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研究生:黃種平
研究生(外文):Chung-Ping Huang
論文名稱:建立罹患憂鬱症或躁鬱症之透析患者的預測模式
論文名稱(外文):The Predicting Model of End-stage Renal Disease Patients with Depression or Bipolar Disorder
指導教授:張怡秋張怡秋引用關係
指導教授(外文):I-Chiu Chang
口試委員:張怡秋胡雅涵林文德謝其政
口試委員(外文):I-Chiu ChangYa-Han HuWen-De LinChi-Jeng Hsieh
口試日期:2014-07-25
學位類別:碩士
校院名稱:國立中正大學
系所名稱:醫療資訊管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:57
中文關鍵詞:預測模式資料探勘憂鬱症躁鬱症末期腎臟病
外文關鍵詞:Prediction modelData miningDepressionBipolar disorderEnd-stage renal disease
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慢性疾病的發生,容易使病患併發精神疾病,較常見的為憂鬱症以及躁鬱症。根據美國腎臟資料系統於 2013 年提出的報告,2010 年臺灣地區末期腎臟病的發生率為世界第三、亞洲第一,而盛行率則為世界第一。且民國 100 年門診以及住院前五大傷病中,慢性腎衰竭分別排名第一、第四。種種數據顯示,末期腎臟病在我國為迫切需要注意的重大傷病。本研究期望透過應用資料探勘技術於全民健康保險研究資料庫,計算國內透析患者罹患精神疾病的比率,並且建立預測模式,以得到患者接受透析之後罹患精神疾病的患者特性,達到及早預防疾病、改善醫療資源分配等目標。
利用1997年至2009年之門診處方及治療明細檔(CD)、門診處方醫令明細檔(OO)、住院醫療費用清單明細檔(DD)、住院醫療費用醫令清單明細檔(DO)、以及重大傷病證明明細檔(HV)進行分析以後,得到新發生透析患者的資料共計107,813筆,並基於病患的基本資料以及曾經被診斷出的合併症,建構出預測模型,可以幫助醫療人員未來遇到新發生的末期腎臟病患時,可以運用此決策模型初步判斷病患罹患憂鬱症或躁鬱症的可能性,進而採取相關醫療措施,以避免延誤病患的治療時程。

Depression and Bipolar disorder can easily be complicated by chronic diseases. And according to UNIRED STATES RENAL DATA SYSTEM, both of the incidence and prevalence of end-stage renal disease in Taiwan are much higher than other countries. This study will apply Data-Mining technique to National Health Insurance Research Database, and try to build a prediction model of patients who have end-stage renal disease and mental disorder.
After analyzing National Health Insurance Research Database, we found the number of end-stage renal disease patients are 107,813. Then we combined patients’ gender, age, and comorbidity data, built the prediction model, in order to help medical staff quickly predict the possibility of the patients that could have depression or bipolar, and take care of them at an early date.

目錄
第一章、 緒論 1
第一節、 研究背景與動機 1
第二節、 研究目的與問題 4
第二章、 文獻探討 6
第一節、 末期腎臟病流行病學 6
第二節、 憂鬱症病學 8
第三節、 躁鬱症 10
第四節、 透析患者罹患憂鬱症相關研究 13
第五節、 資料探勘 19
第三章、 研究方法 23
第一節、 研究架構 23
第二節、 資料選擇 24
第三節、 研究變項與操作型定義 25
第四節、 資料前處理 28
第五節、 資料探勘工具 30
第四章、 實作結果與分析 31
第一節、 實驗結果 31
第二節、 分析與評估 31
第五章、 研究結論與建議 48
第一節、 研究結論 48
第二節、 研究貢獻 48
第三節、 研究限制 49
第四節、 未來研究方向 49
參考文獻 51

圖目錄
圖 1:跨產業資料探勘標準作業程序(Cross Industry Standard Process for Data Mining, CRISP-DM) 23
圖 2:全民健康保險研究資料庫各檔案間串檔變項說明 29

表目錄
表 1:Incidence of ESRD, by year (per million population) 1
表 2:Prevalence of ESRD, by year (per million population) 1
表 3:透析患者罹患憂鬱症國外相關研究整理 14
表 4:透析患者罹患憂鬱症國內相關研究整理 17
表 5:本研究變數定義 26
表 6:採用血液透析的病患罹患憂鬱症之決策規則 32
表 7:採用腹膜透析的病患罹患憂鬱症之決策規則 35
表 8:採用血液透析的病患罹患躁鬱症之決策規則 38
表 9:採用腹膜透析的病患罹患躁鬱症之決策規則 44
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