隨著人類平均壽命逐年提高，面對接踵而來的失智照護問題，有效的應用智慧輔助科技（IAT）對失智患者及整個照護體系來說皆相當重要，然而IAT在失智照護上的應用仍處發展階段，其潛力及評估標準尚待發掘、統整，而在有限資源下，醫療科技評估（HTA）應持續提升評估方法的決策效率及效力。近年多準則決策（MCDM）在HTA之應用開始受到重視，但相關研究還處於起步階段，為瞭解其可行性，本研究以MCDM建立了一套評選模型，提出5項主準則以及10項次準則，模型目標乃提供照護機構在進行失智患者之IAT評選時，優先導入順序的參考。本研究提出了一套四階段方法，並藉由兩個案例分析來進行模型的示例，運用BWM進行權重計算，以及Fuzzy-TOPSIS進行IAT方案排序，最後對專家共識度與分群差異進行分析，並討論各評選準則單一評估值的意義，另外也進行了敏感度分析來探討變動區間及模型穩健性，而該模型所得之最終排序是否真正符合決策者之偏好，將以專家過往經驗進行討論及確認。本研究雖無可避免地必須在許多不確定條件下進行，但仍為未來該領域的研究奠定了初步框架。

As human life expectancy keeps increasing, the rising prevalence of dementia poses a major challenge for global health. In response to that, intelligent assistive technology (IAT) is likely to be a potential solution for people with dementia and the entire care system. However, the current implimentation of IATs into dementia care is still in the start stage, and its evaluation factors are yet to be fully explored. Also, health technology assessment (HTA) should continue to improve the decision-making efficiency and effectiveness. Recently, the application of multi-criteria decision-making (MCDM) method in HTA has drawn more and more attention, but are still in its infancy. As a result, the goal of the study was to establish a pilot MCDM model for care institutions to evaluate the adoption priority of IATs developed for people with dementia. Five main criteria and ten sub-criteria were identified. A four-phase methodology was proposed, and two cases were taken to exemplify the model. BWM was used to rank the criteria and Fuzzy-TOPSIS was used to rank IATs. Furthermore, the consensus of experts and difference between groups were analyzed. Performance assessment of IATs when considering only one criterion at a time was also discussed. In the end, to check the robustness of the model, a sensitivity analysis was performed, and based on the experience of experts, the final ranking was checked and discussed to verify whether the model meets the decision makers’ preferences. Although this study had to inevitably be carried out under many uncertain conditions, it still sets a framework for future studies in this area of research-work.

摘要 i
ABSTRACT ii
目錄 iii
表目錄 v
圖目錄 vii
第一章、緒論 1
1.1研究背景與動機 1
1.2研究目的 3
1.3研究流程 4
第二章、文獻探討 6
2.1失智症照護 6
2.1.1 病程及治療方式 6
2.1.2 失智照顧機構 8
2.2 IAT應用於失智症照護 9
2.2.1 IAT定義與種類 9
2.2.2 IAT現況與挑戰 13
2.3 評選方法 14
2.3.1醫療科技評估（HTA） 14
2.3.2多準則決策分析（MCDM） 16
2.3.3 BWM與Fuzzy-TOPSIS 19
2.4 評選準則 22
第三章、研究方法 28
3.1 研究步驟 28
3.2 目標問題與專家定義 30
3.3 建立層級架構 31
3.3.1 評選準則建立 32
3.3.2 決定IAT評選方案 34
3.4 問卷設計與發放 38
3.5 多準則決策方法 39
3.5.1 Best-Worst Method, BWM 39
3.5.2 Fuzzy-TOPSIS 44
第四章、案例分析與驗證 48
4.1 問卷回收狀況與專家背景 49
4.2 計算準則權重（BWM） 50
4.3 IAT排序（Fuzzy-TOPSIS） 55
4.4 驗證比較 64
4.4.1 專家意見共識度 64
4.4.2 專家意見分群差異 66
4.4.3 各準則單一評估值 69
4.4.4 敏感度分析 71
4.4.5 排序結果驗證 77
第五章、結論與未來建議 80
5.1 結果討論 80
5.1.1 評選準則權重結果 80
5.1.2 IAT排序結果 82
5.2 未來建議 83
參考文獻 85
附錄 89
附錄A. 問卷設計 89
附錄B. Best-to-Other (BO)向量 99
附錄C. Others-to-Worst (OW)向量 101
附錄D. 權重值與一致性比率(C.R.) 103
附錄E. 各專家 IAT評選值對應之模糊數 105

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