JP6412972B2 - Person extraction support device for prevention of severe lifestyle-related disease, method and program for extraction of subject for prevention of severe lifestyle-related disease - Google Patents

Description

  The present invention relates to an apparatus, a method, and a program for supporting extraction of subjects for prevention of aggravation of lifestyle-related diseases.

  Conventionally, a management system for preventing aggravation of lifestyle-related diseases such as diabetes has been known. For example, in Patent Document 1, an appropriate treatment is performed by determining which stage each patient has in a given injury / illness based on the injury / illness name, drug information, and medical practice information extracted from the receipt data. It provides information to do and describes a wound management system to prevent the sickness from becoming serious.

Japanese Patent No. 5203481

  In recent years, the prevention of aggravation of lifestyle-related diseases has been implemented by local governments and the like for citizens who have a high risk of developing lifestyle-related diseases and can expect lifestyle-related diseases to be prevented by lifestyle-related improvements. However, the number of professionals who can prevent the progression of lifestyle-related diseases and the budget of the business are limited, and there is a need for a mechanism for efficiently preventing the progression of lifestyle-related diseases.

  This invention is made | formed in view of such a situation, and it aims at improving the efficiency of lifestyle-related disease seriousness prevention.

  In order to solve the above problems, the lifestyle-related disease aggravation prevention target person extraction support device according to the present invention refers to a database that records medical information and results of a lifestyle-related disease aggravation prevention business for each of a plurality of individuals And one or more variables having a statistically significant difference between the improved group whose health condition has been improved by the prevention of aggravation of lifestyle-related diseases and the non-improved group which has not improved. A variable specifying unit for specifying one or more variables each indicating a change amount of the variable, and for each of the one or more variables specified by the variable specifying unit for any one of the improvement group and the non-improvement group An interval estimation unit that estimates a confidence interval of the value of each of the values, and for each of the one or more variables, each value that the variable can take based on the confidence interval estimated by the interval estimation unit is Due to health A score assigning unit for assigning a score indicating the possibility of improvement of the condition, and for each value of the one or more variables of candidate candidates for prevention of severe lifestyle-related diseases, a score assigned to the value by the score assigning unit And a score specifying unit for specifying.

  In a preferred embodiment, the variable specifying unit is one or more other variables having a statistically significant difference between the improvement group and the non-improvement group, and the presence or absence of a specific disease, a specific treatment method, One or more other variables each indicating the acceptance or non-existence of a specific attribute are specified, and the score assigning unit is included in the improvement group for each of the one or more other variables specified by the variable specifying unit. On the basis of the comparison result of the number of individuals associated with one value of the variable and the number of individuals associated with the database and the number of individuals associated with the one value in the non-improvement group, A score is assigned to each value that can be taken by the variable, and the score specifying unit specifies, for each value of the one or more other variables of the candidate candidate, a score assigned to the value by the score assigning unit. .

  In a further preferred aspect, the lifestyle-related disease aggravation prevention target person extraction support device further includes a selection receiving unit that accepts selection of a method for preventing a lifestyle-related disease aggravation, and the variable specifying unit is connected via the selection receiving unit. Identifying one or more variables having a statistically significant difference between an improved group whose health condition has been improved and a non-improved group which has not improved by the method of preventing aggravated lifestyle-related diseases selected by the method, and estimating the interval The part is identified by the variable identification unit for either the improved group whose health condition has been improved by the method for preventing the progression of lifestyle-related diseases selected through the selection receiving unit or the non-improved group which has not been improved. For each of the one or more variables, a confidence interval of the value of the variable is estimated.

  Moreover, the lifestyle-related disease aggravation prevention target person extraction assistance apparatus which concerns on this invention refers to the database which records medical treatment information and the result of a lifestyle-related disease seriousness prevention business about each of several individuals, and a lifestyle-related disease One or more variables that have a statistically significant difference between the participating group that participated in the prevention of seriousness and the non-participating group that did not participate, and each indicates the test value or the amount of change in the test value A variable specifying unit for specifying the variable, and a section estimating unit for estimating a confidence interval of the value of the variable for each of one or more variables specified by the variable specifying unit for any of the participation group and the non-participating group For each of the one or more variables, a score indicating the possibility of participating in the prevention of aggravation of lifestyle-related diseases is assigned to each possible value of the variable based on the confidence interval estimated by the interval estimation unit. And assignment unit, for each value of said one or more variables of interest candidates lifestyle diseases aggravation preventing, and a score specifying unit configured to specify the scores assigned to the value by the score allocation unit.

  In a preferred embodiment, the variable specifying unit is one or more other variables having a statistically significant difference between the participating group and the non-participating group, the presence or absence of a specific disease, adoption of a specific treatment method Alternatively, one or more other variables each indicating the presence or absence of a specific attribute are specified, and the score assignment unit includes, for each of the one or more other variables specified by the variable specification unit, in the participation group. Based on the comparison result of the number of individuals associated with one value of the variable and the number of individuals associated with the database and the number of individuals associated with the one value within the non-participating group, the variable A score is assigned to each value that can be taken, and the score specifying unit specifies, for each value of the one or more other variables of the candidate candidate, a score assigned to the value by the score assigning unit.

  In a further preferred aspect, when the database is updated, the variable specifying unit respecifies one or more variables having a statistically significant difference, and the interval estimation unit is respecified by the variable specifying unit. The confidence interval of the value of the variable is re-estimated for each of the one or more variables, and the score allocating unit is based on the confidence interval re-estimated by the interval estimation unit for each of the one or more variables. The score is reassigned for each possible value.

  In a further preferred aspect, the interval estimation unit estimates a plurality of confidence intervals having different degrees of reliability for each of the one or more variables, and the score assignment unit determines the interval for each of the one or more variables. A score is assigned to each possible value of the variable based on a plurality of confidence intervals estimated by the estimation unit.

  Further, the lifestyle-related disease seriousness prevention target person extraction support method according to the present invention is a lifestyle-related disease seriousness prevention target person extraction support method executed by the lifestyle-related disease seriousness prevention target person extraction support method, With reference to the database that records medical information and the results of the lifestyle-related disease aggravation prevention project for each individual, the improvement group with improved health status and the non-improvement group that did not improve One or more variables having a statistically significant difference between the test value or the variable indicating the amount of change in the test value, and the improvement group and the non-improvement group, For each of the one or more specified variables, and for each of the one or more variables, the variable is determined based on the estimated confidence interval. Assigning to each possible value a score indicating the possibility of improving the health status due to the prevention of aggravation of lifestyle-related diseases, and for each value of the one or more variables of candidate candidates for prevention of aggravation of lifestyle-related diseases, Identifying a score assigned to the value.

  Further, the lifestyle-related disease seriousness prevention target person extraction support method according to the present invention is a lifestyle-related disease seriousness prevention target person extraction support method executed by the lifestyle-related disease seriousness prevention target person extraction support method, Statistics between participants who participated in the prevention of severe lifestyle-related diseases and non-participants who did not participate, referring to a database that records medical information and results of the prevention of lifestyle-related diseases One or more variables that are significantly different from each other, the step of specifying one or more variables each indicating a test value or a change amount of the test value, and any one of the participating group and the non-participating group, Estimating a confidence interval of the value of the variable for each of the identified one or more variables, and for each of the one or more variables, each value that the variable can take based on the estimated confidence interval. A step of assigning a score indicating the possibility of participating in the prevention of aggravation of lifestyle-related diseases, and for each value of the one or more variables of candidate candidates for the prevention of aggravation of lifestyle-related diseases, a score assigned to the value is specified Steps.

  In addition, the program according to the present invention refers to a database that records medical information and results of a lifestyle-related disease aggravation prevention project for each of a plurality of individuals on a computer. One or more variables having a statistically significant difference between an improved group that has improved and a non-improved group that has not improved, and one or more variables each indicating a test value or a change amount of the test value are identified For each of the one or more specified variables for each of the improvement group and the non-improvement group, and for each of the one or more variables Assigning to each possible value of the variable based on the estimated confidence interval a score indicating the possibility of improving the health status by preventing the progression of lifestyle-related diseases; Reduction for each value of said one or more variables of interest candidates prevention, a program for and a step of identifying a score assigned to that value.

  In addition, the program according to the present invention refers to a database that records medical information and results of a lifestyle-related disease seriousness prevention project for each of a plurality of individuals on a computer, and participates in the prevention of severe lifestyle-related disease Identifying one or more variables that are statistically significant between the group and the non-participating group that did not participate, each indicating a test value or a change in the test value; and Estimating a confidence interval of the value of the variable for each of the identified one or more variables for either the participating group or the non-participating group; and the estimated for each of the one or more variables Assigning a score indicating the possibility of participating in the prevention of aggravation of lifestyle-related diseases to each possible value of the variable based on the confidence interval; For each value of the above variables, a program for and a step of identifying a score assigned to that value.

  ADVANTAGE OF THE INVENTION According to this invention, the efficiency of lifestyle-related disease seriousness prevention can be improved.

It is a figure which shows an example of a structure of the lifestyle-related disease seriousness prevention target person extraction assistance apparatus. It is a figure which shows an example of medical treatment information DB111. It is a figure which shows an example of business result DB112. It is a figure which shows an example of statistical result DB113. It is a figure which shows an example of the score table. It is a figure which shows an example of object person intermediate score DB115. It is a figure which shows an example of object person last score DB116. It is a flowchart which shows an example of a score table creation process. It is a flowchart which shows an example of a lifestyle-related disease seriousness prevention target person evaluation process.

1. Embodiment 1-1. Configuration FIG. 1 is a diagram illustrating an example of a configuration of a lifestyle-related disease aggravation prevention target person extraction support apparatus 1 (hereinafter referred to as “target person extraction support apparatus 1”) according to an embodiment of the present invention. The target person extraction support apparatus 1 is an apparatus intended to support the extraction of an optimal target person in order to efficiently carry out prevention of aggravation of lifestyle-related diseases. Here, prevention of lifestyle-related disease aggravation (or prevention of lifestyle-related disease aggravation) means that there is a high risk of developing or aggravating lifestyle-related diseases, and the development or aggravation of lifestyle-related diseases due to lifestyle improvements It is an act of providing support for reviewing lifestyle habits for those who can expect a preventive effect. Prevention of serious lifestyle-related diseases is carried out mainly by public health nurses, nurses, and registered dietitians. It should be noted that the prevention of aggravation of lifestyle-related diseases in this embodiment is specified in Article 18, Paragraph 1 of the Specific Health Guidance (Act on the Ensuring Medical Care for the Elderly (Act No. 80 of August 17, 1982)) It differs from health guidance provided by those who have specialized knowledge and skills related to health guidance for those who need to maintain their health based on the results of the health checkup. However, this is not the case in modified examples.

  The target person extraction support device 1 is a computer device that includes a control unit 10, a storage unit 11, an operation input unit 12, a display unit 13, and a communication unit 14. As a modification, the target person extraction support device 1 may be configured by a plurality of computer devices connected to each other via a communication line.

  The control unit 10 includes an arithmetic processing unit such as a CPU and a volatile memory, and executes a program stored in the storage unit 11. Functions realized by the control unit 10 executing the program will be described later.

  The storage unit 11 is a storage device such as a hard disk, and stores various databases described below in addition to programs executed by the control unit 10.

  FIG. 2 is a diagram illustrating an example of the medical information DB 111. The medical information DB 111 is a database that records medical information (in other words, medical chart information) for each of a plurality of individuals. Each record of the medical information DB 111 includes the name of the individual and the symbol and number of the insured card, the value and measurement date of HbA1c (hemoglobin A1c), the value and measurement date of BMI (physique index), and blood pressure (systole) And diastole) and measurement date fields. Data recorded in the medical information DB 111 is acquired via the communication line by the information acquisition unit 101 described later, or manually input by the user of the target person extraction support apparatus 1.

  The medical information DB 111 may also store information such as sex, date of birth, and my number as information for identifying an individual. Moreover, the individual registered in the medical treatment information DB 111 is not necessarily limited to the insured. The same applies to the business result DB 112, the target person intermediate score DB 115, and the target person final score DB 116 described below.

  FIG. 3 is a diagram illustrating an example of the business result DB 112. Business result DB112 is a database which records the result of the lifestyle-related disease seriousness prevention business about each of several individuals. Here, the lifestyle-related disease aggravation prevention business is an effort to prevent the aggravation of lifestyle-related diseases for each individual, and is implemented by the government, local governments, companies, and the like. The lifestyle-related disease aggravation prevention business includes, for example, a lifestyle-related disease aggravation prevention program. Each record of this business result DB 112 includes an individual's name, a symbol and number of an insured card, a business name, and presence / absence of consent for participation in the prevention of aggravation of lifestyle-related diseases (in other words, prevention of aggravation of lifestyle-related diseases) And the date of response), the intervention method for preventing lifestyle-related diseases aggravation, the start date of intervention, the intervention result, and the end date of intervention. The data recorded in the business result DB 112 is acquired via the communication line by the information acquisition unit 101 described later, or manually input by the user of the target person extraction support apparatus 1.

  FIG. 4 is a diagram illustrating an example of the statistical result DB 113. The statistical result DB 113 is a database that records test values of test items that are statistically significant for a predetermined classification category that is specified with reference to the medical treatment information DB 111 and the business result DB 112 described above. Each record of the statistical result DB 113 includes fields of business name, classification category, HbA1c value, BMI value, and blood pressure (systolic and diastolic) values. Here, there are two classification categories: an agreement group that has agreed to participate in the prevention of aggravation of lifestyle-related diseases, and an improvement group in which the health condition has been improved by the prevention of aggravation of lifestyle-related diseases.

  FIG. 5 is a diagram illustrating an example of the score table 114. The score table 114 is a table that stores a score assigned to each value of the inspection item with reference to the statistical result DB 113. Each record of the score table 114 is composed of inspection items, numerical values, and score fields assigned to each of a plurality of score categories. Here, the multiple score categories include, for example, the “Awareness / Agreement” category, the “Awareness / Improvement” category, the “Severeness Prevention Guidance / Agreement” category, and the “Severeness Prevention Guidance / Improvement”. There is a category. Among these score categories, the “Awareness / Agreement” and “Severity Prevention Guidance / Agreement” scores indicate the possibility of participating in the prevention of severe lifestyle-related diseases. On the other hand, the scores for “Awareness / Improvement” and “Instruction / Improvement of Severity Prevention” indicate the possibility that the health status will be improved by the prevention of lifestyle-related diseases. Note that the score table 114 illustrated in FIG. 5 is a score table that stores a score for each value of systolic blood pressure, and scores for other examination items (specifically, HbA1c, BMI, and diastolic blood pressure), respectively. A table is prepared.

  FIG. 6 is a diagram illustrating an example of the subject intermediate score DB 115. The subject intermediate score DB 115 is a database that records a score specified for each test value of a candidate candidate for prevention of aggravation of lifestyle-related diseases with reference to the score table 114 described above. Each record of the subject intermediate score DB 115 includes individual fields, symbols and numbers of the insured card, inspection items, and score fields specified for each of a plurality of score categories.

FIG. 7 is a diagram illustrating an example of the subject final score DB 116. The subject final score DB 116 is a database that records a total score and an evaluation index that are identified with respect to the subject candidate for prevention of aggravation of lifestyle-related diseases with reference to the subject intermediate score DB 115. Each record of the target person final score DB 116 includes individual names, insured person symbols and numbers, and total score and evaluation index fields specified for each of a plurality of score categories. Here, among the total score and evaluation index, the total score and evaluation index for each category of “Awareness / Consent” and “Severe Prevention Guidance / Consent” illustrated in FIG. It shows the possibility of participating in the prevention. On the other hand, the total score and evaluation index for each category of “Awareness / Improvement” and “Severe Prevention Guidance / Improvement” indicate the possibility that the health status will be improved by preventing the lifestyle-related disease from becoming more serious. .
The above is the description of the storage unit 11.

  The operation input unit 12 is an input device such as a mouse, a keyboard, or a touch sensor.

  The display unit 13 is a display device such as a liquid crystal display or an organic EL display. The display unit 13 displays data recorded in the subject final score DB 116 in accordance with an instruction from the user.

  The communication unit 14 is a communication module for communicating with an external device via a communication line.

  Said control part 10 implement | achieves the function demonstrated below by running the program memorize | stored in the memory | storage part 11. FIG.

  The information acquisition unit 101 acquires medical information from a medical institution or clinical laboratory through the communication unit 14 and stores it in the medical information DB 111. If there is a database that integrally manages medical information of each medical institution, the medical information may be acquired from the database via the communication unit 14. In addition, the information acquisition unit 101 acquires information on the results of the lifestyle-related disease aggravation prevention business from the medical institution or medical insurer (specifically, the local government, health insurance association, etc.) via the communication unit 14, and the business results Store in the DB 112.

  The variable identification unit 102 refers to the medical treatment information DB 111 and the business result DB 112, and for each business, there is a statistically significant difference between the participating group that participated in the prevention of severe lifestyle-related diseases and the non-participating group that did not participate. Specify one or more inspection items. Here, the participation group is a group consisting of individuals who have agreed to participate in the prevention of severe lifestyle-related diseases, and the non-participation group is an individual who has not agreed to participate in the prevention of severe lifestyle-related diseases. It is a group. The variable specifying unit 102 uses a t-test to confirm a significant difference, and determines whether there is a significant difference in the average of the latest test values before the start date of the intervention between the participating group and the non-participating group. Check.

  In addition, the variable identification unit 102 refers to the medical treatment information DB 111 and the business result DB 112, and statistically determines between the improved group in which the health condition has been improved and the non-improved group in which the health condition has not been improved due to the prevention of serious lifestyle-related diseases Identify one or more test items with significant differences. Here, the improvement group is a group consisting of individuals whose health condition has been improved by prevention of serious lifestyle-related diseases, and the non-improvement group is a group of individuals whose health conditions have been maintained or deteriorated by prevention of serious lifestyle-related diseases. It is a group. The variable identification unit 102 uses a t-test to confirm a significant difference, and whether or not there is a significant difference in the average of the latest test values before the start date of the intervention between the improvement group and the non-improvement group Confirm.

  As a modified example, when the variable specifying unit 102 confirms a significant difference between the participation group and the non-participation group or between the improvement group and the non-improvement group, the variable identification unit 102 determines a predetermined period (for example, 2 It may be confirmed whether or not there is a significant difference in the average of the test values of the previous month). Moreover, you may use well-known test methods other than t test.

  The section estimation unit 103 refers to the medical treatment information DB 111 and the business result DB 112, and estimates the confidence section of the test value of the test item specified for the business by the variable specifying unit 102 for each group for each business. Specifically, the 95% confidence interval of the test value is estimated based on the latest test value before the start date of the intervention of each individual who has agreed to participate in the prevention of severe lifestyle-related diseases related to the business. . When the confidence interval is estimated, it is stored in the statistical result DB 113 in association with the business name and the classification category.

  Further, the section estimation unit 103 refers to the medical treatment information DB 111 and the business result DB 112, and estimates the confidence interval of the inspection value of the inspection item specified for the business by the variable specifying unit 102 for the improvement group for each business. . Specifically, the 95% confidence interval of the test value is estimated based on the latest test value before the start date of the intervention of each individual whose health condition has been improved by the prevention of aggravated lifestyle-related diseases related to the business. . When the confidence interval is estimated, it is stored in the statistical result DB 113 in association with the business name and the classification category.

  As a modified example, when estimating the confidence interval of the test value for the participation group or the improvement group, the interval estimation unit 103 performs the test based on the test value that is a predetermined period (for example, two months) or more before the start date of the project intervention. A confidence interval of values may be estimated. Moreover, you may estimate the confidence interval of reliability other than 95%.

  The score assignment unit 104 refers to the statistical result DB 113 for each score category, and the confidence interval estimated by the interval estimation unit 103 with respect to the value that can be taken by the inspection value of the inspection item specified by the variable specifying unit 102 Assign a score based on. Specifically, for each score category, a score “10” is assigned to a test value included in the confidence interval, and a score “0” is assigned to a test value not included in the confidence interval. As an example, when assigning the alert / improvement score illustrated in FIG. 5 to each possible value of systolic blood pressure, the business name “attention” and the classification category “improvement group” are associated with each other in the statistical result DB 113. The score “10” is assigned to the blood pressure value included in the confidence interval “130 to 190”, while the score “0” is assigned to the blood pressure value not included in the confidence interval. The score assignment unit 104 stores the score of each score category assigned for each inspection item in the score table 114. The scores “10” and “0” described here are merely examples of score values, and may be adjusted to different values by the user in view of the validity of the evaluation result of the present apparatus.

  The score specifying unit 105 refers to the score table 114 and specifies the score of each score category assigned to the test value for each test value of the candidate for the prevention of severe lifestyle-related diseases. Then, the score of each score category specified for each inspection value is stored in the target person intermediate score DB 115 in association with the name of the target candidate and the symbol and number of the insured card. In addition, each test value of the candidate candidate for lifestyle-related disease aggravation prevention may be acquired from medical information DB111, and may be acquired by the information acquisition part 101 via a communication line.

  The total score calculation unit 106 refers to the subject intermediate score DB 115 and sums each score specified by the score specification unit 105 for each score category with respect to the candidate candidates for prevention of severe lifestyle-related diseases. Then, the total score calculated for each score category is stored in the total score calculation unit 106 in association with the name of the candidate candidate and the symbol and number of the insured card.

The evaluation unit 107 refers to the target person final score DB 116 and assigns an evaluation index to the target candidate for prevention of severe lifestyle-related diseases based on the total score calculated by the total score calculation unit 106 for each score category. To do. Specifically, an evaluation index is assigned by comparing the total score with a threshold value for each score category. More specifically, when the total score is greater than or equal to the threshold “40”, the evaluation index “high (double circle)” is assigned, and when the total score is greater than or equal to the threshold “20” and less than “40”, the evaluation is performed. An index “middle (circle)” is assigned, and if the total score is less than the threshold value “20”, an evaluation index “low (cross)” is assigned. When an evaluation index is assigned to each score category, the score is stored in the total score calculation unit 106 in association with the name of the candidate candidate and the symbol and number of the insured card. The threshold values “40” and “20” described here are merely examples of threshold values, and may be adjusted to different values by the user in view of the validity of the evaluation result of the present apparatus.
The above is the description of the function of the control unit 10.

1-2. Operation The operation of the target person extraction support apparatus 1 will be described. Specifically, a score table creation process for creating the score table 114 and a lifestyle-related disease aggravation prevention target person evaluation process for assigning an evaluation index for a candidate for a lifestyle-related disease aggravation prevention will be described.

1-2-1. Score Table Creation Processing FIG. 8 is a flowchart showing an example of the score table creation processing. The score table creation process is repeatedly executed by an instruction from the user of the target person extraction support apparatus 1 or at a predetermined timing, and the score table 114 is updated each time. For example, after the medical treatment information DB 111 and the business result DB 112 are updated every year, this is executed once immediately before the lifestyle-related disease seriousness prevention target person evaluation process is executed.

  The variable identification unit 102 of the target person extraction support apparatus 1 refers to the medical treatment information DB 111 and the business result DB 112 and, for each business, one or more examinations having a statistically significant difference between the participating group and the non-participating group. An item is specified (Sa1). When the inspection item is specified, the section estimation unit 103 refers to the medical treatment information DB 111 and the business result DB 112, and for each participation group for each business, the reliability of the inspection value of the inspection item specified for the business in step Sa1. A section is estimated (Sa2). Then, the estimated confidence interval is stored in the statistical result DB 113 in association with the business name and the classification category. When the confidence interval is estimated, the score assignment unit 104 refers to the statistical result DB 113 for each score category and estimates in step Sa2 the values that can be taken by the inspection values of the inspection items specified in step Sa1. A score is assigned based on the determined confidence interval (Sa3). Then, the score of each score category assigned for each inspection item is stored in the score table 114.

When the score assignment for the participating group is completed, the variable specifying unit 102 next refers to the medical treatment information DB 111 and the business result DB 112, and the statistically significant difference between the improved group and the non-improved group is one or more. The inspection item is specified (Sa4). When the inspection item is specified, the section estimation unit 103 refers to the medical treatment information DB 111 and the business result DB 112, and for each improvement group, the reliability of the inspection value of the inspection item specified for the business in step Sa4. A section is estimated (Sa5). Then, the estimated confidence interval is stored in the statistical result DB 113 in association with the business name and the classification category. When the confidence interval is estimated, the score assigning unit 104 refers to the statistical result DB 113 for each score category, and estimates in step Sa5 for the values that can be taken by the inspection value of the inspection item specified in step Sa4. A score is assigned based on the established confidence interval (Sa6). Then, the score of each score category assigned for each inspection item is stored in the score table 114.
This completes the description of the score table creation process.

1-2-2. FIG. 9 is a flowchart showing an example of a lifestyle-related disease aggravation prevention target person evaluation process. The lifestyle-related disease aggravation prevention target person evaluation process is executed by an instruction from a user of the target person extraction support apparatus 1 or at a predetermined timing. For example, it is executed once every year before the start of the lifestyle-related disease aggravation prevention business.

The score specifying unit 105 of the subject extraction support apparatus 1 refers to the score table 114 and, for each test value of the candidate candidate for prevention of severe lifestyle-related disease, the score of each score category assigned to the test value. Specify (Sb1). Then, the score of each score category specified for each inspection value is stored in the target person intermediate score DB 115 in association with the name of the target candidate and the symbol and number of the insured card. When the score of each score category is specified for each test value, the total score calculation unit 106 refers to the target person intermediate score DB 115 and performs step Sb1 for each target category for target candidates for prevention of severe lifestyle-related diseases. Each score specified in (2) is summed (Sb2). Then, the total score calculated for each score category is stored in the target final score DB 116 in association with the name of the target candidate and the symbol and number of the insured card. When the total score is calculated for each score category, the evaluation unit 107 refers to the target person final score DB 116 and calculates the target candidate for prevention of severe lifestyle-related disease in step Sb2 for each score category. An evaluation index is assigned based on the total score (Sb3). Then, the assigned evaluation index is stored in the target final score DB 116 in association with the name of the target candidate and the symbol and number of the insured card.
The above is description about the lifestyle-related disease seriousness prevention subject evaluation process.

  According to the subject extraction support device 1 described above, for each lifestyle-related disease aggravation prevention business, the health status is increased by the subject who is likely to participate in the prevention of the lifestyle-related disease aggravation and the lifestyle-related disease aggravation prevention. It is possible to identify subjects who are likely to improve. By implementing prevention of a lifestyle-related disease seriously preferentially with respect to such a subject, the efficiency of lifestyle-related disease aggravation prevention can be improved.

2. Modifications The above embodiments may be modified as described below. Note that one or more modified examples described below may be combined with each other.

2-1. Modified Example The subject extraction support device 1 is one of an evaluation index that indicates the possibility of participating in the prevention of aggravation of lifestyle-related diseases and an evaluation index that indicates the possibility of an improvement in the health status due to the prevention of aggravation of lifestyle-related diseases. You may make it give only. That is, in the above score table creation process, only one of steps Sa1 to Sa3 and steps Sa4 to Sa6 may be executed. Moreover, in the lifestyle-related disease seriousness prevention target person evaluation process described above, only one of the evaluation index indicating the participation possibility and the evaluation index indicating the improvement possibility may be given.

2-2. Modification 2
The interval estimation unit 103 may estimate the confidence interval of the test value of the test item specified by the variable specifying unit 102 for the non-participating group instead of the participating group. Similarly, the confidence interval of the inspection value of the inspection item specified by the variable specifying unit 102 may be estimated for the non-improvement group instead of the improvement group. In that case, the score assignment unit 104 assigns a score “−10” instead of the score “10” to the test value included in the confidence interval, and scores “0” for the test value not included in the confidence interval. ". The scores “−10” and “0” described here are merely examples of score values, and may be adjusted to different values by the user in view of the validity of the evaluation result of the present apparatus.

2-3. Modification 3
The subject extraction support apparatus 1 evaluates the participation possibility and improvement possibility of the lifestyle-related disease seriousness prevention target candidate based on the amount of change of the test value instead of the test value recorded in the medical care information DB 111. You may do it. In that case, the variable specifying unit 102 replaces the test items with statistically significant differences between the participating group and the non-participating group, and between the improved group and the non-improved group, with statistically significant test values. Identify the amount of change. At that time, the variable specifying unit 102 uses a t-test to confirm a significant difference, and between the participation group and the non-participation group, between the improvement group and the non-improvement group, It is confirmed whether or not there is a significant difference in the average of the difference from the latest test value on the day before a predetermined period (for example, one year) or more from the intervention start date. Alternatively, it is confirmed whether or not there is a significant difference in the average of values obtained by dividing the difference by the latter test value. Further, the interval estimation unit 103 estimates a confidence interval of the change amount of the test value instead of the test value for the participation group and the improvement group. Specifically, the confidence interval of the difference between the latest test value before the intervention start date of the project and the latest test value on the day before the predetermined period from the intervention start date is estimated. Alternatively, a confidence interval of a value obtained by dividing the difference by the latter test value is estimated. The score assigning unit 104 assigns a score based on the confidence interval estimated by the interval estimating unit 103 to a value that can be taken by the change amount of the inspection value instead of the inspection value. In addition, the score specifying unit 105 specifies the score of each score category assigned to the change amount for the change amount of each test value instead of each test value of the candidate for prevention of severe lifestyle-related diseases.

2-4. Modification 4
The information on the presence or absence of consent for participation in the prevention of severe lifestyle-related diseases recorded in the business result DB 112 may be made more specific. Specifically, “with consent” may be subdivided into “with consent and selection of family doctor” and “with consent and no selection of family doctor”. Alternatively, “with consent” may be subdivided into “with consent and dropout” and “with consent and no dropout”. In this way, when the information on the presence or absence of consent is subdivided, the subject extraction support apparatus 1 is a participation group consisting of individuals who agree to participate and are selected as a family doctor, or agree to participate and do not drop out in the middle For the participating group consisting of individuals, the test items having a statistically significant difference from the group consisting of other individuals may be specified, and the confidence interval of the test values of the specified test items may be estimated. Note that the control unit 10 may further include a selection receiving unit in order to allow the user to select the process of participation as described above.

2-5. Modification 5
The subject extraction support apparatus 1 statistically compares with the group consisting of other individuals about the improvement group consisting of individuals whose health condition has been improved by the method for preventing the specific lifestyle-related disease from becoming serious. A test item having a significant difference may be specified, and a confidence interval of the test value of the specified test item may be estimated. Here, the methods for preventing the progression of lifestyle-related diseases are classified from the three viewpoints of guidance means, professionals for guidance, and guidance contents. There are document notifications, telephone calls, interviews, etc. as the means of guidance. Health professionals, nurses, registered dietitians etc. are instructed professionals, and dietary guidance, exercise guidance, etc. are instructed. Note that the control unit 10 may further include a selection receiving unit in order to allow the user to select a specific lifestyle-related disease aggravation prevention method.

2-6. Modification 6
The intervention result information recorded in the business result DB 112 may be made more specific. Specifically, for each of HbA1c, BMI, and blood pressure (systolic and diastolic), it may be recorded whether it corresponds to improvement, maintenance, or deterioration. In that case, the subject extraction support apparatus 1 has a statistically significant difference between the improvement group consisting of individuals whose test values of one or more specific test items are improved and the group consisting of other individuals. And the confidence interval of the inspection value of the specified inspection item may be estimated. In addition, in order to make a user select one or more specific inspection items, the control unit 10 may further include a selection receiving unit.

2-7. Modification 7
The section estimation unit 103 may estimate a plurality of confidence sections having different degrees of reliability for each of the inspection items specified for the business by the variable specifying unit 102. For example, three confidence intervals of a 99% confidence interval, a 95% confidence interval, and a 68% confidence interval may be estimated. Then, the score assigning unit 104 assigns a score based on a plurality of confidence intervals estimated by the interval estimating unit 103 to values that can be taken by the inspection value of the inspection item specified by the variable specifying unit 102. Also good. For example, a score “10” is assigned to a test value included in the 68% confidence interval, and a score “5” is assigned to a test value not included in the 68% confidence interval but included in the 95% confidence interval. Allocation, score “3” is assigned to test values not included in the 95% confidence interval but included in the 99% confidence interval, and score “0” is assigned to the test value not included in the 99% confidence interval May be assigned. Each score described here is merely an example of a score value, and may be adjusted to another value by the user in view of the validity of the evaluation result of the present apparatus.

2-8. Modification 8
HbA1c, BMI, and blood pressure recorded in the medical information DB 111 are merely examples of test values. In addition to or instead of these, test values such as blood glucose level, neutral fat, HDL cholesterol, LDL cholesterol, urine protein, urine sugar, waist circumference, body weight, etc. may be recorded.

2-9. Modification 9
Test values such as HbA1c, BMI, and blood pressure recorded in the medical information DB 111 are merely examples of medical information. In addition to or instead of these, medical information such as a disease name, finding, medical history, treatment method, and attribute may be recorded in association with the medical date. Here, the treatment method includes a prescription (specifically, a prescription drug name, a drug amount, a prescription amount, etc.) and a treatment (specifically, an operation name, a technique, etc.), and attributes include an address, gender, Includes age and occupation. When medical information such as a disease name is recorded, the variable identification unit 102 does not participate in the participation group and non-participation in the same manner as the examination items for quantitative variables such as medical treatment period, medical history, medical history, drug dose, prescription amount, and age. Identify variables with statistically significant differences between groups and between improved and unimproved groups. Then, the interval estimation unit 103 estimates the confidence interval of the value of the variable specified by the variable specifying unit 102 for the participation group and the improvement group. Then, the score assigning unit 104 assigns a score based on the confidence interval estimated by the interval estimating unit 103 to the values that can be taken by the variable specified by the variable specifying unit 102. And the score specific | specification part 105 specifies the score of each score category assigned to the said value about the value of the said variable of the candidate candidate for lifestyle-related disease seriousness prevention.

  On the other hand, for other qualitative variables such as a disease name, the variable specifying unit 102 specifies a variable having a statistically significant difference between the participating group and the non-participating group using a test such as chi-square test. Specifically, there is a difference in the number of individuals associated with the value of the variable in the medical treatment information DB 111 within a predetermined period (for example, one year) from the start date of the intervention between the participating group and the non-participating group. Check if it is significant. Similarly, the variable specifying unit 102 specifies a variable having a statistically significant difference between the improved group and the non-improved group using a test such as a chi-square test. Specifically, the difference between the improvement group and the non-improvement group in the number of individuals associated with the value of the variable in the medical information DB 111 within a predetermined period (for example, one year) from the start date of the intervention of the business Whether or not is significant. Then, the score assigning unit 104, with respect to the value that can be taken by the value of the variable specified by the variable specifying unit 102, the individual value associated with one value of the variable in the participation group in the medical care information DB 111. A score is assigned based on the comparison result of the number and the number of individuals associated in the medical care information DB 111 in the non-participating group. For example, if the number of individuals suffering from diabetes in the participating group is greater than the number of individuals suffering from diabetes in the non-participating group, the score “10” for the category “with diabetes” And a score “0” is assigned to the category “without diabetes”. Similarly, the score allocating unit 104 is an individual associated with one value of the variable in the improvement information group 111 in the medical care information DB 111 with respect to the value that the variable specified by the variable specifying unit 102 can take. A score is assigned based on the comparison result of the number of individuals and the number of individuals associated with each other in the medical treatment information DB 111 in the non-improvement group. And the score specific | specification part 105 specifies the score of each score category allocated to the said value about the value of the said variable of a lifestyle-related disease seriousness prevention candidate candidate.

2-10. Modification 10
The program executed in the target person extraction support device 1 may be recorded and distributed on a recording medium readable by a computer device. Here, the recording medium is, for example, a magnetic recording medium such as a magnetic tape or a magnetic disk, an optical recording medium such as an optical disk, a magneto-optical recording medium, or a semiconductor memory. Further, this program may be distributed via a network such as the Internet.

2-11. Modification 11
The subject extraction support apparatus 1 may omit the provision of the evaluation index (step Sb3) in the lifestyle-related disease seriousness prevention target person evaluation process described above. In other words, the function of the evaluation unit 107 may be omitted in the device. Or in said lifestyle-related disease seriousness prevention target person evaluation process, in addition to provision of an evaluation index, you may abbreviate | omit calculation of a total score (step Sb2). In other words, the function of the total score calculation unit 106 in addition to the evaluation unit 107 may be omitted in the device. Even in these cases, the user of the device refers to the subject who is likely to participate in the prevention of aggravation of lifestyle-related diseases by referring to the total score or the score specified for each test value. It is possible to identify subjects who are highly likely to improve their health status through prevention. In the former example, the subject extraction support apparatus 1 may extract candidate candidates whose total score exceeds a predetermined threshold for each score category. In the latter example, for each score category, the apparatus has a predetermined number of candidate candidates whose score specified for any test value exceeds a predetermined threshold or the number of test values whose score exceeds a predetermined threshold. You may make it extract the candidate candidate who exceeded the number of.

DESCRIPTION OF SYMBOLS 1 ... Lifestyle extraction disease seriousness prevention target person extraction assistance apparatus, 10 ... Control part, 11 ... Memory | storage part, 12 ... Operation input part, 13 ... Display part, 14 ... Communication part, 101 ... Information acquisition part, 102 ... Variable specification , 103 ... section estimation unit, 104 ... score assignment unit, 105 ... score identification unit, 106 ... total score calculation unit, 107 ... evaluation unit, 111 ... medical treatment information DB, 112 ... business result DB, 113 ... statistical result DB, 114 ... Score table, 115 ... Target person intermediate score DB, 116 ... Target person final score DB

Claims (9)

With reference to a database that records medical information and the results of the lifestyle-related disease seriousness prevention project for each of multiple individuals, an improved group with improved health status due to prevention of severe lifestyle-related disease and an unimproved group that did not improve A variable specifying unit that specifies one or more variables that are statistically significantly different from each other and each indicates a test value or a change amount of the test value;
An interval estimation unit that estimates a confidence interval of a value of the variable for each of one or more variables specified by the variable specifying unit for either the improvement group or the non-improvement group;
For each of the one or more variables, a score indicating the possibility of improving the health status by preventing the progression of lifestyle-related diseases is assigned to each value that the variable can take based on the confidence interval estimated by the interval estimation unit. A score assignment unit;
For each value of the one or more variables of the candidate for prevention of severe lifestyle-related diseases, a score specifying unit that specifies the score assigned to the value by the score assigning unit ,
The variable specifying unit is one or more other variables having a statistically significant difference between the improvement group and the non-improvement group, and the presence or absence of a specific disease, adoption of a specific treatment method, or a specific Identify one or more other variables, each indicating the presence or absence of an attribute,
The score assigning unit, for each of the one or more other variables specified by the variable specifying unit, the value of the variable in the improvement group and the number of individuals associated in the database Based on the comparison result of the number of individuals associated in the database with the one value in the non-improvement group, assign a score to each value that the variable can take,
The score specifying unit specifies, for each value of the one or more other variables of the candidate candidate, a score assigned to the value by the score assigning unit.
A device for supporting the extraction of subjects for prevention of aggravated lifestyle-related diseases. It further comprises a selection reception unit that accepts selection of a method for preventing the progression of lifestyle-related diseases,
The variable identification unit has a statistically significant difference between the improved group whose health condition has been improved and the non-improved group which has not been improved by the method for preventing the progression of lifestyle-related diseases selected via the selection receiving unit. Identify one or more variables,
The interval estimation unit is configured to specify the variable for any of an improved group whose health condition has been improved by a method for preventing aggravation of lifestyle-related diseases selected via the selection receiving unit and a non-improved group which has not been improved. lifestyle diseases aggravation preventing subject extraction assist apparatus according to claim 1, characterized in that to estimate the confidence interval of the values of the variables for each of one or more variables specified by section. By referring to a database that records medical information and results of lifestyle-related disease seriousness prevention projects for each of multiple individuals, between participating groups who participated in prevention of severe lifestyle-related diseases and non-participated groups who did not participate A variable identification unit that identifies one or more variables that are statistically significant and each indicate a test value or a change amount of the test value;
For any one of the participating group and the non-participating group, an interval estimation unit that estimates a confidence interval of the value of the variable for each of the one or more variables specified by the variable specifying unit;
For each of the one or more variables, a score assigning unit that assigns a score indicating the possibility of participating in prevention of severe lifestyle-related diseases to each value that can be taken by the variable based on the confidence interval estimated by the interval estimation unit When,
For each value of the one or more variables of the candidate for prevention of severe lifestyle-related diseases, a score specifying unit that specifies the score assigned to the value by the score assigning unit ,
The variable specifying unit is one or more other variables having a statistically significant difference between the participating group and the non-participating group, the presence or absence of a specific disease, adoption of a specific treatment method, or a specific attribute Identify one or more other variables that each indicate the presence or absence of
The score assigning unit, for each of the one or more other variables specified by the variable specifying unit, a value of the variable in the participation group and the number of individuals associated in the database Based on the comparison result of the number of individuals associated in the database with the one value in the non-participating group, assign a score to each value that the variable can take,
The score specifying unit specifies, for each value of the one or more other variables of the candidate candidate, a score assigned to the value by the score assigning unit.
A device for supporting the extraction of subjects for prevention of aggravated lifestyle-related diseases. When the database is updated, the variable specifying unit respecifies one or more variables having a statistically significant difference,
The interval estimation unit re-estimates a confidence interval of the value of the variable for each of one or more variables re-specified by the variable specifying unit,
The score assigning unit reassigns a score to each value that can be taken by the variable based on the confidence interval re-estimated by the interval estimation unit for each of the one or more variables. The life support disease seriousness prevention target person extraction assistance apparatus of any one of Claims 1 thru | or 3 . The interval estimation unit estimates a plurality of confidence intervals having different degrees of reliability for each of the one or more variables,
The score assigning unit assigns a score to each value that can be taken by the variable based on a plurality of confidence intervals estimated by the interval estimation unit for each of the one or more variables. 5. The person extraction support device according to any one of 4 above, wherein the lifestyle-related disease is prevented from becoming serious. A method for supporting the extraction of subjects for the prevention of the progression of lifestyle-related diseases
With reference to a database that records medical information and the results of the lifestyle-related disease seriousness prevention project for each of multiple individuals, an improved group with improved health status due to prevention of severe lifestyle-related disease and an unimproved group that did not improve Identifying one or more variables that are statistically significantly different from each other and each indicating a test value or a change amount of the test value;
Estimating a confidence interval for the value of the variable for each of the identified one or more variables for either the improvement group or the non-improvement group;
For each of the one or more variables, assigning to each value that the variable can take on the basis of the estimated confidence interval, assigning a score indicating the possibility of improving the health status due to prevention of aggravated lifestyle-related diseases;
For each value of the one or more variables of candidate candidates for prevention of severe lifestyle-related diseases, identifying a score assigned to the value ;
One or more other variables having a statistically significant difference between the improvement group and the non-improvement group, each indicating the presence or absence of a specific disease, adoption of a specific treatment method, or presence or absence of a specific attribute Identifying one or more other variables;
For each of the one or more other variables identified, one value of the variable in the improvement group, the number of individuals associated in the database, and the one in the non-improvement group Assigning a score to each possible value of the variable based on a comparison of the value and the number of individuals associated in the database;
A method for supporting the extraction of a lifestyle-related disease aggravation prevention subject, comprising: for each value of the one or more other variables of the candidate candidate, specifying a score assigned to the value . A method for supporting the extraction of subjects for the prevention of the progression of lifestyle-related diseases
By referring to a database that records medical information and results of lifestyle-related disease seriousness prevention projects for each of multiple individuals, between participating groups who participated in prevention of severe lifestyle-related diseases and non-participated groups who did not participate Identifying one or more variables having a statistically significant difference, each indicating a test value or a change amount of the test value;
Estimating a confidence interval of the value of the variable for each of the identified one or more variables for either the participating group or the non-participating group;
For each of the one or more variables, assigning a score indicating the possibility of participating in prevention of severe lifestyle-related diseases to each value that the variable can take based on the estimated confidence interval;
For each value of the one or more variables of candidate candidates for prevention of severe lifestyle-related diseases, identifying a score assigned to the value ;
One or more other variables having a statistically significant difference between the participating group and the non-participating group, each indicating the presence or absence of a specific disease, adoption of a specific treatment method, or presence or absence of a specific attribute Identifying these other variables,
For each of the one or more other variables identified, one value of the variable in the participating group, the number of individuals associated in the database, and the one value in the non-participating group And assigning a score to each possible value of the variable based on the comparison result of the number of individuals associated in the database;
A method for supporting the extraction of a lifestyle-related disease aggravation prevention subject, comprising: for each value of the one or more other variables of the candidate candidate, specifying a score assigned to the value . On the computer,
With reference to a database that records medical information and the results of the lifestyle-related disease seriousness prevention project for each of multiple individuals, an improved group with improved health status due to prevention of severe lifestyle-related disease and an unimproved group that did not improve Identifying one or more variables that are statistically significantly different from each other and each indicating a test value or a change amount of the test value;
Estimating a confidence interval for the value of the variable for each of the identified one or more variables for either the improvement group or the non-improvement group;
For each of the one or more variables, assigning to each value that the variable can take on the basis of the estimated confidence interval, assigning a score indicating the possibility of improving the health status due to prevention of aggravated lifestyle-related diseases;
For each value of the one or more variables of candidate candidates for prevention of severe lifestyle-related diseases, identifying a score assigned to the value ;
One or more other variables having a statistically significant difference between the improvement group and the non-improvement group, each indicating the presence or absence of a specific disease, adoption of a specific treatment method, or presence or absence of a specific attribute Identifying one or more other variables;
For each of the one or more other variables identified, one value of the variable in the improvement group, the number of individuals associated in the database, and the one in the non-improvement group Assigning a score to each possible value of the variable based on a comparison of the value and the number of individuals associated in the database;
A program for executing, for each value of the one or more other variables of the candidate candidate, a step of specifying a score assigned to the value . On the computer,
By referring to a database that records medical information and results of lifestyle-related disease seriousness prevention projects for each of multiple individuals, between participating groups who participated in prevention of severe lifestyle-related diseases and non-participated groups who did not participate Identifying one or more variables having a statistically significant difference, each indicating a test value or a change amount of the test value;
Estimating a confidence interval of the value of the variable for each of the identified one or more variables for either the participating group or the non-participating group;
For each of the one or more variables, assigning a score indicating the possibility of participating in prevention of severe lifestyle-related diseases to each value that the variable can take based on the estimated confidence interval;
For each value of the one or more variables of candidate candidates for prevention of severe lifestyle-related diseases, identifying a score assigned to the value ;
One or more other variables having a statistically significant difference between the participating group and the non-participating group, each indicating the presence or absence of a specific disease, adoption of a specific treatment method, or presence or absence of a specific attribute Identifying these other variables,
For each of the one or more other variables identified, one value of the variable in the participating group, the number of individuals associated in the database, and the one value in the non-participating group And assigning a score to each possible value of the variable based on the comparison result of the number of individuals associated in the database;
A program for executing, for each value of the one or more other variables of the candidate candidate, a step of specifying a score assigned to the value .

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