臺灣博碩士論文加值系統

根據目前全民健康保險研究資料庫的案例統計，6歲以下學齡前兒童發展遲緩的盛行率每年都持續增加，但實際的盛行率與就醫紀錄數據明顯低於國際發展趨勢，顯示我國對兒童發展遲緩的監測仍嚴重不足，為有效追蹤個案發展狀況，本研究開發一套發展評估追蹤系統，藉由父母和醫生的合作參與並對發展遲緩的兒童進行早期識別和介入輔導，有效協助學齡前兒童早期療育的相關工作。

本研究與馬偕早期療育評估中心醫護團隊進行跨領域合作，持續收集學齡前兒童進行幼兒神經發展的評估測試，該評估系統是以適應性測驗機制為基礎，根據家長逐題回答狀況給予相對合適評估孩童學習能力的題目，依據答題結果進行多面向的發展評估，並將不同年齡階段的評估結果以資料視覺化方式呈現，提供家長和醫生能依據科學統計數據快速理解孩童當下的神經發展狀況。並判斷是否需要進行早期介入治療。

本研究透過遠距醫療定期進行評估測試，有效提升學前兒童定期評估之效率，並期望替代傳統繁複的評估機制。目前將初步收案的評估結果與早療臨床診斷結果進行比對分析，整體量表識別發展遲緩的準確率初步僅達0.65及F1-score的0.64，主要原因可歸咎於目前量表系統仍為雛型版本且臨床樣本數量較少，造成整體量表的準確度較低，此現象可以藉由收案數量的增加持續進行量表優化。

The prevalence rate of developmental delayed children increases annually according to statistical reports from the National Health Insurance Research Database in Taiwan. However, the clinical records are significantly lower than the world trend, which reflects that Taiwan’s monitoring mechanisms for child developmental delays are severely deficient. The research proposed an adaptive assessment tracking system based on cooperation of parents and doctors, and the system provides an efficient mechanism for early identification and appropriate intervening treatments for children with developmental delay.

The research team comprises professionals from Early Evaluation and Treatment Center, Mackay Children Hospital to develop the system and continuously collect subjects for neurodevelopmental assessment. According to answers provided from parents, the assessment system provides questions at different levels to assess children's developmental situation adaptive ley. The assessment contents were designed and performed in multiple aspects and results were visualized to display children's current development status according to her/his biological ages. According to the assessment results, doctors could make a quick decision whether the child was required for early treatment.

The system allows parents to perform periodic assessment remotely and save time to visit hospital in person. The proposed intelligent information system is expected to provide an alternative solution for traditional evaluation mechanisms. However, the performance of the adaptive assessment system only reached an accuracy of 65% and an F1-score of 64%. The main reasons for such a low accuracy rate was due to the system was yet a prototype version and insufficient number of clinical samples. We believe that the assessment performance will be continually improved and optimized when the clinical samples could be gradually increased in the near future.

摘要 i
ABSTRACT iii
誌謝 v
目錄 vi
表目錄 viii
圖目錄 x
第一章 緒論 1
1.1 研究背景 1
1.2 研究動機 2
1.3 研究目的 3
第二章 相關研究 4
2.1 發展評估系統 4
2.2 電腦化適應性測驗 5
2.3 Rasch Model 5
2.4 單頁應用 6
2.5 表現層狀態轉移(RESTful) 6
2.6 JSON Web Tokens (JWT) 6
2.7 數據傳輸對象 7
2.8 物件關聯對映 7
第三章 系統設計與評估模型 9
3.1 需求分析 9
3.2 系統架構 9
3.3 收案流程 11
3.4 適應性評估機制 12
3.5 量表難度分析模型 15
3.6 子系統模組設計 17
3.6.1 發展評估模組 17
3.6.2 量表難度分析模組 22
3.6.3 量表管理模組 24
3.6.4 影片資料集搜集模組 25
3.6.5 權限管理模組 28
3.6.6 個案管理模組 32
第四章 實驗結果 35
4.1 實驗環境 35
4.2 系統實作畫面 36
4.2.1 使用者功能 36
4.2.2 管理員功能 41
4.3 適應性評估結果分析 45
第五章 討論與結論 50
5.1 討論 50
5.2 結論 51
參考文獻 53
縮寫對照表 56

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