, Yuko / Miyata, Hiroaki

Surgery today

2022 Volume 52, Issue 12, Page(s) 1766–1774

Abstract: Purpose: To assess the increase in hospital costs associated with postoperative complications after lower anterior resection (LAR) for rectal cancer.: Methods: The subjects of this retrospective analysis were patients who underwent elective LAR ... ...

Abstract	Purpose: To assess the increase in hospital costs associated with postoperative complications after lower anterior resection (LAR) for rectal cancer. Methods: The subjects of this retrospective analysis were patients who underwent elective LAR surgery between April, 2015 and March, 2017, collected from a Japanese nationwide gastroenterological surgery registry linked to hospital-based claims data. We evaluated total and category-specific hospitalization costs based on the level of postoperative complications categorized using the Clavien-Dindo (CD) classification. We assessed the relative increase in hospital costs, adjusting for preoperative factors and hospital case volume. Results: We identified 15,187 patients (mean age 66.8) treated at 884 hospitals. Overall, 71.8% had no recorded complications, whereas 7.6%, 10.8%, 9.0%, 0.6%, and 0.2% had postoperative complications of CD grades I-V, respectively. The median (25th-75th percentiles) hospital costs were $17.3 K (16.1-19.3) for the no-complications group, and $19.1 K (17.3-22.2), $21.0 K (18.5-25.0), $27.4 K (22.4-33.9), $41.8 K (291-618), and $22.7 K (183-421) for the CD grades I-V complication groups, respectively. The multivariable model identified that complications of CD grades I-V were associated with 11%, 21%, 61%, 142%, and 70% increases in in-hospital costs compared with no complications. Conclusions: Postoperative complications and their severity are strongly associated with increased hospital costs and health-care resource utilization. Implementing strategies to prevent postoperative complications will improve patients' clinical outcomes and reduce hospital care costs substantially.
MeSH term(s)	Humans ; Aged ; Retrospective Studies ; Rectal Neoplasms/surgery ; Rectal Neoplasms/complications ; Postoperative Complications/etiology ; Hospital Costs ; Registries
Language	English
Publishing date	2022-05-24
Publishing country	Japan
Document type	Journal Article
ZDB-ID	1115435-4
ISSN	1436-2813 ; 0941-1291
ISSN (online)	1436-2813
ISSN	0941-1291
DOI	10.1007/s00595-022-02523-6
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Article ; Online: Factors Associated With Time to Achieve Physical Functional Recovery in Patients With Severe Stoke After Inpatient Rehabilitation

Reiko Yamaura, MPH / Tetsuji Kaneko, MHS / Koichi Benjamin Ishikawa, PhD / Shunya Ikeda, MD, PhD / Kiyohide Fushimi, MD, PhD / Tsutomu Yamazaki, MD, PhD

Archives of Rehabilitation Research and Clinical Translation, Vol 4, Iss 4, Pp 100229- (2022)

A Retrospective Nationwide Cohort Study in Japan

2022

Abstract	Objective: To describe characteristics of patient with severe stroke (FIM motor score [FIM motor] 20-49 at admission) and examine association between pre-specified factors (age, sex, modified Rankin Scale before stroke onset, body mass index, FIM motor, and FIM cognitive) and time to achieve FIM motor ≥70, that is, self-independent level. Design: Retrospective cohort study using a large database in Japan. Setting: Rehabilitation wards. Participants: Patients with severe stroke (N=1422) who received inpatient rehabilitation were included (median age: 76 years; interquartile range [IQR]: 68.0-84.0). A total of 54.6% were men, and 65.8% were ischemic stroke. Interventions: Not applicable. Main Outcome Measure(s): Time to achieve FIM motor ≥70. Results: After inpatient rehabilitation, 40.4% (N=575) achieved FIM motor ≥70 (admission FIM motor 20-29, 30-39 and 40-49: 18.6%, 33.6%, and 47.8%, respectively). Patients who achieved FIM motor ≥70 stayed median 81.0 days [IQR, 51.0-120.0]) and received median: 6.94 units per day [IQR, 5.48-7.78], 1 unit=20 minutes). Adjusted Fine–Gray regression revealed that shorter time to achieve FIM motor ≥70 was associated with higher admission FIM motor (hazard ratio [HR] 2.87 [95% confidence interval [CI] 2.27-3.62]: 20-29 vs 40-49), higher admission FIM cognitive (HR 1.81 [95% CI: 1.39-2.35]: 5-14 vs 25-35), and younger (HR 3.20 [95% CI: 2.32-4.42]: ≥85 years vs 20-69 years). Conclusions: Most patients with severe stroke did not achieve FIM motor ≥70 after inpatient rehabilitation. Older patients and patients with lower admission FIM motor require more attention. They should be prioritized for state-of-the-art rehabilitation therapy.
Keywords	Activities of daily living ; Functional status ; Recovery of function ; Rehabilitation ; Stroke ; Medicine (General) ; R5-920
Subject code	616 ; 796
Language	English
Publishing date	2022-12-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: [Chemotherapy and DPC, prospective payment].

Ishikawa, Koichi Benjamin

Gan to kagaku ryoho. Cancer & chemotherapy

2006 Volume 33, Issue 2, Page(s) 159–163

Abstract: In 2003, the Japanese government introduced a prospective payment methodology into acute inpatient care services by developing a new, national patient grouping, called Diagnosis Procedure Combination(DPC). It raised issues relating to; 1) settling ... ...

Abstract	In 2003, the Japanese government introduced a prospective payment methodology into acute inpatient care services by developing a new, national patient grouping, called Diagnosis Procedure Combination(DPC). It raised issues relating to; 1) settling charges for combinations of treatment modalities in a single admission, 2) large practice variations in chemotherapeutic regimens and its pharmaceutical costs, 3) effects of shorter length of stays and outpatient chemotherapy, 4) payment adjustment for hospitals providing care to terminally ill, relapse and metastatic cases. In order to overcome these issues; a) oncologists need to develop treatment guidelines and standardize chemotherapeutic regimens, b) refine DPC to incorporate chemotherapy protocols, c) develop adjustment measures for different densities of care and casemix.
MeSH term(s)	Diagnosis-Related Groups ; Drug Therapy/economics ; Humans ; Japan ; Length of Stay ; National Health Programs/economics ; Neoplasms/classification ; Neoplasms/drug therapy ; Neoplasms/economics ; Prospective Payment System/classification
Language	Japanese
Publishing date	2006-02
Publishing country	Japan
Document type	English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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Article: [DPC and its implications for clinical practice in cancer treatment].

Ishikawa, Koichi Benjamin

Gan to kagaku ryoho. Cancer & chemotherapy

2004 Volume 31, Issue 8, Page(s) 1169–1173

Abstract: In April 2003, the Japanese government introduced a casemix classification based reimbursement methodology into acute inpatient care services by developing a new, national patient grouping, called Diagnosis Procedure Combination (DPC). The result, so far, ...

Abstract	In April 2003, the Japanese government introduced a casemix classification based reimbursement methodology into acute inpatient care services by developing a new, national patient grouping, called Diagnosis Procedure Combination (DPC). The result, so far, has been successful, but analysis of data gathered using DPC revealed; 1) large deficit accumulating in short-term chemotherapy and examination admissions, 2) great variation in practice patterns within academic medical centers adopting the new system. Such phenomenon may lead to rapid shift of related services to outpatient setting, initiate debate over standardization of practice in cancer treatment. Efforts are needed to overcome these issues before the next reform planned in 2006.
MeSH term(s)	Breast Neoplasms/economics ; Diagnosis-Related Groups ; Female ; Health Care Costs ; Humans ; Length of Stay/economics ; Liver Neoplasms/economics ; Male ; Neoplasms/economics ; Neoplasms/therapy ; Prospective Payment System
Language	Japanese
Publishing date	2004-08
Publishing country	Japan
Document type	English Abstract ; Journal Article
ZDB-ID	604842-0
ISSN	0385-0684
ISSN	0385-0684
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Article ; Online: End-of-life care for cancer patients in Japanese acute care hospitals: A nationwide retrospective administrative database survey.

Sato, Yuko / Miyashita, Mitsunori / Sato, Kazuki / Fujimori, Kenji / Ishikawa, Koichi Benjamin / Horiguchi, Hiromasa / Fushimi, Kiyohide / Ishioka, Chikashi

Japanese journal of clinical oncology

2018 Volume 48, Issue 10, Page(s) 877–883

Abstract: Background: End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described.: Methods: We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health ... ...

Abstract	Background: End-of-life (EOL) cancer care in Japanese acute care hospitals has not been well described. Methods: We aimed to assess the aggressiveness of EOL care and examine common treatments administered to cancer patients using a health administrative database. Subjects are adult cancer patients who died at acute care hospitals between April 2011 and March 2014. Data from the Japanese Diagnosis Procedure Combination database were analysed to measure the aggressiveness of care (chemotherapy, intensive care unit [ICU] admission and cardiopulmonary resuscitation [CPR]) and describe procedures and prescriptions administered in the last 14 and 30 days of life, disaggregated by hospital case volume: high, intermediate and low volumes. Results: Of 248,978 cancer decedents, 170,024 died in high-, 70,231 in intermediate- and 8,723 in low-volume hospitals. Aggressive treatment in the last 14 days of life included chemotherapy (9.4%, 7.3%, and 5.4%, respectively), ICU admission (3.0%, 2.0%, and 2.4%) and CPR (5.8%, 6.4%, and 8.3%). Opioids were administered to 66.0%, 59.0% and 49.4% patients, while Palliative Care Team intervention was performed for 8.5%, 2.2% and 2.0% of patients, respectively in the last 30 days. In high-volume hospitals, radiotherapy and certified outpatient chemotherapy fees were more frequent. Catecholamines and hyperalimentation were more frequently administered in low-volume hospitals. Conclusion: This is the first study to assess EOL care among Japanese acute care hospitals. More frequent use of chemotherapy at high-volume hospitals may reflect a well-established cancer treatment system. The approach for low-volume hospitals might improve the EOL care for all cancer patients in Japan.
MeSH term(s)	Aged ; Aged, 80 and over ; Databases, Factual ; Female ; Hospitals ; Humans ; Japan ; Male ; Middle Aged ; Neoplasms/rehabilitation ; Neoplasms/therapy ; Retrospective Studies ; Surveys and Questionnaires ; Terminal Care/methods
Language	English
Publishing date	2018-08-11
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	190978-2
ISSN	1465-3621 ; 0368-2811
ISSN (online)	1465-3621
ISSN	0368-2811
DOI	10.1093/jjco/hyy117
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Article ; Online: Global Wheat Head Detection 2021: An Improved Dataset for Benchmarking Wheat Head Detection Methods.

David, Etienne / Serouart, Mario / Smith, Daniel / Madec, Simon / Velumani, Kaaviya / Liu, Shouyang / Wang, Xu / Pinto, Francisco / Shafiee, Shahameh / Tahir, Izzat S A / Tsujimoto, Hisashi / Nasuda, Shuhei / Zheng, Bangyou / Kirchgessner, Norbert / Aasen, Helge / Hund, Andreas / Sadhegi-Tehran, Pouria / Nagasawa, Koichi / Ishikawa, Goro /

Dandrifosse, Sébastien / Carlier, Alexis / Dumont, Benjamin / Mercatoris, Benoit / Evers, Byron / Kuroki, Ken / Wang, Haozhou / Ishii, Masanori / Badhon, Minhajul A / Pozniak, Curtis / LeBauer, David Shaner / Lillemo, Morten / Poland, Jesse / Chapman, Scott / de Solan, Benoit / Baret, Frédéric / Stavness, Ian / Guo, Wei

Plant phenomics (Washington, D.C.)

2021 Volume 2021, Page(s) 9846158

Abstract: The Global Wheat Head Detection (GWHD) dataset was created in 2020 and has assembled 193,634 labelled wheat heads from 4700 RGB images acquired from various acquisition platforms and 7 countries/institutions. With an associated competition hosted in ... ...

Abstract	The Global Wheat Head Detection (GWHD) dataset was created in 2020 and has assembled 193,634 labelled wheat heads from 4700 RGB images acquired from various acquisition platforms and 7 countries/institutions. With an associated competition hosted in Kaggle, GWHD_2020 has successfully attracted attention from both the computer vision and agricultural science communities. From this first experience, a few avenues for improvements have been identified regarding data size, head diversity, and label reliability. To address these issues, the 2020 dataset has been reexamined, relabeled, and complemented by adding 1722 images from 5 additional countries, allowing for 81,553 additional wheat heads. We now release in 2021 a new version of the Global Wheat Head Detection dataset, which is bigger, more diverse, and less noisy than the GWHD_2020 version.
Language	English
Publishing date	2021-09-22
Publishing country	United States
Document type	Journal Article
ISSN	2643-6515
ISSN (online)	2643-6515
DOI	10.34133/2021/9846158
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Article ; Online: Comparative Quality of Laparoscopic and Open Cholecystectomy in the Elderly Using Propensity Score Matching Analysis

Kazuaki Kuwabara / Shinya Matsuda / Koichi Benjamin Ishikawa / Hiromasa Horiguchi / Kenji Fujimori

Gastroenterology Research and Practice, Vol

2010 Volume 2010

Keywords	Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Gastroenterology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
Language	English
Publishing date	2010-01-01T00:00:00Z
Publisher	Hindawi Publishing Corporation
Document type	Article ; Online
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