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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/31941

    標題: 多向度電腦化適性測驗在臨床失智評量表之應用
    Application of Multi-dimensional Computerized Adaptive Test on Clinical Dementia Rating Scale using Computer-aided Technique
    作者: 丁恩惠
    貢獻者: 醫務管理系
    關鍵字: 失智症
    computer adaptive testing
    cutting point
    日期: 2018
    上傳時間: 2019-02-27 16:49:18 (UTC+8)
    摘要: 背景與目的:人口老化的社會(≧65歲者佔人口比率14%以上)稱為老年人的社會。失智症是主要影響老年人的認知功能障礙,其特徵是漸進性認知的功能減退,早期診斷是非常重要的。然而,能有效快速診斷失智症是困難的,尤其是在失智症的初期。如何發展網路平台,方便民眾使用電腦、平板或手機,自行在線上進行失智症之評估,並能早期有效篩檢出失智症患者,並進而改善其症狀及增強日常生活能力,不僅能提高病人的生活品質,同時可以減少後續的醫療成本與負擔。本研究旨在發展一套高精準度與效率之多向度電腦化適性測驗,以為臨床之應用。方法:研究對象係以南部某醫學中心臨床神經科醫師所開立之 失智症檢查366人資料, 利用多向度 Rasch 模式的 Conquest 軟體進行試題的參數估計,再進行失智量表8向度(即分量表)的電腦化適性測驗(Multi-dimensional Computerized Adaptive Test)的模擬分析,與全部作答傳統非電腦適性測驗(Non Adaptive Test NAT)的精準度(不相等分數比率小於5%)及效率性(答題數量的節省),及決定其決斷點。結果:結果顯示,電腦化適性測驗(MCAT)比傳統非電腦適性測驗(NAT) 的題目節省20.19%(=(53-42.3)/53)。顯注表現電腦化適性測驗(MCAT)各構面呈現高度相關。受試成績不同百分比小於5%的 t 檢定顯示能?估計值沒有顯著差?。總體決斷點分數可以設定於-0.7與0.7洛基分數,即33%及67%。結論:發展網路平台,方便民眾使用電腦、平板或手機自行在線上進行快速有效失智症的評估,將有助於篩檢之推廣。
    Objectives: Along with the elder population in increase, the diagnosis of dementia with efficiency and accuracy is important in healthcare settings. We aimed to develop a website that can help parents with their own computers, tablets, or smart phones for online screening and prediction of dementia responding Clinical Dementia Rating (CDR) Scale.Methods: The CDR scale was applied to 366 outpatients in a hospital of southern part Taiwan, (1) using multi-dimensional computer adaptive test(MCAT) with parameters for items across six dimensions, (2) simulating responses to compare the efficiency and precision of MCAT and NAT(non-adaptive test). The number of items saved and the cutoff points determined for the tool were determined.Results: MCAT yielded significantly more precise measurements and was significantly more efficient than was NAT: it yielded a 20.19% (=(53-42.3)/53) saving in item length when measurement differences less than 5% were allowed. Person-measure correlation coefficients were highly consistent among the five domains. The cutoff points for the overall measures were -0.7 and 0.7 logits, which was equivalent to 33 and 67 in percentile scores. Significantly fewer items were answered on MCAT than on NAT without compromising MCAT’s precision.Conclusions: Developing a website to help parents with their own computers, tablets, or smart phones for online screening and prediction of dementia in elders is useful and not difficult.
    關聯: 電子全文公開日期:2018-08-04,學年度:106, 61頁
    Appears in Collections:[醫務管理系(所)] 博碩士論文

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