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Takao Takeshima received consulting fees from Otsuka Pharmaceutical Co., Ltd., during the conduct of the study; consulting fees from Otsuka Pharmaceutical Co., Ltd., Hedgehog MedTech, Inc., and Sawai Pharmaceutical Co., Ltd.; honoraria for lectures from Otsuka Pharmaceutical Co., Ltd., Amgen Inc., Eli Lilly Japan K.K., and DAIICHI SANKYO Co., Ltd., outside the submitted work; Clinical trials, contract research and collaborative research funding from Eisai Co., Ltd., Eli Lilly Japan K.K., Shionogi & Co., Ltd., Biohaven Ltd., and Lundbeck Japan K.K. Takeo Nakayama received consulting fees from Otsuka Pharmaceutical Co., Ltd., during the conduct of the study; consulting fees from Dainippon Sumitomo Pharmaceutical Co., Ltd., Otsuka Pharmaceutical Co., Ltd.; grants or contracts from I&H Co., Ltd., and Nakagawa Pharmacy Co.; lecture Honoria from Pfizer Japan Inc., MSD K.K., Chugai Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Janssen Pharmaceutical K.K., Boehringer Ingelheim International GmbH., Eli Lilly Japan K.K., Baxter Ltd., Mitsubishi Tanabe Pharma Co., Otsuka Pharmaceutical Co., Ltd. and Novartis Pharma K.K., outside the submitted work.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"We utilized only a preexisting anonymously processed database developed and managed by DeSC. Originally, upon database construction, DeSC offered insured individuals the option to opt out of the provision of their medical data. Moreover, before proceeding to the survey questions, the kencom\u00ae application explained that the response data would be anonymized and provided to a third party, and proceeding to the questions would serve as consent for the use of their response data. These claims and survey data were linked and then anonymized by the DeSC in such a way that it was not possible to identify individuals and provided to the study investigators. Informed consent was not required for studies that used de-identified anonymized data. Therefore, no new individual consent was obtained for the use of the data in this study. The study protocol was approved by the Ethics Committee of the Research Institute of Healthcare Data Science (Approval no. RI220622; registration ID UMIN000050349) and was conducted in accordance with the Declaration of Helsinki (revised October 2013) by the World Medical Association and the Ethical Guidelines for Medical Research Involving Human Subjects. The authors had full access to the study data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}