BACKGROUND: physicians' awareness regarding evidence-based medicine (EBM), clinical practice guidelines, and clinical information resources were rarely examined in Japan. We need to know them prior to the initiation of the Medical Information Network Distribution Service (Minds) by the Japan Council for Quality Health Care (JCQHC) .
METHODS: A total of 10, 000 directors/owners of private clinics (CDs: clinic physicians) affiliated with the Japan Medical Association (JMA) and 8682 physicians working for hospitals certified by the JCQHC (HDs: hospital physicians) were randomly selected and surveyed by a mailed questionnaire.
RESULTS: The response rate to the questionnaire was 18.7% (n=1865) among CDs and 67.8% (n=5885) among HDs. The percentage of respondents who uses internet was 39.9% among CDs and 69.3% among HDs. The information resource most commonly used by all respondents was medical journals, followed by textbooks. The percentage of respondents who used medical literature database was 10.8% among CDs and 49.7% among HDs, respectively. Approximately 80% of all respondents approved implementing EBM in daily practice. Fifty percent of all respondents indicated to have used clinical practice guidelines, and 90% of all the guideline users replied that clinical practice guidelines are useful tools for clinical decision-making. Over half of HDs required to access to the abstracts of the literature cited in the guidelines.
CONCLUSIONS: Many physicians who responded to the survey acknowledged that EBM will contribute to improving the quality of medical services. They are positive in using clinical practice guidelines that include a series of recommendations proposed by specialists in the relevant field (s) in accordance to the reviewed evidence.

BACKGROUND: The purpose of our study was to compare the characteristics of medical practitioners who prefer using the Internet as their information resource and those who prefer using printed materials.
METHODS: From December 2002 to January 2003, a non-anonymous questionnaire was sent out by post to members of the Japanese Medical Association (JMA) and physicians working in hospitals. Contributing factors were examined by using logistic regression analysis.
RESULTS: The response rates for the questionnaires were 18.7% (n=1868) for JMA physicians and 68.0% (n=5901) for hospital physicians. Factors associated with the preference for using the Internet were: ‘younger age’; ‘use of the Internet to solve clinical problems and uncertainties’; ‘use of personal computers at work’; and, ‘use of personal computers at home’.
CONCLUSION: The results of this study show that, although some younger physicians prefer printed materials, providing medical information via the Internet is better suited for younger physicians who are making full use of computers. In contrast, older physicians prefer printed materials because they tend to be less familiar with using computers and may have limited accessibility to the Internet. Therefore, using both the Internet and printed materials to provide medical information is necessary to meet the needs of the larger physician population.

BACKGROUND/AIMS: Helicobacter pylori infection causes gastritis, peptic ulcers and gastric malignancies, and its eradication has been advocated by many groups. We determined the H. pylori carrier status and eradication rates of patients with chronic hepatitis C virus (HCV) infection. METHODS: In total, 76 chronically HCV-infected patients were enrolled for comparison with 228 HCV-noninfected, age- and sex-matched controls. H. pylori infection was confirmed by H. pylori antibody and urea breath testing. RESULTS: The H. pylori infection rate was significantly higher for HCV-infected patients (67 of 76, 88.2%) than for HCV-noninfected controls (158 of 228, 69.3%). Endoscopic findings showed that the rates of gastric ulcers and gastritis were significantly higher for the 67 HCV-infected patients with H. pylori infection (34.3% and 77.6%) than for the 158 HCV-noninfected controls with H. pylori infection (15.2% and 57.6%). Treatment to eradicate H. pylori had a significantly higher success rate for HCV-infected patients (61 of 67, 91.0%) than for HCV-noninfected controls (115 of 158, 72.8%). CONCLUSIONS: The markedly high H. pylori eradication rate observed in this study shows that eradication of H. pylori holds promise for the improvement of the long-term health condition of patients with chronic HCV infection.
Gastritis ; Helicobacter ; Helicobacter pylori ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Peptic Ulcer ; Stomach Ulcer ; Urea ; Viruses

OBJECTIVESTo assess trends in smoking prevalence among Japanese adolescents and to analyze possible causal factors for the decrease in smoking prevalence observed in a 2004 survey.

METHODSNationwide cross-sectional surveys were conducted in 1996, 2000 and 2004. Survey schools, both junior and senior high schools, considered to be representative of the whole of Japan were sampled randomly. Enrolled students were asked to complete a self-reporting anonymous questionnaire on smoking behavior. The questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. School principals were asked about the policy of their respective school on smoking restrictions.

RESULTSCigarette smoking prevalence (lifetime, current, and daily smoking) in 2004, based on the completed questionnaires, had decreased relative to previous years in both sexes and in all school grades. The most important trends were: a decrease in smoking prevalence among the fathers and older brothers of the students; an increase in the proportion of students who did not have friends; a decrease in the proportion of current smokers who usually bought cigarettes in stores decreased in 2004, in particular for the oldest boys. An association was found between a lower smoking rate at a school and a smoke-free school policy.

CONCLUSIONSJapan has experienced a decrease in the prevalence of smoking among adolescents. A decrease in smoking prevalence among the fathers and older brothers, limitations to minors' access to tobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decreasing trend.

BRCA2 Protein/genetics* ; Germ Cells ; Humans ; Male ; Muscular Atrophy ; Mutation ; Prostate ; Prostatic Neoplasms/genetics*