隨著科技進步，政府及民眾對醫療觀念的重視，臨床醫療工作者除了擔負臨床診治的工作外，也需要照顧病患或其家屬提出的問題解答。但在繁忙及充滿醫療不確定性的環境中，臨床醫療工作者如何自從大量的醫學資訊中快速擷取可用的資訊，作為臨床決策和解答病患問題的參考，將是提昇醫療品質中重要的關鍵。
本研究主要運用資料庫索引典結構設計一簡易的實證文獻檢索模式，應用ICD9-CM key word及MeSH (Medical Subject Heading)相同概念之病名詞彙作對應，使臨床人員能以熟悉的臨床詞彙無須再透過轉換檢索詞而能直接以資料庫之檢索詞找到相同詞彙概念之文獻，且可直接呈現PubMed實證資料庫之相關英文文獻，檢索者毋需一一搜尋各個資料庫也能獲得較精確之搜尋結果，希望臨床工作者在相當忙錄的醫療環境下也能藉由此結合臨床概念的介面，降低其搜尋文獻之困境，更易隨時獲得最新資訊，期能進一步發展為臨床決策之輔助系統。

Due to progress of medical technology and more emphases on medical issue, clinicians have to face more clinical problems in their daily work. As a clinician, how to obtain correct information faster from massive collections of literatures in order to improve his medical decision has played a pivotal role in the improvement of medical practice.
This study will build a web site for clinicians where a specific disease code is given, it will automatically of show a series related articles lay Medical Subheading hierarchical structure, and then used a variety of search engine to get more information which includes all web site articles selected from evidence based medicine. The advantage of this is that the searchers do not need to consider about different databases and their searching methods, nevertheless it can offer high quality articles what searchers really need.
Design a interface from the Medical Subheading 2002 related with ICD-9CM coded disease term and Apply to each disease searching methods, this ICD-9CM coded concept integrally, it will be more easier apply to different clinical needs what medical procedures related with a ICD-9CM code。

目錄
頁數
標題 i
審定書 ii
上網授權書 iii
國科會授權書 iv
誌謝 vi
目錄 vii
表目次 viii
圖目次 ix
中文摘要 x
英文摘要 xi
第一章 緒論
1.1研究背景…………………………………………………………… 1
1.2 研究目的……………………………………………………………4
1.3研究動機……………………………………………………………4
1.3.1上網搜尋專業知識是未來的趨勢……………………………5
1.3.2更有證據的醫療觀點可作為醫療品質的把關………………6
1.3.3 不易檢索網路上符合個人需要的醫學知識…………………6
第二章文獻探討
2.1醫學編碼探討……………………………………………………… 7
2.1.1 ICD9-CM………………………………………………… 7
2.1.2 MeSH………………………………………………...……7
2.1.3 UMLS…………………………………………………… .8
2.1.4 SNOMED………..………………………………………..8
2.2 ICD-9CM及MeSH之相關研究……………………………………… 8
2.2.1 ICD-9CM及UMLS及MeSH………………………………………9
2.3 文獻搜尋回覆方式…………………………………………………10
2.3.1國內外相關擷取醫學文獻臨床應用模式……………………10
2.3.2資訊搜尋者行為探討…………………………………………12
2.3.3使用者檢索詞彙相關研究探討………………………………14
第三章研究材料與方法
3.1 國際疾病診斷碼系統ICD9-CM 架構分析……………………16
3.2 MeSH 架構分析…………………………………………………21
3.3 PubMed 資料庫分析……………………………………………27
3.4 ICD9-CM及MeSH資料比較分析……………………………… 29
3.5 搜尋詞彙的產生……………………………………………… 31
3.6 搜尋結果評估方法……………………………………………… 34
第四章研究結果
4.1系統實作環境…………………………………………………… 36
4.2搜尋結果評估…………………………………………………… 38
4.2.1 Precision 及Recall結果分析…………………………38
4.2.2 ICD9-CM Keyword 對應MeSH結果分析…………………40
4.2.3 文章不重覆性結果分析…………………………………42
第五章討論………………………………………………………………… 43
第六章結論與建議………………………………………………………… 46
第七章參考文獻…………………………………………………………… 51
中文文獻 ……………………………………………………………51
英文文獻 ……………………………………………………………52
電子資料 ……………………………………………………………52
附錄
附錄一
附錄二
附錄三

中文文獻
余金燕，潘德樑，「疾病分碼原則」，台北:合記出版社，2002 ，頁3:21
徐均宏譯，「ICD9-CM疾病分類手冊」，高雄:長年出版社，1999 ，頁3:8
李瑞華編著，「國際疾病分類指引」，台北:南山堂出版社，1999 ，頁1:14
吳昭新,李友專，「醫學資訊管理學」，台北:華杏叢書，2001， 頁98
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Harold C. Sox ,JR., M.D., Marshal A.Blatt , Michael C.Higgins ,PH.D,Keith I. Marton,MD,. Medical Decision Making. Butterworths-Heinemann ,1998
Karen Sparck Jones and Peter Willett, Reading in Information Retrieval ,Morgan Kaufmann Publishers,inc,U.S.A, 1997,p183
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附錄一
Precision Assessment of Journal Search
Precision definition = Related articles / Total search articles
ICD9-CM code: 427.9
ICD9-CM definition: cardiac dysrhythmia, unspecified
Arrhythmia (cardiac) NOS
Search database: Pub Med Systematic Reviews
http://www.ncbi.nlm.nih.gov/entrez/query/static/clinical.html
Question 1.
Which term is not suitable for key word about the concept of ICD9-CM code (427.9):
Arrhythmia Disorder cardiac, functional Irregular, action, heart
Arrhythmia Sinus Disorder heart action Rhythm disorder
Disease Heart functional Disturbance rhythm, heart Rhythm heart, abnormal
Action, heart disorder Dysfunction heart
Action, heart irregular Dysrhythmia cardiac
Question 2
Which citation is not suitable for the concept of ICD9-CM code (427.9)
(Citations see attach file):
Signature: assessment date: