Five Years of Activity in Our Palliative Care Team and Coronavirus Disease

Purpose: We investigated the activity of our palliative care team over the past five years and how the new coronavirus infection (COVID-19) affects palliative care in our hospital. Methods: We retrospectively compared and analyzed patient data intervened by the Tokyo Medical University Hospital Palliative Care Team from April 2016 to March 2021. Results: There were no major differences in the total number of requests, patient background, reasons for request, and reasons for intervention from FY2016 to FY2020. In FY2020, the number of patients with PS0 at the time of request and who discharged from the hospital at home increased significantly compared to other years. Discussion and Conclusion: From the results of this survey, it was found that the introduction of palliative care from an early stage is progressing. On the other hand, because the outbreak of COVID-19 has restricted visits to inpatients at our hospital, it is possible that the proportion of patients who choose home care is increasing. Intervention requests to the palliative care team did not change significantly over the 5-year period without the impact of the COVID-19 pandemic. Strict visitation restrictions for inpatients have become barriers to the practice of palliative care.

Validity of Japanese Version of Neuropathic Pain Screening Questionnaire for Cancer Pain with Neuropathic Pain

Introduction: The diagnosis of cancer-related neuropathic pain is often difficult for non-pain medicine specialists. We examined whether a Japanese version of a neuropathic pain screening questionnaire (Japan-Q), which was developed for chronic pain, is appropriate for screening cancer-related neuropathic pain. Methods: Our palliative care team screened 104 patients from May 2014 to December 2015 and compared total points of the Japan-Q with diagnosis of the type of cancer pain by specialized pain clinicians. Validity was evaluated using a receiver operating characteristic (ROC) curve. Results: The area under the ROC curve in terms of the total score, sensitivity, and specificity for the Japan Q was 0.82, which indicated a moderate level of diagnostic accuracy. A cut-off value of 3 points was shown to be best (sensitivity: 79%, specificity: 82%). When a cut-off value of 9 points was used as the diagnostic criterion for neuropathic pain, there was greatly reduced sensitivity (sensitivity: 40%, specificity: 97%). Conclusion: Although the Japan-Q shows moderate diagnostic accuracy related to cancer pain, the cut-off value for this tool is lower than that for chronic pain. Cancer-related neuropathic pain should be suspected with a total score of 3 or more in the Japan-Q.

An ex post facto evaluation of the 82nd and 83rd national examination for Physicians' license / 医学教育

The 82 nd and 83 rd National Examination for Physicians' License, which were held in 1988 and 1989 respectively, were evaluated from question to question as well as in all the questions as a whole to set minimum pass scores and analysis “relevance” and “difficulty” in a matrix utilizing a modified Ebel's method.<BR>The evaluators were teachers in different disciplines in nationwide medical schools and teaching hospitals and clinical trainees who had taken and passed the immediate past examinations.<BR>Following data processing, the questionable and difficult questions were on the decrease compared with the preceding year, and it was tentatively concluded that the National Examinations have gradually improved year by year.