請用此 Handle URI 來引用此文件:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/31961
完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 金傳春(Chwan-Chuen King) | |
dc.contributor.author | Tsung-Shu Wu | en |
dc.contributor.author | 吳宗樹 | zh_TW |
dc.date.accessioned | 2021-06-13T03:26:01Z | - |
dc.date.available | 2012-02-15 | |
dc.date.copyright | 2006-10-17 | |
dc.date.issued | 2006 | |
dc.date.submitted | 2006-07-28 | |
dc.identifier.citation | Ang, B. C., M. I. Chen, et al. (2005). 'An assessment of electronically captured data in the patient care enhancement system (PACES) for syndromic surveillance.' Ann Acad Med Singapore 34(9): 539-4.
Arita, I., M. Nakane, et al. (2004). 'Role of a sentinel surveillance system in the context of global surveillance of infectious diseases.' Lancet Infect Dis 4(3): 171-7. Baker, E. L., A. Friede, et al. (1995). 'CDC's Information Network for Public Health Officials (INPHO): a framework for integrated public health information and practice.' J Public Health Manag Pract 1(1): 43-7. Balter, S., D. Weiss, et al. (2005). 'Three years of emergency department gastrointestinal syndromic surveillance in New York City: what have we found?' MMWR Morb Mortal Wkly Rep 54 Suppl: 175-80. Bean, N. H. and S. M. Martin (2001). 'Implementing a network for electronic surveillance reporting from public health reference laboratories: an international perspective.' Emerg Infect Dis 7(5): 773-9. Bean, N. H., S. M. Martin, et al. (1992). 'PHLIS: an electronic system for reporting public health data from remote sites.' Am J Public Health 82(9): 1273-6. Beatty, M. E., S. Phelps, et al. (2006). 'Blackout of 2003: public health effects and emergency response.' Public Health Rep 121(1): 36-44. Birkhead, G., T. L. Chorba, et al. (1991). 'Timeliness of national reporting of communicable diseases: the experience of the National Electronic Telecommunications System for Surveillance.' Am J Public Health 81(10): 1313-5. Box, G. E. P. and G. M. Jenkins (1970). Time Series Analysis: Forecasting and Control. San Francisco, Holden-Day. Bradley, C. A., H. Rolka, et al. (2005). 'BioSense: implementation of a National Early Event Detection and Situational Awareness System.' MMWR Morb Mortal Wkly Rep 54 Suppl: 11-9. Brown, S. M., J. C. Benneyan, et al. (2002). 'Binary cumulative sums and moving averages in nosocomial infection cluster detection.' Emerg Infect Dis 8(12): 1426-32. Buehler, J. W. (1998). Surveillnace, Lippincott-Raven. Buehler, J. W., R. L. Berkelman, et al. (2003). 'Syndromic surveillance and bioterrorism-related epidemics.' Emerg Infect Dis 9(10): 1197-204. Buehler, J. W., R. S. Hopkins, et al. (2004). 'Framework for evaluating public health surveillance systems for early detection of outbreaks: recommendations from the CDC Working Group.' MMWR Recomm Rep 53(RR-5): 1-11. Burkle, T., A. W. Friedrich, et al. (2004). 'Infectious disease surveillance - a topic revisited with a commercial hospital information system.' Medinfo 2004(CD): 1538. Buss, P. M. (2002). 'Globalization and disease: in an unequal world, unequal health!' Cad Saude Publica 18(6): 1783-8. CDC, U. S. (1991). 'National Electronic Telecommunications System for Surveillance--United States, 1990-1991.' MMWR Morb Mortal Wkly Rep 40(29): 502-3. Chapman, W. W., L. M. Christensen, et al. (2005). 'Classifying free-text triage chief complaints into syndromic categories with natural language processing.' Artif Intell Med 33(1): 31-40. Chapman, W. W., J. N. Dowling, et al. (2004). 'Fever detection from free-text clinical records for biosurveillance.' J Biomed Inform 37(2): 120-7. Chapman, W. W., J. N. Dowling, et al. (2005). 'Classification of emergency department chief complaints into 7 syndromes: a retrospective analysis of 527,228 patients.' Ann Emerg Med 46(5): 445-55. Chen, J. H., K. Schmit, et al. (2005). 'Use of Medicaid prescription data for syndromic surveillance--New York.' MMWR Morb Mortal Wkly Rep 54 Suppl: 31-4. Cooper, B. and M. Lipsitch (2004). 'The analysis of hospital infection data using hidden Markov models.' Biostatistics 5(2): 223-37. Cooper, D. L., N. Q. Verlander, et al. (2006). 'Can syndromic surveillance data detect local outbreaks of communicable disease? A model using a historical cryptosporidiosis outbreak.' Epidemiol Infect 134(1): 13-20. Costagliola, D., A. Flahault, et al. (1991). 'A routine tool for detection and assessment of epidemics of influenza-like syndromes in France.' Am J Public Health 81(1): 97-9. Dalton, C. B., P. M. Griffin, et al. (1997). 'Electronic communication and the rapid dissemination of public health information.' Emerg Infect Dis 3(1): 80-1. Das, D., D. Weiss, et al. (2003). 'Enhanced drop-in syndromic surveillance in New York City following September 11, 2001.' J Urban Health 80(2 Suppl 1): i76-88. Department of Health, N. Y. C. (2002). 'Syndromic surveillance for bioterrorism following the attacks on the World Trade Center--New York City, 2001.' MMWR Morb Mortal Wkly Rep 51 Spec No: 13-5. Doroshenko, A., D. Cooper, et al. (2005). 'Evaluation of syndromic surveillance based on National Health Service Direct derived data--England and Wales.' MMWR Morb Mortal Wkly Rep 54 Suppl: 117-22. Doyle, T. J., M. K. Glynn, et al. (2002). 'Completeness of notifiable infectious disease reporting in the United States: an analytical literature review.' Am J Epidemiol 155(9): 866-74. Effler, P., M. Ching-Lee, et al. (1999). 'Statewide system of electronic notifiable disease reporting from clinical laboratories: comparing automated reporting with conventional methods.' Jama 282(19): 1845-50. Farrington, C. P., N. J. Andrews, et al. (1996). 'A Statistical Algorithm for the Early Detection of Outbreaks of Infectious Disease.' Journal of the Royal Statistical Society. Series A (Statistics in Society) 159(3): 547-563. Fidler, D. P. (1996). 'Globalization, international law, and emerging infectious diseases.' Emerg Infect Dis 2(2): 77-84. Freedman, D. O., P. E. Kozarsky, et al. (1999). 'GeoSentinel: the global emerging infections sentinel network of the International Society of Travel Medicine.' J Travel Med 6(2): 94-8. Frenk, J. and O. Gomez-Dantes (2002). 'Globalization and the challenges to health systems.' Health Aff (Millwood) 21(3): 160-5. Gesteland, P. H., R. M. Gardner, et al. (2003). 'Automated syndromic surveillance for the 2002 Winter Olympics.' J Am Med Inform Assoc 10(6): 547-54. Goldenberg, A., G. Shmueli, et al. (2002). 'Early statistical detection of anthrax outbreaks by tracking over-the-counter medication sales.' Proc Natl Acad Sci U S A 99(8): 5237-40. Graitcer, P. L. and A. H. Burton (1987). 'The Epidemiologic Surveillance Project: a computer-based system for disease surveillance.' Am J Prev Med 3(3): 123-7. Greaves, F. (2004). 'What are the most appropriate methods of surveillance for monitoring an emerging respiratory infection such as SARS?' J Public Health (Oxf) 26(3): 288-92. Harcourt, S. E., G. E. Smith, et al. (2001). 'Can calls to NHS Direct be used for syndromic surveillance?' Commun Dis Public Health 4(3): 178-82. Heffernan, R., F. Mostashari, et al. (2004). 'New York City syndromic surveillance systems.' MMWR Morb Mortal Wkly Rep 53 Suppl: 23-7. Heffernan, R., F. Mostashari, et al. (2004). 'Syndromic surveillance in public health practice, New York City.' Emerg Infect Dis 10(5): 858-64. Henning, K. J. (2004). 'What is syndromic surveillance?' MMWR Morb Mortal Wkly Rep 53 Suppl: 5-11. Hung, J., J. Posey, et al. (1998). 'Electronic surveillance of disease states: a preliminary study in electronic detection of respiratory diseases in a primary care setting.' Proc AMIA Symp: 688-92. Hutwagner, L., W. Thompson, et al. (2003). 'The bioterrorism preparedness and response Early Aberration Reporting System (EARS).' J Urban Health 80(2 Suppl 1): i89-96. Hutwagner, L. C., E. K. Maloney, et al. (1997). 'Using laboratory-based surveillance data for prevention: an algorithm for detecting Salmonella outbreaks.' Emerg Infect Dis 3(3): 395-400. Jajosky, R. A. and S. L. Groseclose (2004). 'Evaluation of reporting timeliness of public health surveillance systems for infectious diseases.' BMC Public Health 4(1): 29. Kaszuba, A. and G. Gibson (1977). 'Hospital emergency department surveillance system: a data base for patient care, management, research and teaching.' Jacep 6(7): 304-7. King, C.-C., F.-Y. F. Shih, et al. (2005). Syndromic Surveillance of Influenza-like Illness (ILI) versus SARS in Taiwan Syndromic Surveillance Conference, Seattle, WA. King, C. C., M. Y. Yen, et al. (2004). Taiwan Syndromic Surveillance Systems to Detect Infectious Disease Outbreak. Syndromic Surveillance Conference. Boston, Mass. Koo, D. and S. F. Wetterhall (1996). 'History and current status of the National Notifiable Diseases Surveillance System.' J Public Health Manag Pract 2(4): 4-10. Krause, G., G. Ropers, et al. (2005). 'Notifiable disease surveillance and practicing physicians.' Emerg Infect Dis 11(3): 442-5. Kulldorff, M., E. J. Feuer, et al. (1997). 'Breast cancer clusters in the northeast United States: a geographic analysis.' Am J Epidemiol 146(2): 161-70. Lazarus, R., K. P. Kleinman, et al. (2001). 'Using automated medical records for rapid identification of illness syndromes (syndromic surveillance): the example of lower respiratory infection.' BMC Public Health 1(1): 9. Lober, W. B., L. J. Trigg, et al. (2003). 'Syndromic surveillance using automated collection of computerized discharge diagnoses.' J Urban Health 80(2 Suppl 1): i97-106. Lombardo, J., H. Burkom, et al. (2003). 'A systems overview of the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE II).' J Urban Health 80(2 Suppl 1): i32-42. Loonsk, J. W. (2004). 'BioSense--a national initiative for early detection and quantification of public health emergencies.' MMWR Morb Mortal Wkly Rep 53 Suppl: 53-5. Ma, H., H. Rolka, et al. (2005). 'Implementation of laboratory order data in BioSense Early Event Detection and Situation Awareness System.' MMWR Morb Mortal Wkly Rep 54 Suppl: 27-30. MacDonald, R. D., B. Farr, et al. (2004). 'An emergency medical services transfer authorization center in response to the Toronto severe acute respiratory syndrome outbreak.' Prehosp Emerg Care 8(2): 223-31. Mandl, K. D., J. M. Overhage, et al. (2004). 'Implementing syndromic surveillance: a practical guide informed by the early experience.' J Am Med Inform Assoc 11(2): 141-50. Marx, M. A., C. V. Rodriguez, et al. (2006). 'Diarrheal illness detected through syndromic surveillance after a massive power outage: New York City, August 2003.' Am J Public Health 96(3): 547-53. Mikosz, C. A., J. Silva, et al. (2004). 'Comparison of two major emergency department-based free-text chief-complaint coding systems.' MMWR Morb Mortal Wkly Rep 53 Suppl: 101-5. Moore, K. (2004). 'Real-time syndrome surveillance in Ontario, Canada: the potential use of emergency departments and Telehealth.' Eur J Emerg Med 11(1): 3-11. Morton, A. P., M. Whitby, et al. (2001). 'The application of statistical process control charts to the detection and monitoring of hospital-acquired infections.' J Qual Clin Pract 21(4): 112-7. Muscatello, D. J., T. Churches, et al. (2005). 'An automated, broad-based, near real-time public health surveillance system using presentations to hospital Emergency Departments in New South Wales, Australia.' BMC Public Health 5: 141. Nakajima, H. (1997). 'Emerging infectious disease: global response, global alert.' Health Millions 23(2): 19. Nordin, J. D., M. J. Goodman, et al. (2005). 'Simulated anthrax attacks and syndromic surveillance.' Emerg Infect Dis 11(9): 1394-8. Payne, J. N. (1992). 'The introduction of a computerized system for notification and improved analysis of infectious diseases in Sheffield.' J Public Health Med 14(1): 62-7. Petersen, L. R., A. Ammon, et al. (2000). 'Developing national epidemiologic capacity to meet the challenges of emerging infections in Germany.' Emerg Infect Dis 6(6): 576-84. Pinzon, E., J. M. Wilson, et al. (2005). 'Climate-based health monitoring systems for eco-climatic conditions associated with infectious diseases.' Bull Soc Pathol Exot 98(3): 239-43. Platt, R., C. Bocchino, et al. (2003). 'Syndromic surveillance using minimum transfer of identifiable data: the example of the National Bioterrorism Syndromic Surveillance Demonstration Program.' J Urban Health 80(2 Suppl 1): i25-31. Reingold, A. (2003). 'If syndromic surveillance is the answer, what is the question?' Biosecur Bioterror 1(2): 77-81. Reis, B. Y. and K. D. Mandl (2003). 'Time series modeling for syndromic surveillance.' BMC Med Inform Decis Mak 3(1): 2. Reis, B. Y. and K. D. Mandl (2004). 'Syndromic surveillance: the effects of syndrome grouping on model accuracy and outbreak detection.' Ann Emerg Med 44(3): 235-41. Rigau-Perez, J. G., P. S. Millard, et al. (1999). 'A deviation bar chart for detecting dengue outbreaks in Puerto Rico.' Am J Public Health 89(3): 374-8. Rolland, E., K. M. Moore, et al. (2006). 'Using Ontario's 'Telehealth' health telephone helpline as an early-warning system: a study protocol.' BMC Health Serv Res 6: 10. Rossi, G., L. Lampugnani, et al. (1999). 'An approximate CUSUM procedure for surveillance of health events.' Stat Med 18(16): 2111-22. Shewhart, W. A. (1931). Economic Control of Quality of Manufactured Product. Londan, Macmillan. Sosin, D. M. (2003). 'Draft framework for evaluating syndromic surveillance systems.' J Urban Health 80(2 Suppl 1): i8-13. Stroup, D. F., S. B. Thacker, et al. (1988). 'Application of multiple time series analysis to the estimation of pneumonia and influenza mortality by age 1962-1983.' Stat Med 7(10): 1045-59. Stroup, D. F., M. Wharton, et al. (1993). 'Evaluation of a method for detecting aberrations in public health surveillance data.' Am J Epidemiol 137(3): 373-80. Stroup, D. F., G. D. Williamson, et al. (1989). 'Detection of aberrations in the occurrence of notifiable diseases surveillance data.' Stat Med 8(3): 323-9; discussion 331-2. Terry, W., B. Ostrowsky, et al. (2004). 'Should we be worried? Investigation of signals generated by an electronic syndromic surveillance system--Westchester County, New York.' MMWR Morb Mortal Wkly Rep 53 Suppl: 190-5. Thomson, J., M. Lin, et al. (1999). 'Australia's notifiable diseases status, 1998. Annual report of the National Notifiable Diseases Surveillance System.' Commun Dis Intell 23(11): 277-305. Timoney, P. J. (2000). 'The increasing significance of international trade in equids and its influence on the spread of infectious diseases.' Ann N Y Acad Sci 916: 55-60. Tsui, F. C., J. U. Espino, et al. (2003). 'Technical description of RODS: a real-time public health surveillance system.' J Am Med Inform Assoc 10(5): 399-408. Valleron, A. J. and P. Garnerin (1993). 'Computerised surveillance of communicable diseases in France.' Commun Dis Rep CDR Rev 3(6): R82-7. Voors, A. W. (1966). 'Data storage, retrieval, and reuse in epidemiologic studies.' Public Health Rep 81(12): 1092-4. Waters, W. F. (2001). 'Globalization, socioeconomic restructuring, and community health.' J Community Health 26(2): 79-92. Williamson, G. D. and G. Weatherby Hudson (1999). 'A monitoring system for detecting aberrations in public health surveillance reports.' Stat Med 18(23): 3283-98. Wu, T. S., P. I. Lee, et al. (2005). Rapid Enterovirus-71 Monitoring System - Using the Syndromic Surveillance System in Taiwan. Syndromic Surveillance Conference, Seattle, WA. Zeng, G., J. K. Zhang, et al. (1998). 'Infectious disease surveillance in China.' Biomed Environ Sci 11(1): 31-7. Zucs, A. P., J. Benzler, et al. (2005). 'Mandatory disease reporting by German laboratories: a survey of attitudes, practices and needs.' Euro Surveill 10(1): 26-7. 吳美滿 (1983). 評估我國傳染病報告系統. 公共衛生研究所, 國立臺灣大學. 疾病管制局 (2006). 定點醫師監視通報系統-系統簡介. 行政院衛生署疾病管制局. 陳志成 (1992). 建立臺灣地區以校園為基準的傳染病偵測系統. 公共衛生研究所, 國立臺灣大學. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/31961 | - |
dc.description.abstract | 台灣2003年發生嚴重急性呼吸道症候群的流行,造成民眾健康與經濟的重大損失。為改善傳統的傳染病偵測為被動式醫院通報的低時效性,本研究首度嘗試在台灣醫院急診建立具有高度時效性、自動化資料收集且能提供作為主動調查依據的症候群偵測系統。本研究包括兩部分:(一)建立全國性的189家醫院急診症候群偵測系統,並分析自2004年4月1日至2005年3月31日共2,692,325名來院病患的基本流行病學與經由國際疾病分類碼(international classification of diseases 9th revision, ICD-9)分組的症候群特徵;及(二)以台北市某醫院為例,建立區域性急診症候群偵測系統的日常運作流程、訊號調查、資料品質維護的以及採集病患檢體的『整合性工作流程』,分析自2005年10月1日至2006年4月30日共130,313人的急診症候群資料ICD-9碼型態,進行傳染病切實偵測並提出具體建議。
做法上,參考國外症候群偵測系統的研究經驗以及國內專家學者的建議,以國際疾病分類碼ICD9組成的11種急診症候群組進行分析,對於全國性急診症候群偵測系統各症候群數量均可獲知其年度流行趨勢,尤其冬季的腸胃道病患趨增,夏季也有呼吸道與類流感病患,且類腸病毒感染與每年多在六歲以下成兩波流行。另研究台灣急診來院病人症候群偵測系統資料,發現在周末或例假日時急診就醫病患的總數會有顯著的上升,約為平常日的1.3倍(p<0.001);農曆新年更是約為平常2倍的病患數量(p<0.001)。年齡分布上,以10歲以下幼兒(18.6%)和20-39歲青壯年(17.4%)最多,性別比為1.12:1,同台灣男女性別組成比仍以男多。由2004年7月開始的不同症候群病例數趨勢,發現發燒症候群、呼吸道症候群和類流感症候群的病例數均有逐漸上升現象,顯示台灣可能有夏季呼吸道疾病的流行,值得更進一步研究。因此針對類流行性感冒症候群的部份,特別回顧檢視2004年6月24日–7月28日兩週內的1,281份台北市某醫院C院區急診全部病歷,研究不同的國際疾病分類碼組合對於類流感病患偵測敏感度與特異度的影響,採用增加醫師較常用的類流感ICD-9碼及刪除氣喘、發燒、頭暈後組成後的症候群分組分析,其病例偵測敏感度可提陞為75.5%、特異度增加為84.4%,後續針對台北市類流感症候群病患的偵測,均採此新版本的症候群分組定義。 此外,由全國類腸病毒感染症候群的趨勢,發現以中部病例數上升時間早且最多,病例的年齡群和性別上並無數量變化的明顯差異,且病例數上升的較全國定點醫師偵測系統中的手足口症病例數量提早二週。在其他症候群上,發現消化道症候群自2004年11月起病患數量有逐漸上升的趨勢。此特殊的趨勢也可由台北市急診消化道症候群偵測系統的資料分析得到類似的結果,但台北市某醫院的資料會因不同院區別而有些許差異,顯示該醫院不同院區可能代表其區域性的不同。此外由台北市的30-39歲的男性類流感症候群數量增加的時間較其他年齡層早,顯示此年齡層對流感的社區傳播可能扮演部分重要的角色。 在台灣症候群偵測系統有限的歷史資料下,本研究探討歷史資料設限法與累積和流程控制法二種異常警示統計方法在症候群偵測系統資料分析的適用性,結果發現考慮週日別差異的歷史資料設限統計法之流行偵測敏感度約為67%,但累積和方法則對於資料基值變動過於敏感,以至於週末或假日時容易發生訊號,因此其適用性仍需更進一步改善,但現階段此二種統計方法均可快速地應用至公共衛生防疫工作,但仍需設法減少『偽警訊』。 症候群偵測系統與現有傳染病偵測系統相較下,具有良好的偵測時效性與系統彈性,並能提供公共衛生單位進行主動疫情調查的參考依據,且可作為跨領域研究整合以及防疫的基礎平台。未來應持續增加各項醫療資訊基礎建設、提陞公共衛生防疫專業人才的進用與素質,及改進不同的統計預測模型以發揮此系統最佳的偵測新興傳染病之宏效。 | zh_TW |
dc.description.abstract | According to the challenges of emerging infectious diseases (EID) and bioterrorist attack in the 21st Century, the traditional infectious disease surveillance systems have lacked active surveillance and failed to detect the 2001 anthrax attacks and the 2003 cross-country spread of severe acute respiratory syndrome (SARS) early. In order to establish scientific evidence-based active infectious disease surveillance system, we initiated a hospital emergency department (ED)-based timely and automatic syndromic surveillance system (ED-SSS) in Taiwan for the basis of further epidemiological investigation. Through the introduction of the real-time outbreak and disease reporting system (RODS) from the University of Pittsburg to Taiwan, we established both a nation-wide ED-SSS involving 189 hospitals and set up more integrative procedures of local ED-SSS for daily operation, signal investigation, checking data quality and specimens taken at one regional hospital with 5 branches in metropolitan Taipei. In this study, we built up the daily operation procedures to perform further implementation and signal investigation and conducted epidemiological syndrome data analysis, using two data set of ICD-9 codes of ED visits: (1) 2,692,325 visits of nation-wide ED-SSS in Taiwan, April 1, 2004 - March 31, 2005. (2) 130,313 visits in one regional Taipei hospital, October 1, 2005- April 30, 2006.
Daily patterns and trends of nation-wide ED-SSS ICD-9 codes involving 11 syndrome groups were analyzed, according to the international research experiences and recommendations of infectious disease experts in Taiwan. We found increasing trends in gastro-intestinal (GI) syndromes during winter season, and appearing peaks of respiratory or influenza-like illness (ILI) in summer periods, plus two waves of enterovirus (EV)-like infections under 6 years of age. In addition, striking increase of ED-visits were shown in weekends (1.3-fold p<0.001), and holidays, especially 2.0-fold higher during Chinese Lunar New Year (p<0.001). Most ED visits were children aged <10 y/o (18.6%) and 20-39 year-old young adults (17.4%). Male vs. female ED visits were 1.12:1. Starting from July of 2004, case numbers of fever, respiratory and ILI syndromes gradually increase, indicating possible presence of respiratory infections in Taiwan that had been seldom reported and worthwhile future investigating. Therefore, we examined the sensitivity, specificity and positive-predictive values of different ICD-9 code syndrome groupings of ILI cases from the 1,281 cases through medical charts review at C-hospital in Taipei, June 24, 2004 – July 8, 2004. The modified version of ILI syndrome that deleted asthma, fever and dizziness had 75.5% sensitivity and 84.4% specificity. We then applied it to detect ILI cases in Taipei ED-SSS. Increased numbers and earlier detected EVI syndrome cases of nation-wide ED-SSS were found in central Taiwan, but there was no significant difference in patterns by different age and gender groups. Compared with sentinel physicians’ hand-foot-mouth disease surveillance, the ED-SSS was 2 weeks earlier in detecting the increased EVI syndrome cases in Taiwan. Additionally, the Taipei X-Hospital ED-SSS also showed similar pattern. Among the patterns of other syndrome groups, GI syndrome cases in both nation-wide and Taipei ED-SSS increased from Nov. of 2004. On the other hand, Taipei X-Hospital ED-SSS with different branches showed regional differences. Moreover, 30-39 year-old male adults showed one week earlier in the increasing of ILI syndrome cases implying possible important transmission role in this age group in a metropolitan city. With the limit historical ED-SSS data, both historical control limits (HCL) using past four-week background data and cumulative sum (CUSUM) process control methods were used for our aberration detection and their required conditions in ED-SSS. The weekday and weekend stratified HCL method showed 67% sensitivity to detect the Taiwan-CDC identified outbreaks and the modified CUSUM method was too sensitive to demonstrate signals on weekends and holidays and needed to be improved due to its higher sensitivity for the changes of continuous baseline. Undoubtedly, both methods are applicable to public health use for immediate prevention and control of infectious diseases but they need further researches to reduce false signals. Evaluation of surveillance systems found that ED-SSS, providing more information for further epidemiological investigation, had the best timeliness and better flexibility to integrate with other database for multi-disciplinary research than other infectious disease surveillance systems existed. It can serve two-way frequent communications between public health agencies and medical departments. With the large baseline data of community health, it can also apply to research on other domains in public health. Future efforts are needed for continuous investment of medical informatics, to recruit more high quality infection control public health personnel, and to improve different statistical prediction models for maximizing effectiveness for early EID detection. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T03:26:01Z (GMT). No. of bitstreams: 1 ntu-95-R93842016-1.pdf: 3013970 bytes, checksum: ce3c296d0cf482d111a4bdc1bab75f59 (MD5) Previous issue date: 2006 | en |
dc.description.tableofcontents | 目錄 1
圖次目錄 3 表次目錄 7 致謝 9 中文摘要 10 英文摘要 11 第一章、 緒論 12 第一節、 傳染病偵測系統的發展與重要性 12 第二節、 研究目的 14 第三節、 研究假說 15 第二章、 文獻回顧 16 第一節、 傳統傳染病偵測系統的回顧 16 第二節、 症候群偵測系統的介紹 19 第三節、 世界各國症候群偵測系統發展現況 23 第四節、 台灣症候群偵測系統發展現況 28 第五節、 症候群偵測系統異常數量的統計方法 29 第六節、 症候群偵測系統評鑑方法 34 第三章、 研究材料與分析方法 39 第一節、 研究材料 39 一. 症候群偵測系統資料 39 1. 全國急診症候群偵測系統資料 39 2. 北市某醫院急診症候群偵測系統資料 39 二. 現有傳染病偵測系統資料 40 三. 政府公佈的已知爆發流行之資料 40 四. 急診就醫病患病歷回顧資料 40 五. 氣象與環境因子資料 41 第二節、 研究方法 42 一. 建立即時性急診為基礎的症候群偵測系統之方法 42 二. 資料存取方法與分析工具軟體 43 三. 建立症候群/疾病相關監測定義與疾病分類碼組合方法 45 四. 建立常規化監測流程 45 五. 統計分析方法 45 六. 系統評鑑工作方法 48 第四章、 結果 51 第一節、 建構症候群偵測系統之策劃與考量 51 第二節、 症候群偵測系統在公共衛生體系常規化運作的實務需求與流程 54 第三節、 症候群偵測系統的病患資料之臨床症候群組分析 58 一. 醫院急診症候群偵測系統之地理分布 58 二. 急診病患的臨床症候群組分析 58 1. 全國急診症候群偵測系統資料分析結果 59 2. 台北市某醫院急診症候群偵測系統資料分析結果 62 第四節、 類流感和類腸病毒感染的症候群定義與ICD-9碼組合分析之結果 67 一. 症候群/疾病監測定義與國際疾病分類碼組合之評鑑 67 二. 類流行性感冒症候群組描述流行病學分析結果 69 三. 類腸病毒感染症候群組描述流行病學分析結果 70 第五節、 異常警示統計方法比較 70 一. 歷史資料設限法異常警示統計結果與評鑑 71 二. 累積和製程管制統計法分析結果 72 第六節、 系統初步評鑑結果 74 第五章、 討論 79 第一節、 症候群偵測系統建立過程綜合討論 79 第二節、 症候群偵測的應用 81 第三節、 症候群偵測系統與現有系統比較評鑑及其適用性探討 84 第四節、 異常警示統計方法討論 86 第五節、 研究限制 87 第六章、 未來研究與公共衛生建議 88 參考文獻 91 圖表結果 96 附錄 162 附錄一、急診症候群偵測系統症候群國際疾病分類碼分組組合表 162 附錄二、國內外學術會議發表摘要 184 作者小傳 188 | |
dc.language.iso | zh-TW | |
dc.title | 建立臺灣地區急診為基礎的傳染病症候群偵測系統-ICD-9異常訊號偵測法、流行病學特徵、系統評比與建議 | zh_TW |
dc.title | Establishing Emergency Department-Based Infectious Disease Syndromic Surveillance System in Taiwan–Aberration Detection Methods, Epidemiological Characteristics, System Evaluation and Recommendations | en |
dc.type | Thesis | |
dc.date.schoolyear | 94-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 何美鄉(Mei-Shang Ho),黃景祥(Jing-Shiang Hwang),李文宗(Wen-Chung Lee),李秉穎(Ping-Ing Lee),方啟泰(Chi-Tai Fang),陳宜君(Yee-Chun Chen) | |
dc.subject.keyword | 症候群偵測,傳染流行病學,偵測系統評鑑,醫療資訊,國際疾病分類碼,警示統計法,新興傳染病,腸病毒感染,流行性感冒,國家安全,臺灣公共衛生, | zh_TW |
dc.subject.keyword | Syndromic Surveillance,Emerging Infectious Diseases,Infectious Disease Epidemiology,Evaluation of Surveillance System,Medical Informatics,ICD-9 Codes,Early Detection Statistical Modeling,Enterovirus,Influenza,National Security,Taiwan Public Health, | en |
dc.relation.page | 188 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2006-07-29 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
文件中的檔案:
檔案 | 大小 | 格式 | |
---|---|---|---|
ntu-95-1.pdf 目前未授權公開取用 | 2.94 MB | Adobe PDF |
系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。