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研究生: 劉宜佩
Yi-pei Liu
論文名稱: 發展一探勘模式於醫師用藥行為探討-以史蒂芬氏強生症候群為例
Developing a Mining Approach to Investigate Physician Prescription Behavior-An Example of Stevens-Johnson Syndrome
指導教授: 歐陽超
Chao Ou-Yang
口試委員: 郭人介
Ren-Jieh Kuo
汪漢澄
Han-Cheng wang
學位類別: 碩士
Master
系所名稱: 管理學院 - 工業管理系
Department of Industrial Management
論文出版年: 2011
畢業學年度: 99
語文別: 中文
論文頁數: 92
中文關鍵詞: 資料探勘分類分群F-measure凝聚式的階層分群演算法序列性關聯用藥行為史蒂芬氏強生症候群
外文關鍵詞: Matrix Similarity, F-measure, Physicians’ Prescription Behaviors, Stevens-Johnson Syndrome
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  • 隨著科技的日新月異,資料蒐集以及儲存方法的進步,因此能夠快速累積龐大的資料,然而如何能從大量的資料,萃取有用的資訊,甚至發現一些新奇以及有用的樣式,是一大課題。其中資料探勘即是一種能夠在大量資料自動化發現一些有用資訊的流程,且過去資料探勘的發展,已廣泛的被應用在各個知識領域中如醫療、工程、科學等。本研究希望發展一套有效的醫師用藥行為探勘模式,用以探討具有嚴重用藥併發症之疾病,會對醫師之用藥行為產生怎樣的變化。
    本研究以全民健保資料庫,某一年份之史蒂芬氏強生症候群病人為例,希望以病人住院前、後用藥的觀點,藉由資料探勘的手法,透過以規則為基礎之分類的方法,將病人做分類,發現病人之用藥行為,除此之外,將病人之用藥以矩陣表示,透過F-measure相似度的計算,結合凝聚式的階層分群演算法,將用藥模式相似的病人做分群,再透過序列性關聯,發現各群的特徵用藥序列,做為醫生開藥的方針。其中病人用藥矩陣相似度的計算,可先將用藥相似病人歸為一群,如此可避免從大量資料中,透過序列性關聯,找出過多無意義之特徵用藥序列。


    In clinical practice, a severe illness might be the result of an untoward reaction to the pharmacological treatment for another disease. For instance, Stevens-Johnson syndrome (SJS) can be caused by antibiotics; nonsteroidal anti-inflammatory drugs; antiepileptics; antugout agents; and cardiovascular drugs, as well as the drugs for local use in ophthalmology and dermatology. Since there are so many drugs covering various different medical fields, very few physicians are familiar with all the potential drugs that can cause SJS. Hence new cases or even recurrent cases of drug-induced SJS are still reported from time to time.
    Currently in Taiwan, the causal relations between physicians’ prescription behaviors and the occurrence of SJS are not clear. Therefore, in this research, by applying the SJS cases data from National Health Insurance database, a pharmacological treatment mining approach is proposed to investigate physicians’ prescription behaviors before and after the occurrence of SJS.
    This research will describe the behavior of pharmacological treatment by the rule-based classification method. A matrix will be used to specify the pharmacological record for each SJS case. Then, a modified F-measure will be used to measure the similarity between each pair of matrices. The measured data will be used to cluster the cases. For each group of cases, its frequent item sets will be mined and the behavior pattern of the pharmacological treatment will be identified.

    摘要 i Abstract ii 致謝 iii 目錄 iv 圖目錄 vii 表目錄 viii 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 1.4論文架構 3 第二章、文獻探討 5 2.1流程相似度 6 2.2資料探勘 8 2.2.1分群演算法 9 2.2.2序列性關聯 9 2.3總結 10 第三章、研究方法 11 3.1概念階段 11 3.2設計階段 12 3.2.1資料前處理 12 3.2.2病人用藥行為分類 13 3.2.3建構個別病人住院前用藥矩陣 16 3.2.4以F-measure計算相似度 18 3.2.5利用凝聚式階層演算法將病人做分群 23 3.2.6依序列性關聯發現各群較常出現之特徵用藥序列 24 3.2.7研究限制 27 第四章、實作研究 28 4.1資料前處理 29 4.1.1專藥用藥取得 29 4.1.2專業用藥編碼 31 4.1.3刪除出現頻率低之專業用藥 33 4.2病人用藥行為分類 34 4.3病人用藥矩陣相似度計算 35 4.4具備相似用藥模式病人之分群 36 4.5依序列性關聯發現特徵用藥序列 43 4.6結果呈現 44 4.7驗證分析與結果討論 47 4.7.1驗證分析 47 4.7.2結果討論 48 第五章、結論與建議 52 5.1結論 52 5.2未來建議 54 參考文獻 56 附錄A-1、{f10,f01}類病人用藥相似度矩陣 59 附錄A-2、{f11}類病人用藥相似度矩陣 60 附錄A-3、{f10}類病人用藥相似度矩陣 61 附錄A-4、{f11,f10}類病人用藥相似度矩陣 62 附錄A-5、{f11,f10,f01}類病人用藥相似度矩陣 63 附錄B-1、{f10,f01}類病人分群樹狀圖 64 附錄B-2、{f11}類病人分群樹狀圖 64 附錄B-3、{f10}類病人分群樹狀圖 64 附錄B-4、{f11,f10}類病人分群樹狀圖 64 附錄B-5、{f11,f10,f01}類病人分群樹狀圖 64 附錄C-1.1、{f10,f01}類1.1群病人之用藥紀錄 65 附錄C-1.2、{f10,f01}類1.2群病人之用藥紀錄 66 附錄C-1.3、{f10,f01}類1.3群病人之用藥紀錄 69 附錄C-1.4、{f10,f01}類1.4群病人之用藥紀錄 70 附錄C-1.5、{f10,f01}類1.5群病人之用藥紀錄 71 附錄C-1.6、{f10,f01}類1.6群病人之用藥紀錄 72 附錄C-2.1、{f10}類2.1群病人之用藥紀錄 74 附錄C-2.2、{f10}類2.2群病人之用藥紀錄 75 附錄C-2.3、{f10}類2.3群病人之用藥紀錄 76 附錄C-2.4、{f10}類2.4群病人之用藥紀錄 77 附錄C-2.5、{f10}類2.5群病人之用藥紀錄 78 附錄C-3.1、{f11,f10,f01}類4.1群病人之用藥紀錄 79 附錄C-3.2、{f11,f10,f01}類4.2群病人之用藥紀錄 80 附錄C-3.3、{f11,f10,f01}類4.3群病人之用藥紀錄 80 附錄C-3.4、{f11,f10,f01}類4.4群病人之用藥紀錄(住院前) 81 附錄C-3.5、{f11,f10,f01}類4.4群病人之用藥紀錄(住院後) 82 附錄C-3.6、{f11,f10,f01}類4.5群病人之用藥紀錄(住院前) 83 附錄C-3.7、{f11,f10,f01}類4.5群病人之用藥紀錄(住院後) 84 附錄C-4.1、{f11}類5.1群病人之用藥紀錄 85 附錄C-4.2、{f11}類5.2群病人之用藥紀錄 86 附錄C-4.3、{f11}類5.3群病人之用藥紀錄 86 附錄C-4.4、{f11}類5.4群病人之用藥紀錄 87 附錄C-4.5、{f11}類5.5群病人之用藥紀錄 88 附錄C-5.1、{f11,f10}類6.1群病人之用藥紀錄 89 附錄C-5.2、{f11,f10}類6.2群病人之用藥紀錄 90 附錄C-5.3、{f11,f10}類6.3群病人之用藥紀錄 92

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