2016/1/19

6935211

MMC

415

151

185

14

416

194

50

80

dr.kenta.sato@gmail.com

14

104

55

199 2

1073044

76%

10%

0.6%
HP http://www.min-iren.gr.jp/ikei-gakusei/igakusei/zi5_medi/2011/049/mw-ken-49.html
HP http://www.chidoribashi-hp.or.jp/chidoribashi-hph/index.html

2016/1/19

Common Disease

2
4

Common disease

Common disease

TOP50

400

150
150

150

16

12

3
12

WebSNS

NPO

ICTIT

IT

etc.

Google
https://www.igaku-shoin.co.jp/paperDetail.do?id=PA02985_05

2016/1/19

SOAP

NEJMCRPData

NEJMWarrant
CRPClaim

DataWarrant

NEJM

DataWarrant
CRP

https://kogolearn.wordpress.com/studyskill/chap4/sec2/

Claim

Data/Warrant

Evidence based medicine !?

Data

EBM

Warrant

Data

Warrant
EBM
http://spell.umin.jp/EBM.htm

Claim

Subjective

A
Plan

Objective

2016/1/19

Problem Oriented System

SOAP

AP

SOAP

SO
AP

Amazon

POSSO

DataWarrant

2016/1/19

3
O

etc

Subjective

(OPQRST)

Review of Systems

EBM

or

http://spell.umin.jp/EBM.htm

ADL

2016/1/19

Objective

General appearance
First impressionABCD
Vital signs
Head to Toe

General appearance

Ns

GoodSosoBad

BMJ
https://www.facebook.com/journalofI/posts/287005368067429

https://www.jstage.jst.go.jp/article/generalist/35/4/35_299/_article/-char/ja/

General appearance
JCS0BP9456PR96RR26SpO2 92%R/ABT36.8

S3(+)(-)
(-)(-)(-)
(+)

BUN20.1Cr1.23T
PVCHR90V1-4ST
XpCTR55

Pertinent

Pertinent positive
Pertinent negative
Non-pertinent positive
Non-pertinent negative

Jolt
Kernig

Non-pertinent
Pertinent negative

2016/1/19

Brief summary

Assessment

Brief summary

Opening statement

SO

I think ~~~, because

SOData
STT

Warrant

Pertinent

30

#1ACS
Brief summary

30

Definite
Less likely

AHASTEMI

#2

ACS
ACS

STEMI(2013)

definiteprobablepossibleless likelyunlikelyruled out

S/O R/O

SOAP
SO

AP

2016/1/19

Assessment

Plan

52319

Plan

Tx

Dx

Ex

PCI
Tx20mg550mL4mL/
100mg275mg4
Dx
ECGSpO25
Ex

Px

SOAP

CVA

IE

UpToDate

Fever work-up
MRI

PxACE

SO
ASODataWarrant
Claim
P

2016/1/19

SOAP

Simple
11

Comprex

Complicated

60
AKI
RADM

Chaotic

70

MaintenanceCrisis

40
DMDLNAFLDHCV

30

Simple

Complicated

By ploblem

Complex

Chaotic

SOAP

SOAP

2016/1/19

Complicated

0
1

#1.

2
Semantic qualifier : SQ

#2.

#3.

4
58

SO

Semantic Qualifier

10

2016/1/19

#1. 14.4.20
MCV7014.4.20SQ)
514.4.22SQ)
CF14.4.26
14.4.30
cStageT3N2M114.5.3
PS4PPS14.8.24

#1.

SQ)

#1.100Nohria4

Post PCIDESHFrEFCHF stageC

#2.
#1

Simple is BEST!!

#1. ACS#2. #3.

#1. ACS#2. #3.

#4. #5. #6.
#7. #8.
#9. #10 . #11.

#1. ACS#2.

#2. #3.
#4. #5. #6.
#7. #8.
#9. #10 . #11.

A
SO

#1. ACS#2. #3.

S

A#1. ACS

P
S

A#1. ACS

#2.
#3.
P

# # #1.#a.
#1. #2. #3.
#a. #b. #c.

11

2016/1/19

Complex

OA

OA

Complex/moderateFrailOrgan13282
OA
CHF(HFrEFAHA stage2)
LDL
AUDIT

ACP

ACP

Brief title
Opning statement

Complex / hardFrail + CVD13

12

2016/1/19

RIME

Kolb

Reporter()

SO

Interpreter()

SOA

Manager()

AP

Educater()

13

2016/1/19

Frequent

Accurate

Specific

Timely

12

http://www.igaku-shoin.co.jp/paperDetail.do?id=PA02985_05

HP

http://www.nanzando.com/journals/chiryo/

14