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題名:婦科癌症病人焦慮與憂鬱症預測模式之探討
書刊名:醫務管理期刊
作者:蔡王金英許弘毅 引用關係黃志銘
作者(外文):Tsai, Wnag-chin-yingShi, Hon-yiHuang, Chih-ming
出版日期:2017
卷期:18:4
頁次:頁335-353
主題關鍵詞:子宮頸癌子宮內膜癌卵巢癌焦慮症類神經網路Cervical cancerEndometrial cancerOvarian cancerAnxiety disordersArtificial neural networkANN
原始連結:連回原系統網址new window
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  • 共同引用共同引用:17
  • 點閱點閱:9
目的:一、利用效益指標比較婦科癌症病人焦慮與憂鬱症在類神經網路、邏輯斯迴歸及比例風險迴歸模式之準確性。二、利用全域敏感度分析婦科癌症患者焦慮與憂鬱症重要預測因子之權重。方法:資料來源為1996~2010年全民健保資料庫。以年齡≧18歲、ICD-9-CM代碼180、182、183為研究對象,共6,801人,並利用病人特性、醫療機構特性來探討婦科癌症病人焦慮或憂鬱症之重要影響因子。結果:結果顯示類神經網路預測模式優於邏輯斯迴歸(LR)與比例風險迴歸(COX)預測模式。婦科癌症病人焦慮或憂鬱症的準確性,在敏感性部份類神經網路、邏輯斯迴歸(LR)與比例風險迴歸(COX)分別為67.23%、2.90%與52.02%;陰性預測值(NPV)分別為84.04%、66.91%與0.00%;準確性(Accuracy)分別為81.19%、66.36%與17.32%;在AU-ROC曲線分別為88%、53%與26%。結論:研究結果證明類神經網路預測模式是優於邏輯斯迴歸和比例風險迴歸模式。建議醫學研究可運用此模式做為臨床評估及決策參考,找出最重要的預測因子,提升醫療品質。
Objectives: 1. To compare the performance indices between artificial neural networks (ANN), multiple logistic regression (MLR), and Cox proportional hazards (COX) models; and 2. To conduct a global sensitivity analysis to identify the significance of these weighted predictors. Methods: This a retrospective study using the National Health Insurance Research Database from 1996-2010. The study involved 6801 gynecologic cancer patients > 18 years of age, with ICD-9-CM diagnosis codes 180, 182, and 183, and use patient characteristics and hospital characteristics were used to identify the impact of anxiety and depressive disorders. Results: The accuracy of ANN, MLR and COX was 81.19%, 66.36% and 17.32%, respectively. The corresponding area under the receiver operating characteristic curve (AU-ROC) was 88%, 53% and 26%, the sensitivity was 67.23%, 2.90%, and 52.02%, and the NPV was 84.04%, 66.91%, and 0.00%, respectively. The ANN model showed better performance indices for anxiety and depressive disorders than the MLR and COX models. Conclusions: The ANN model was shown to be superior to the MLR and COX models. Therefore, medical research can use this model as a clinical assessment and decision-making reference to identify the most important predictors for improving the quality of medical care.
期刊論文
1.Carlson, L. E.、Bultz, B. D.(2003)。Cancer distress screening: Needs, models, and methods。Journal of Psychosomatic Research,55(5),403-409。  new window
2.釋慧岳、釋宗惇、陳慶餘(20070800)。癌末病人憂鬱症之靈性照顧。安寧療護,12(3),273-286。new window  延伸查詢new window
3.吳淑芬、林佑樺、李來涼、簡婉儀(20140600)。婦科癌症患者的疾病不確定感與憂鬱之相關性探討。護理暨健康照護研究,10(2),83-93。new window  延伸查詢new window
4.江淑華、林佳靜(20101100)。頭頸癌病人術後接受放射化學治療之症狀困擾與生活干擾程度探討。新臺北護理期刊,12(2),17-26。  延伸查詢new window
5.Chen, C. J.、Shi, H. Y.、Lee, K. T.、Huang, T. Y.(2013)。In-hospital mortality prediction in patients receiving mechanical ventilation in Taiwan。American Journal of Critical Care,22(6),506-513。  new window
6.Fradelos, E. C.、Papathanasiou, I. V.、Veneti, A.、Daglas, A.、Christodoulou, E.、Zyga, S.、Kourakos, M.(2017)。Psychological Distress and Resilience in Women Diagnosed with Breast Cancer in Greece。Asian Pacific Journal of Cancer Prevention,18(9),2545-2550。  new window
7.Ho, R. T.、Kwan, T. T.、Cheung, I. K.、Chan, C. K.、Lo, P. H.、Yip, P. S.、Chan, C. Y.(2015)。Association of Fatigue with Perceived Stress in Chinese Women with Early Stage Breast Cancer Awaiting Adjuvant Radiotherapy。Stress Health,31(3),214-221。  new window
8.Mukherjee, A.、Mazumder, K.、Kaushal, V.、Ghoshal, S.(2017)。Effect of Supportive Psychotherapy on Mental Health Status and Quality of Life of Female Cancer Patients Receiving Chemotherapy for Recurrent Disease。Indian Journal of Palliative Care,23(4),399-402。  new window
9.Faradmal, J.、Soltanian, A. R.、Roshanaei, G.、Khodabakhshi, R.、Kasaeian, A.(2014)。Comparison of the performance of log-logistic regression and artificial neural networks for predicting breast cancer relapse。Asian Pacific Journal of Cancer Prevention,15(14),5883-5888。  new window
10.佘專然、施小婷、蘇柳青(2006)。子宮頸癌放射治療患者心理待徵與對策。實用臨床醫學,7(1),122-124。  延伸查詢new window
11.蔡慧君、張德馨、古雪貞(20120100)。運用Watson關懷理論於一位憂鬱症生育婦女罹患卵巢癌之護理經驗。馬偕護理雜誌,6(1),101-112。  延伸查詢new window
12.Akel, R.、El Darsa, H.、Anouti, B.、Mukherji, D.、Temraz, S.、Raslan, R.、Assi, H.(2017)。Anxiety, Depression and Quality of Life in Breast Cancer Patients in the Levant。Asian Pacific Journal of Cancer Prevention,18(10),2809-2816。  new window
13.Biglarian, A.、Bakhshi, E.、Gohari, M. R.、Khodabakhshi, R.(2012)。Artificial Neural Network for Prediction of Distant Metastasis in Colorectal Cancer。Asian Pacific Journal of Cancer Prevention,13(3),927-930。  new window
14.Bottomley, A.(1998)。Depression in cancer patients: a literature review。European Journal of Cancer Care,7(3),181-191。  new window
15.陳雅萍、葉淑惠、龔福財、何美瑤(20070600)。子宮頸癌住院病人症狀困擾、憂鬱及生活品質之相關性研究。實證護理,3(2),89-98。new window  延伸查詢new window
學位論文
1.黃雅芳(2009)。運用資料探勘方法評估冠狀動脈疾病之研究(碩士論文)。高雄醫學大學,高雄。  延伸查詢new window
2.洪婉婷(2013)。肝癌病患確診後合併焦慮症、憂鬱症、醫療資源利用與存活分析之研究--以全國人口為基礎(碩士論文)。高雄醫學大學,高雄。  延伸查詢new window
3.馬秀玲(2013)。住院跌倒病人跌倒傷害預測模式之探討(碩士論文)。高雄醫學大學,高雄。  延伸查詢new window
4.蔡麗珍(2014)。癌症病人社會資本與身心健康關係之研究(碩士論文)。高雄醫學大學,高雄。  延伸查詢new window
其他
1.衛生福利部國民健康署(2013)。102年全國主要癌症死亡原因,http://health99.hpa.gov.tw/Article/ArticleDetail.aspx?TopIcNo=846&DS=l-life。  延伸查詢new window
 
 
 
 
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