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Article History

First Online: 4 August 2017

Compliance with Ethical Standards

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: The institutional review boards of the two participating hospitals approved the study. Because all data were obtained as part of routine daily practice, the institutional review boards waived the need for informed consent.

: Drs. Koizumi, Ohta, Sakuma, Okamoto, Matsumoto, and Morimoto have no conflicts of interest. Dr. Bates received equity from Intensix, which makes software to support clinical decision making in intensive care; is named as co-inventor on patent no. 6029138 held by Brigham and Women’s Hospital (Boston, MA, USA) on the use of decision-support software for medical management licensed to the Medicalis Corporation; holds a minority equity position in Medicalis, which develops web-based decision support for radiology test ordering; consults for EarlySense, which makes patient safety monitoring systems; has received equity and cash compensation from QPID Inc., a company focused on intelligence systems for electronic health records; has received cash compensation from CDI (Negev) Ltd., a not-for-profit incubator for health IT startups; and has received equity from Enelgy, which makes software to support evidence-based clinical decisions, from Ethosmart, which makes software to help patients with chronic diseases, and from MDClone, which takes clinical data and produces de-identified versions of it.

: This work was supported by JSPS KAKENHI Grant numbers JP17689022, JP21659130, JP22390103, JP22790494, JP23659256, JP24689027, JP25860484, JP26293159, JP15K21535, JP15K08862, and Grants from the Ministry of Health, Labour and Welfare of Japan, Grants from the Pfizer Health Research Foundation and the Uehara Memorial Foundation.

: This study was approved by all institutional review boards at all participating hospitals and was conducted in accordance with the provisions of the Declaration of Helsinki and the ethical guidelines for clinical studies in Japan.