離散事件模擬法與慢性肝病進程之預測(I)

Abstract

慢性B型肝炎病毒(HBV)感染是一個動態的過程，具有初期之複製階段和活 躍的肝炎病毒感染史。HBV能導致長期的感染並且引起嚴重的臨床和診療問題， 影響全世界至少4億的人口。然而，目前某些難解的問題仍無法以現存的臨床資 料處理。這些問題包括預測B型肝炎的自然進程和有關它的治療成本效益。雖然 世界上已有很多國家在考慮一些決策模型中使用不同的診療策略來比較和分析 其成本效益，但是離散事件模擬法(Discrete Event Simulation)可以設定不同的研究 標的，是一種了解HBV情境過程靈活又強有效的分析工具。本計畫主要的目的是 以台灣醫學專家的臨床資料和數學決策模型，運用資料庫資源，建立決策支援系 統模型，以協助醫生觀察和了解不同醫療決策所可能造成的影響。 Chronic hepatitis B virus (HBV) infection is a dynamic process with an early replication phase and active liver disease. HBV can result in long-term infection causing a serious clinical problem, affecting 400 million individuals worldwide. Several unresolved issues are difficult to address using currently available clinical data. These include prognosis of hepatitis B with its natural history and the relative cost-effectiveness of the management procedures. Although some decision models with different strategies are used in many countries across the world to consider the cost-effectiveness of alternative healthcare interventions, Discrete Event Simulation (DES) presents a flexible and powerful analysis tool for respective purposes in HBV studies. A model of decision support system is developed for providing alternative suggestions of treatments based on simulation outputs for prognosis for progression of HBV infection.