文献

J-GLOBAL ID：202002276799035553   整理番号：20A2055927

糖尿病/AI:1型糖尿病若年患者での自動化人工知能を用いた決定支援システムによるインスリン投与量最適化

Insulin dose optimization using an automated artificial intelligence-based decision support system in youths with type 1 diabetes

著者 (70件)： NIMRI Revital (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  PHILLIP Moshe (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  PHILLIP Moshe (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  NIMRI Revital (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  SHALITIN Shlomit (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  BELLO Rachel (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  NEVO-SHENKER Michal (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  FISCH-SHVALB Naama (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  SHIOVITCH-MANTZURI Galit (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  CHORESH Orit (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  DRUTZ Irit (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  NAVA Yehiel (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  HEMO Alona (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  HERMON Orna (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  NAVE Rachel (Jesse Z and Sara Lea Shafer Inst. for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children’s Medical Center of Israel, Petah Tikva, ISR) ,  BATTELINO Tadej (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  DOVC Klemen (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  BATTELINO Tadej (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  DOVC Klemen (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  BRATINA Natasa (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  SMIGOE-SCHWEIGER Darja (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  MALI Brigita (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  GIANINI Ana (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  SEVER Urska (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  BERKOPEC Barbara Murn (Dep. of Endocrinology, Diabetes and Metabolic Diseases, UMC-Univ. Children’s Hospital Ljubljana, and Fac. of Medicine, Univ. Ljubljana, Ljubljana, SVN) ,  LAFFEL Lori M. (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  LAFFEL Lori M. (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  KATZ Michelle (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  ISGANAITIS Elvira (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  MEHTA Sanjeev (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  QUINN Heidi (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  NAIK Nisha (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  GUO Zijing (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  VOLKENING Lisa (Joslin Diabetes Center, One Joslin Place, Harvard Medical School, Boston, MA, USA) ,  SLOVER Robert H. (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  SLOVER Robert H. (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  FORLENZA Gregory (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  WADWA R. Paul (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  ALONSO G. Todd (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  MESSER Laurel (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  TOWERS Lindsey (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  THIVENER Katie (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  BERGET Cari (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  LANGE Samantha (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  JOST Emily (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  ROSSICK-SOLIS Maria (Barbara Davis Center for Childhood Diabetes, Univ. Colorado Anschutz Medical Campus, Aurora, CO, USA) ,  SCHATZ Desmond (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  SCHATZ Desmond (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  HALLER Michael (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  HIERS Paul (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  JACOBSEN Laura (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  SMITH Madison (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  O’NEILL Anastasia (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  HOSFORD Jennifer (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  PERRY Alexis (Dep. of Pediatrics, Coll. of Medicine, Univ. Florida, Gainesville, FL, USA) ,  WEINZIMER Stuart A. (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  WEINZIMER Stuart A. (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  CENGIZ Eda (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  SHERR Jennifer (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  GIBBONS Kathryn (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  CARRIA Lori (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  ZGORSKI Melinda (Pediatric Endocrinology & Diabetes, Yale School of Medicine, New Haven, CT, USA) ,  DANNE Thomas (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  DANNE Thomas (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  BIESTER Torben (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  KORDONOURI Olga (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  VON DEM BERGE Thekla (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  BIESTER Sarah (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  REMUS Kerstin (Diabetes Center for Children and Adolescents, Children’s Hospital AUF DER BULT, Hannover, DEU) ,  PHILLIP Moshe (Sackler Fac. of Medicine, Tel Aviv Univ., Tel Aviv, ISR)
資料名： Nature Medicine  (Nature Medicine)
巻： 26  号： 9  ページ： 1380-1384  発行年： 2020年09月 
JST資料番号： W0636A  ISSN： 1078-8956  資料種別： 逐次刊行物 (A)
記事区分： 原著論文  発行国： アメリカ合衆国 (USA)  言語： 英語 (EN)

抄録/ポイント： インスリンポンプと持続血糖モニタリングデバイスの採用は増えてきているが,ほとんどの1型糖尿病患者では目標とする血糖値が達成されていない。これは,臨床医がセンサー付きポンプの複雑なデータを解析するための専門知識や十分な時間を持てないために起きている可能性がある。我々は,自動化された人工知能を使った意思決定支援システム(AI-DSS)によって導かれる頻繁なインスリン投与量調節が,グルコースレベルの制御については,医師による指導よりも効果的で安全であるかを検討した。ADVICE4Uは,多国籍多施設での並行群間無作為化比較による非劣性試験であり,インスリンポンプ療法を使っている10~21歳の1型糖尿病患者108人を対象に6か月にわたって行われた(ClinicalTrials.gov no.NCT03003806)。参加者は1:1に無作為に分けられ,3週間ごとにAI-DSS(AI-DSS群,n=54)あるいは医師(医師群,n=54)の指導によるインスリン投与量遠隔調節を受けた。主要評価項目の算定は,目標グルコース範囲〔70~180mg/dl(3.9~10.0mmol/l)〕内で経過した時間の割合とし,AI-DSS群での結果は,医師群のそれと比較して統計的に非劣性だった(AI-DSS群50.2±11.1%に対して医師群51.6±11.3%,P<1×10^-7)。AI-DSS群内での54mg/dl未満(<3.0mmol/l)の測定値の割合は,医師群と比べると非劣性だった(AI-DSS群内1.3±1.4%,医師群1.0±0.9%,P<0.0001)。糖尿病に関係する重篤な有害事象は,医師群では3例(重篤な低血糖症2例,糖尿病性ケトアシドーシス1例)報告されたが,AI-DSS群では報告されなかった。まとめると,自動化された意思決定支援手段を用いたインスリンポンプ設定の最適化は,糖尿病を専門とする研究センターの医師が行う集中的なインスリン滴定に対して非劣性であると,我々は結論する。Copyright Nature Japan KK 2020

シソーラス用語： *最適化 ,  *自動化 ,  *インスリン ,  *糖尿病 ,  *人工知能 ,  劣性 ,  低血糖症 ,  評価基準 ,  *意思決定支援システム ,  *1型糖尿病
準シソーラス用語： 血糖値 ,  臨床医 ,  意思決定支援 ,  持続血糖モニタリング ,  有害事象 , 【Automatic Indexing@JST】

分類 (1件)： 代謝異常・栄養性疾患一般  (GD05010J)

タイトルに関連する用語 (10件)： 糖尿病 ,  AI ,  1型糖尿病 ,  若年患者 ,  自動化 ,  人工知能 ,  決定支援システム ,  インスリン ,  投与量 ,  最適化