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題名:電腦化進行醫院臨床失智評量表之可行性分析--以南部某醫學中心檢查紀錄為例
書刊名:醫務管理期刊
作者:林美蓮陳俞成 引用關係林高章錢才瑋
作者(外文):Lin, Mei-lienChen, Yu-chengLin, Gau-jungChien, Tsair-wei
出版日期:2014
卷期:15:4
頁次:頁306-326
主題關鍵詞:尤登圖失智量表分數加總法電腦化法傳統手工法Youden plotClinical dementia ratingCDRSumming-all-itemSAIComputer-aided digitalCADTraditional hand-plus-human-brainTHB
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目的:比較電腦化及傳統手工失智症的評估效益及其可行性。方法:以366病人所做臨床失智評估量表(CDR)資料(含病人及家屬雙方),以組內相關係數(ICC)、Kappa 係數、卡方檢定(1)電腦化6向度(即記憶、方向感、問題解決能力、社區活動、居家習慣、及自我照顧能力)與(2)分數加總法,對照(3)傳統手工6向度失智分數程度(由0至5分)的一致性及其構面結構的相同性。尤登圖作為醫師對病人家屬解說失智症程度的對照視覺化圖示報表。結果:電腦化法比分數加總法有較高的(1)Kappa係數(0.87,95%CI=0.66,1.00及0.66,95%CI=0.46,0.87)、(2)ICC(0.96,95%CI=0.91,1.0及0.88,95%CI=0.85, 0.90),及(3)較小的卡方值(0.423及17.84)。電腦化法比傳統手工法每100人的失智症評估,可節省專業技術員時間達6.5小時。利用尤登圖可以協助醫師對病人家屬解說失智症程度,提供更多有用的訊息。結論:作者設計的電腦化失智症評估法,結合尤登圖來評估病人的失智症,推薦未來研究者進行更多的臨床檢測。
Objective: To compare the feasibility and efficiency of using computer-aided digital (CAD) and traditional hand-plus-human-brain (THB) methods to score the Clinical Dementia Rating (CDR) Scale in patients with dementia. Methods: The CDR scale was used with 366 outpatients in a hospital using (1) CAD and (2) THB methods to score six dimensions (memory, directional sense, problem-solving skills, community activity, habits at home, and self-care ability), as well as (3) the summing-all-item (SAI) scores in comparison with each other on the CDR scales responded by patients and family members. The multiple-regression method with scores of patients and family members was used to predict the CDR scores derived by the traditional method. Kappa, ICC (intra-class coefficient) and Chisquare tests were done to compare consistency and structural similarity between the traditional and computer-aided methods. A Youden plot was used to create a visual presentation of the CDR results for patients and physicians. Results: In comparing CAD and THB in terms of SAI scores, CAD was more consistent and reached more similar conclusions about the extent of patient dementia as shown by: (1) Kappa coefficient (0.87, 95%CI=0.66,1.00 vs. 0.66,95%CI=0.46,0.87), (2)ICC (0.96, 95%CI=0.91, 1.0 vs. 0.88, 95%CI=0.85, 0.90) and (3) a smaller Chi-square value (0.423 vs. 17.84). The time saving in finishing CDR evaluations per 100 patients using the CAD method could be as much as a 6.5 hour reduction in a professional technician's workload. Using a Youden plot to characterize the patient with dementia offers much more useful information to clinical consultants. Conclusion: The author-designed CAD method along with a Youden plot to assess patients with dementia is recommended to future researchers for use in clinical settings.
期刊論文
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5.夏以晨、林藍萍、林金定(20131200)。評估智能障礙者失智症之量表比較:文獻回顧。臺灣老人保健學刊,9(2),144-152。new window  延伸查詢new window
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研究報告
1.行政院經濟建設委員會(2010)。2010年至2060年台灣人口推計。  延伸查詢new window
圖書
1.王文中、錢才瑋(2012)。統計學與EXCEL資料分析之實習應用。台北:博碩。  延伸查詢new window
其他
1.台灣失智症學會(2012)。101-145年臺灣地區失智症人口推計報告,http://www.tada2002.org.tw/tada_know_02.html, 2012/06/15。  延伸查詢new window
 
 
 
 
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