小佐見 光樹

ABSTRACT Background Case reports are an important academic output for general medicine physicians; however, publication rates in Japan remain low, and barriers to preparing case reports have not been fully clarified. Thus, we aimed to identify barriers perceived by Japanese general medicine physicians when writing case reports. Methods A web‐based questionnaire survey was administered to physician members of JPCA between November and December 2021. Sixteen potential barriers identified in previous studies were assessed using an 11‐point Likert scale (0–10). Participants were categorized into two groups based on their experience writing case reports. Group comparisons were performed using the Mann–Whitney test and chi‐squared test. Logistic regression analyses, adjusted for age and sex, were conducted to estimate adjusted odds ratios (aORs) for each barrier. Results Overall, 315 physicians responded to the survey (response rate: 10.2%). Of these, 159 (50.4%) had experience in writing case reports. Fifteen of the 16 barrier items scored significantly higher among inexperienced physicians. The aORs were significantly elevated for 13 items, excluding financial factors. The major barriers included lack of sufficient medical documentation to write a report (aOR: 7.99), unfamiliarity with writing case reports (aOR: 6.44), not recognizing suitable cases (aOR: 4.79), and difficulty identifying the main case points and clinical messages (aOR: 3.80). Experienced physicians not “having adequate time to write” remained the main obstacle (69.8%). Conclusions Barriers to writing case reports vary markedly by experience. Systematic education, strengthened mentorship, and organizational support for protected academic time are essential to promoting case report writing among general medicine physicians.

BACKGROUND: We investigated the association between the development of sarcoidosis and personal or family medical history, with a focus on immune-mediated inflammatory diseases (IMIDs), in a Japanese population. METHODS: In this exploratory case-control study, self-administered questionnaires were completed by 164 patients with newly diagnosed sarcoidosis (64 men, 100 women) who visited public health centres in 7 prefectures between 2018 and 2020 to apply for medical expense subsidies (cases) and by 1779 community-dwelling controls (641 men, 1138 women) undergoing municipal health checkups (controls). The questionnaire collected information on personal and family medical histories, including IMIDs. Logistic regression analyses adjusted for age and sex were used to identify risk factors associated with onset of sarcoidosis. RESULTS: A history of IMIDs was associated with a greater likelihood of sarcoidosis (adjusted odds ratio [aOR] 3.05, 95 % confidence interval [CI] 1.79-5.21). Increased risk was observed for rheumatoid arthritis (aOR 2.63, 95 % CI 1.06-6.53), Sjögren's syndrome (aOR 14.39, 95 % CI 4.30-48.10), and hypothyroidism (aOR 4.91, 95 % CI 2.20-10.97). Some conditions, such as asthma, lymphoma, and insulin use, showed possible associations, with wide CIs including 1.0. Additionally, a family history of sarcoidosis was strongly associated with disease occurrence (aOR 21.30, 95 % CI 3.86-117.68), supporting a potential genetic predisposition consistent with previous epidemiological findings. CONCLUSIONS: This study suggests that sarcoidosis may be associated with IMIDs in the Japanese population. However, its findings should be interpreted with caution, given its exploratory design and limited statistical power.