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題名 運用層級分析法與案例式推理建立脂肪肝預測模型
A fatty liver prediction model utilizing analytical hierarchy process and case-based reasoning作者 陳姵潔
Chen, Pei Chieh貢獻者 李有仁
陳姵潔
Chen, Pei Chieh關鍵詞 脂肪肝
健康檢查
案例式推理
層級分析法日期 2011 上傳時間 30-Oct-2012 13:59:49 (UTC+8) 摘要 從現今社會的進步與發展，可以發現人們的生活品質不斷提升且生活型態逐漸改變，生活型態的改變使得疾病的型態隨之改變，從過去的傳染病演變成現今的社會文明病─ 慢性疾病。近年來的社會繁榮與經濟進步，使國人有更良好的飲食營養，且工商進步使得應酬喝酒的機會增加，逐漸使肥胖、血脂過高、糖尿病的國人越來越多，因此有脂肪肝的人也越來越多，幾乎高達三分之一。脂肪肝盛行所帶來的健康問題使國人不得不更注意身體的健康，更擴展到疾病預防的概念，希望能透過及早發現與及早治療來促進健康並省下龐大的醫療費用。因此醫療照護需求更廣更高。在科技的進步下使得醫學界使用越來越多的資訊科技來輔助疾病診斷、進行健康管理，另外，醫學界亦越來越注重預防醫學的概念用以面對龐大的慢性疾病患者，故疾病預測的概念更加被醫學界所關注，不論是在醫療的前中後期，都依賴著資訊科技輔助其管理與診斷。 目前大多數醫院的健康檢查僅提供檢查報告的數值並隨報告附上正常標準值的對照資訊，用以提供給健檢者做為建議與自我健康管理的參考。但是對於僅進行最基本健康檢查的健檢者，如：員工、校園新生等，透過健檢報告的數值來提供個人化疾病資訊建議的情況較為少見，故本研究希望能透過案例式推理脂肪肝預測模型來給予患者透過健康檢查報告的數值與日常健康行為的問卷，進行脂肪肝疾病的預測，幫助健檢者提升對於健檢報告與疾病關係的瞭解，加強健檢者的自我健康管理，期望幫助未進行完整付費健康檢查的健檢者也能夠透過簡單的脂肪肝預測模型來初步評估自我健康情況，並作為是否進一步就醫的參考依據；並提供許多相似案例給醫生從更宏觀的角度去診斷病患，幫助降低診斷錯誤且改善醫療品質及醫療治療的成效，以達到更完善的自我健康管理及降低個人、社會醫療成本的負擔。 參考文獻 英文部分 Aamodt, A., Plaza, E. 1994. “Case-based reasoning: foundational issues, methodological variations, and system,” AI Communications (7:1), pp. 39-59. Adams, L. A., Angulo, P., and Lindor, K. D. 2005. “Nonalcoholic fatty liver disease.,” CMAJ : Canadian Medical Association journal = journal del’Association medicale canadienne (172:7), pp. 899-905. Adams, L. A., Lymp, J. F., St. Sauver, J., Sanderson, S. O., Lindor, K. D., Feldstein, A., and Angulo, P. 2005. “The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study,” Gastroenterology (129:1), pp. 113-121. Aha, D.W. 1990. A Study of Instance-based Learning Algorithms for Supervised Learning Tasks: Mathematical, Empirical, and Psychological Evaluations, TR 90-42, Irvine, CA: University of California, Department of Information and Computer Science. Angelico, F., Ben, M. D., Conti, R., Francioso, S., Feole, K., Maccioni, D., Antonini, T. M., and Alessandri, C. 2003. “Non-alcoholic fatty liver syndrome : A hepatic consequence of common metabolic diseases,” Journal of Gastroenterology and Hepatology (18), pp. 588-594. Rocha, F., Ben, M. D. E. L., Conti, R., Francioso, S., Feole, K., Maccioni, D., Antonini, T. M., and Alessandri, C. 2003. “Non-alcoholic fatty liver syndrome : A hepatic consequence of common metabolic diseases,” Journal of Gastroenterology and Hepatology (18), pp. 588-594. Bichindaritz, I., Montani, S. 2011. “Advances in case-based reasoning in the health sciences,” Artificial Intelligence in Medicine (51:2), pp. 75-79. Bradburn, C. and Zeleznikow, J. 1993. “The Application of Case-Based Reasoning to the Tasks of Health Care Planning,” Proceeding of European Workshop on CBR, Berlin: Springer, pp. 365-378. Clark, Philip J. and Evans, Francis C. 1954. “Distance to Nearest Neighbor as a Measure of Spatial Relationships in Populations,” Ecology (35:4) October, pp. 445-453. de Alwis, N. M. W., and Day, C. P. 2008. “Non-alcoholic fatty liver disease: the mist gradually clears.,” Journal of Hepatology (48), pp. S104-12. Falck-Ytter, Y., Younossi, Z.M., Marchesini, G., McCullough, A. 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Marchesini G, Brizi M, Morselli-Labate AM, Bianchi G, Bugianesi E, McCullough AJ, Forlani G, Melchionda N., 1999. “Association of nonalcoholic fatty liver disease with insulin resistance.,” American Journal of Medicine (107:5), November, pp.450-5. Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., and Rizzetto, M. 2003. “Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome.,” Hepatology (Baltimore, Md.) (37:4), pp. 917-23. Marchesini, G., Forlani, G. 2012. “Diabetes and hepatocellular cancer risk: Not only a matter of hyperglycemia,” Hepatology (55), pp. 1298–1300. Nakao, K., Nakata, K., Ohtsubo, N., Maeda, M., Moriuchi, T., Ichikawa, T., Hamasaki, K., Kato, Y., Eguchi, K., Yukawa, K., and Ishii, N. 2002. “Association Between Nonalcoholic Fatty Liver, Markers of Obesity, and Serum Leptin Level in Young Adults.,” The American journal of Gastroenterology (97:7), pp. 1796-801. 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The Analytic Hierarchy Process, New York, McGraw-Hill. Saaty, T. L. 1990. “How to make a decision: The analytic hierarchy process,” European Journal of Operational Research (48:1), pp. 9-26. Saaty, T. L. 1994. “How to make a decision: The analytic hierarchy process,” Interfaces (24:6), pp. 19-43. Saaty, T. L. 2005. Analytic Hierarchy Process, Encyclopedia of Biostatistics. Saaty, T. L. 2008. “Decision making with the analytic hierarchy process,” International Journal of Services Sciences (1:1), pp. 83. Schank, R. C. and Abelson R. P. 1977. Scripts, Plans, Goals, and Understanding: An Inquiry into Human Knowledge Structures, Hillsdale, New Jersey: Lawrence Erlbaum Associates. Schank, R. C. 1983. Dynamic Memory: A Theory of Reminding and Learning in Computers and People, New York: Cambridge University Press. Slade, S. 1991. “Case-Based Reasoning: A Research Paradigm,” AI Magazine (4:1), pp. 42-55. Su, C.-C., Wang, K., Hsia, T.-L., Chen, C.-S., and Tung, T.-H. 2006. “Association of Nonalcoholic Fatty Liver Disease with Abnormal Aminotransferase and Postprandial Hyperglycemia.,” Journal of clinical gastroenterology (40:6), pp. 551-4. Targher, G., Bertolini, L., Rodella, S., Zoppini, G., Scala, L., Zenari, L., and Falezza, G. 2006. “Associations between plasma adiponectin concentrations and liver histology in patients with nonalcoholic fatty liver disease.,” Clinical endocrinology (64:6), pp. 679-83. Targher, G., Bertolini, L., Padovani, R., Rodella, S., Zoppini, G., Pichiri, I., Sorgato, C., Zenari, L., and Bonora, E. 2010. “Prevalence of non-alcoholic fatty liver disease and its association with cardiovascular disease in patients with type 1 diabetes.,” Journal of hepatology (53:4) European Association for the Study of the Liver, pp. 713-8. Vaidya, O. S., and Kumar, S. 2006. “Analytic hierarchy process: An overview of applications,” European Journal Of Operational Research (169:1), pp. 1-29. Virkki-Hatakka, T., Kraslawski, A., Koiranen, T. and Nyström, L. 1997. “Adaptation Phase in Case-Based Reasoning System for Process Equipment Selection,” Computers and Chemical Engineering (21), pp. S643-S648. Watson, I. 1997. Applying Case-based Reasoning: Techniques for Enterprise Systems, CA, USA/CA, Morgan Kaufmann. Watson, I. 1998. Applying Case-based Reasoning: Techniques for Enterprise Systems, San Francisco, CA: Morgan Kaufmann. Watson, I. 1999. “Case-based reasoning is a methodology not a technology,” Knowledge-Based system (12:December), pp. 303-308. Wong, V. W.-S., Chan, H. L.-Y., Hui, a Y., Chan, K.-F., Liew, C.-T., Chan, F.K.-L., and Sung, J. J.-Y. 2004. “Clinical and histological features of non-alcoholic fatty liver disease in Hong Kong Chinese.,” Alimentary pharmacology & therapeutics (20:1), pp. 45-9. Youssef, W., and McCullough, A.J. 2002. “Diabetes mellitus, obesity, and hepatic steatosis,” Semin Gastrointest Dis (13), pp. 17-30. 中文部分 王濟川、郭志剛(2000)，Logistic 迴歸模型─方法及應用，高等教育出版社，台北。 朱佳雯 (2004)，『案例式推理與類神經網路在心電圖診斷之應用研究』，私立真理大學管理科學研究所碩士論文，台北。 江瑞坤、顏韶宏、陳世琦、劉鎮嘉、陳慶餘（2005），『新陳代謝後群』，基層醫學，第二十卷，第一期，頁 2-7。 行政院衛生署國民健康局(2006)，遠離糖尿病完全學習手冊，行政院衛生署國民健康局，台北。 行政院衛生署（2012），「99 年死因統計結果分析」，行政院衛生署官方網站，網址：http://www.doh.gov.tw/CHT2006/index_populace.aspx，上網日期：2011-06-15。 吳建國(2011)，『酒精性脂肪肝探析』，中醫肝病醫學雜誌，第七卷，第一期，頁 25-29。 李博智（2002），『資料探勘在慢性病預測模式之建構』，私立元智大學資訊管理學系碩士論文，桃園。 侯丞、戴嘉言 (2002)，『老病新談—再談脂肪肝』，高醫醫訊月刊，第二十一卷，第十一期。 姚開屏（2002），『健康相關生活品質概念與測量原理之簡介』，台灣醫學會，第三卷，第一期，頁 183-192。 高雄醫學大學附設中和紀念醫院腎臟照護團隊(2011)，慢性腎臟病健康管理67 手冊，行政院衛生署國民健康局，台北。 國民健康局(2012)，『預防保健服務檢查對象與服務項目：成人預防保健服務』，國民健康局，台北。 楊培銘 (2010) 『好肝不卡油 拋開脂肪肝 輕盈好健康』，好心肝會刊，第五十期，財團法人肝病防治學術基金會，網址： http://liver.org.tw/index.php?option=com_content&view=article&layout=liverarticle&catid=110&id=1037 楊超然 (2004)，『利用文件及影像檢索建立胃癌診斷與治療的案例式推理』，臺北醫學大學醫學資訊研究所碩士論文，台北。 榮泰生 (2011)，EXPERT CHOICE在分析層級程序法(AHP)之應用，五南圖書出版股份有限公司，台北，初版。 劉俊人、楊偉勛 (2010)『脂肪肝患者 如何消脂保肝』，好心肝會刊，第五十期，財團法人肝病防治學術基金會，網址：http://liver.org.tw/index.php?option=com_content&view=article&layout=liverarticle&catid=47&id=204&COLUMNMODE=2 蔡崇煌、李怡慶、羅永杰、周俊德(2006) 『台灣中部地區某區域醫院非酒精性脂肪肝疾病與肥胖相關因子之研究』，台灣家庭醫學誌，第十六卷，頁215-225。 蔡崇煌、黃素雲、羅永杰、林高德（2004），『新陳代謝症候群』，基層醫學，第十九卷，第十一期，頁 270-273。 蔡崇煌、黃素雲 (2005)『非酒精性脂肪肝疾病』，基層醫學，第二十卷，第八期，頁 182-186。 鍾玉衡、林敏雄 (2011)，『非酒精性脂肪肝疾病與心血管疾病的相關研究』，家庭醫學與基層醫療，第二十六卷，第十期，頁 410-414。 職場健康促進暨菸害防制輔導中心、陳叡瑜、葉錦瑩、蘇千田、黃百粲、黃建文(2007)，員工健康檢查實用手冊，行政院衛生署國民健康局，台北。 描述 碩士
國立政治大學
資訊管理研究所
99356019
100資料來源 http://thesis.lib.nccu.edu.tw/record/#G0099356019 資料類型 thesis dc.contributor.advisor 李有仁 zh_TW dc.contributor.author (Authors) 陳姵潔 zh_TW dc.contributor.author (Authors) Chen, Pei Chieh en_US dc.creator (作者) 陳姵潔 zh_TW dc.creator (作者) Chen, Pei Chieh en_US dc.date (日期) 2011 en_US dc.date.accessioned 30-Oct-2012 13:59:49 (UTC+8) - dc.date.available 30-Oct-2012 13:59:49 (UTC+8) - dc.date.issued (上傳時間) 30-Oct-2012 13:59:49 (UTC+8) - dc.identifier (Other Identifiers) G0099356019 en_US dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/54852 - dc.description (描述) 碩士 zh_TW dc.description (描述) 國立政治大學 zh_TW dc.description (描述) 資訊管理研究所 zh_TW dc.description (描述) 99356019 zh_TW dc.description (描述) 100 zh_TW dc.description.abstract (摘要) 從現今社會的進步與發展，可以發現人們的生活品質不斷提升且生活型態逐漸改變，生活型態的改變使得疾病的型態隨之改變，從過去的傳染病演變成現今的社會文明病─ 慢性疾病。近年來的社會繁榮與經濟進步，使國人有更良好的飲食營養，且工商進步使得應酬喝酒的機會增加，逐漸使肥胖、血脂過高、糖尿病的國人越來越多，因此有脂肪肝的人也越來越多，幾乎高達三分之一。脂肪肝盛行所帶來的健康問題使國人不得不更注意身體的健康，更擴展到疾病預防的概念，希望能透過及早發現與及早治療來促進健康並省下龐大的醫療費用。因此醫療照護需求更廣更高。在科技的進步下使得醫學界使用越來越多的資訊科技來輔助疾病診斷、進行健康管理，另外，醫學界亦越來越注重預防醫學的概念用以面對龐大的慢性疾病患者，故疾病預測的概念更加被醫學界所關注，不論是在醫療的前中後期，都依賴著資訊科技輔助其管理與診斷。 目前大多數醫院的健康檢查僅提供檢查報告的數值並隨報告附上正常標準值的對照資訊，用以提供給健檢者做為建議與自我健康管理的參考。但是對於僅進行最基本健康檢查的健檢者，如：員工、校園新生等，透過健檢報告的數值來提供個人化疾病資訊建議的情況較為少見，故本研究希望能透過案例式推理脂肪肝預測模型來給予患者透過健康檢查報告的數值與日常健康行為的問卷，進行脂肪肝疾病的預測，幫助健檢者提升對於健檢報告與疾病關係的瞭解，加強健檢者的自我健康管理，期望幫助未進行完整付費健康檢查的健檢者也能夠透過簡單的脂肪肝預測模型來初步評估自我健康情況，並作為是否進一步就醫的參考依據；並提供許多相似案例給醫生從更宏觀的角度去診斷病患，幫助降低診斷錯誤且改善醫療品質及醫療治療的成效，以達到更完善的自我健康管理及降低個人、社會醫療成本的負擔。 zh_TW dc.description.tableofcontents 第一章 緒論....................................................................................................... 4 第一節 研究背景與動機........................................................................................ 4 第二節 研究目的與貢獻........................................................................................ 6 第三節 研究流程.................................................................................................... 7 第二章 文獻探討 ............................................................................................... 8 第一節 健康檢查.................................................................................................... 8 2.1.1 健康檢查項目說明.................................................................................... 8 第二節 脂肪肝...................................................................................................... 13 2.2.1 脂肪肝定義.............................................................................................. 13 2.2.2 脂肪肝相關研究...................................................................................... 13 第三節 層級分析法.............................................................................................. 24 2.3.1 定義及發展.............................................................................................. 24 2.3.2 層級及要素.............................................................................................. 25 2.3.3 貢獻與應用範圍...................................................................................... 26 第四節 案例式推理.............................................................................................. 27 2.4.1 案例式推理演進...................................................................................... 27 2.4.2 案例式推理的定義與運作流程.............................................................. 28 2.4.3 案例式推理在醫學上的應用.................................................................. 31 第三章 研究方法 .............................................................................................. 35 第一節 研究架構.................................................................................................. 35 第二節 層級分析法.............................................................................................. 36 3.2.1 定義問題與層級架構建立...................................................................... 36 3.2.2 問卷設計.................................................................................................. 37 3.2.3 建立成對比較矩陣.................................................................................. 37 3.2.4 一致性檢定.............................................................................................. 39 第三節 個案推理.................................................................................................. 40 3.3.1 研究工具.................................................................................................. 40 3.3.2 最近相鄰法計算案例相似度.................................................................. 40 第四節 脂肪肝預測模型...................................................................................... 42 第四章 資料分析與研究結果 ............................................................................ 43 第一節 層級分析法.............................................................................................. 43 4.1.1 專家問卷回收.......................................................................................... 43 4.1.2 問卷資料結果.......................................................................................... 44 第二節 案例式推理.............................................................................................. 47 4.2.1 資料收集與前置處理.............................................................................. 47 4.2.2 脂肪肝預測模型與驗證.......................................................................... 48 第五章 討論與結論 .......................................................................................... 53 第六章 研究限制與未來發展 ............................................................................ 57 zh_TW dc.language.iso en_US - dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0099356019 en_US dc.subject (關鍵詞) 脂肪肝 zh_TW dc.subject (關鍵詞) 健康檢查 zh_TW dc.subject (關鍵詞) 案例式推理 zh_TW dc.subject (關鍵詞) 層級分析法 zh_TW dc.title (題名) 運用層級分析法與案例式推理建立脂肪肝預測模型 zh_TW dc.title (題名) A fatty liver prediction model utilizing analytical hierarchy process and case-based reasoning en_US dc.type (資料類型) thesis en dc.relation.reference (參考文獻) 英文部分 Aamodt, A., Plaza, E. 1994. “Case-based reasoning: foundational issues, methodological variations, and system,” AI Communications (7:1), pp. 39-59. 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