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Introduction: Patients often refer to information on the Internet when selecting a medical institution, and some patients provide feedback on their experiences. In this study, we analyzed the content of patients' evaluations of medical institutions on Google.Methods: This study evaluated Google reviews and ratings of medical institutions in Shizuoka Prefecture. We coded the reviews with 12 items according to their content, and further categorized them into "positive," "negative," "unclassifiable," and "no description." We used modified Poisson regression analysis to investigate the relationship between ratings and assessment items.Results: Our sample consisted of 2,044 medical institutions. The number of reviews included in the analysis was 13,769. Reviews frequently commented on "doctor's behaviors," and positive comments about doctor's behaviors were significantly associated with high ratings (B: 0.76, 95%CI: 0.70 to 0.82), whereas negative comments were associated with low ratings (−4.65, −5.24 to −4.06).Conclusion: Within the reviews on Google, doctors' behavior had an impact on the ratings of medical institutions.
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<p><b>OBJECTIVES</b>Sleep disorders and psychological stress have become major concerns as health risks in modern Japanese society. Chronic sleep deprivation could lead to physical and mental exhaustion, which could affect the circulatory condition. In this study, we have investigated the effects of long-term sleep problems and mental health conditions on abnormal ECG findings from the standpoint of community health.</p><p><b>METHODS</b>Data were obtained from the records of community physical checkups conducted in a town in Okinawa from 1993 to 2001. Data regarding average sleep duration and the 12-item version of the general health questionnaire (GHQ) were also collected at the community physical checkups. In order to compute the odds ratio of electrocardiographic (ECG) findings according to mental health condition and sleep duration, we conducted multivariate analysis using logistic regression maneuvers.</p><p><b>RESULTS</b>There was a significant difference of average GHQ scores according to sleep duration, with shorter sleep duration (< or =6 h) correlating with poorer GHQ and longer sleep duration (> or =8 h) correlating with healthier GHQ (p < 0.05). In the multivariate logistic regression analysis among subjects with poorer GHQ, shorter sleep duration showed significantly high odds ratio (OR = 7.14) for abnormal ECG findings.</p><p><b>CONCLUSIONS</b>The present study suggested that the mental health condition appears to impact ECG results indirectly through its strong association with sleep duration and provided ground for suggestion that mental health items to be included in community physical checkup examination items.</p>
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<p><b>OBJECTIVES</b>Changes in B-type natriuretic peptide (BNP) and electrocardiographic (ECG) findings in an adult Japanese population were measured over a 5-year period, and the statistical relationships between these were evaluated.</p><p><b>METHODS</b>This was a longitudinal analysis in which data were collected on 353 subjects (135 men and 218 women) who had undergone general health checks in 1998 and 2003.</p><p><b>RESULTS</b>Data were examined by correlation coefficient and one-way analysis of covariance using repeated measurements. The correlation coefficient for BNP between 1998 and 2003 was 0.622 (P < 0.0001) for the men and 0.557 (P < 0.0001) for women. The changes in BNP over the same period were 13.71 +/- 26.06 (P < 0.0001) pg/ml in the men and 20.17 +/- 32.01 (P < 0.0001) pg/ml in the women. In 99 men and 145 women who had undergone ECG tests, with both normal and abnormal findings, visual inspections of changes in the ECG findings with respect to BNP changes were performed over the 5-year period. In men, both age and BNP significantly correlated with changes in ECG findings; however, in women, no significant correlation between BNP and changes in ECG findings was observed.</p><p><b>CONCLUSIONS</b>This regional longitudinal study revealed a gender difference in the relationship between long-term changes in BNP and ECG findings, suggesting that a 10 pg/ml or more increase in BNP in men over a 5-year period may a indicate worsening of cardiac function and the need for intervention.</p>