1997

2003

2008

2011 10


1.

2.

3.

4.

QuickTime
LvO
sN`Kv
B

2009

14

2500

2010

56

7027

etc

>>>


1.

2.

3.

4.

(PCOS)

PCOS

51%

40%


100%

(100%)

(80%)()

(Clinical Reasoning)

(Clinical Reasoning)

1.

2.

3.

1.

2.

15-30%

3.

4.

1.

2.

3.

(Heuristic)

1. Representativeness
2. (Availability)
3.
(Anchoring and adjustment)

1.
2.
3.
4.


Availability

1.

2.

3.

4.


Anchoring and adjustment

-
-
-

40%
40%
20%

0%

0%
0%
0.1%0.1%

11%
gf@
12%

77%

A+B

CD

A+C

B+D

A+B+C+D

(Sensitivity) A / (A+B)
Snout

(Specificity) D / (C+D)
Spin

(LR+) = / (1-)

(LR-) = (1-) /

Centor Criteria
1.

2.

3.

4.

6.3
20% 60%

20%
20%
60%

0%

0%
0%
0.1%0.1%

0%

100%

-
100%

0%

1.

2.

3.

0%

100%

0%

100%

7
(0.1%)
()
(

16

(NNT3000-4000)

0%

10%

-
50%

60%

100%


1.

2.

20%
20%
60%

0%

0%
0%
0.1%0.1%

3-7
(>65)

// (10-20%)
()
()

62%
98%

(-)
LR- 0.39
0%
30% 40%
20%

9%

(+)
LR+ 31

100%
89%


90%
96%

0%

10%
13%

LR- 0.10

50% 60%

+
LR+ 23

100%
99%

1.

2.

3.

JAMA The Rational Clinical Examination

KeiMiyazaki.MD@gmail.com

35

45%
45%
10%

0%

0%
0%
0.1%0.1%

THE LANCET Vol 354 October 9, 1999

QuickTime
LvO
sN`Kv
B

242
(1-2m)4

LR+

LR+ 2.3
LR+ 7.1

-
0%

>90%

30% 40%

100%

45%

89%
LR+ 7.1


General Medicine 2011; 12: p.51-60

95% 98%


1.

2.

62%
98%

+
LR+ 31

-
0%

30% 40%

88%

LR- 0.39 95%

99.8%

100%

0%100%

1.

0.1%1%50%99%99.9%

2.

3.

Pubmed

Journal Watch

JAMA Rational Clinical Examination

1.
2.

Uptodate

Dynamed

Essential Evidence Plus

Uptodate

/
Dynamed

Essential Evidence Plus

iphone

SNS

227 Meta-analysis

62% 98%

Journal Watch

29 TFC

32

Web

Web

(web)

SNS
Web

Web

1.

2.

3.

JAMA The Rational Clinical

Examination

KeiMiyazaki.MD@gmail.com