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利用基于规则的方法发现全膝关节置换术(TKA)中的医疗资源利用情况。

Discovering medical resource utilization in total knee arthroplasty (TKA) using rule-based method.

机构信息

Department of Orthopedics, Jiannren Hospital, 136, Nanyang Rd., Nanzih District, Kaohsiung 811, Taiwan.

出版信息

Arch Gerontol Geriatr. 2012 Jul-Aug;55(1):157-64. doi: 10.1016/j.archger.2011.07.002. Epub 2011 Aug 2.

Abstract

TKA is a highly effective means of treating (advanced knee arthritis) degenerative joint disease. Previous studies have demonstrated that a high surgical volume for total joint arthroplasty reduces morbidity and improved economic outcome, these methods for themselves are fraught with complexity, uncertainty and non-linear problem in terms of medical datasets may be unable to more accurately finding important information. As medical datasets often include a large number of features (attributes), some of which are irrelevant, and therefore it cannot intuitively understand the corresponding to main factors which affecting the resource utilizations of healthcare. In order to solve the problems mentioned above, this study employs specialist advice to filter relevant cases (records) and proposed an integrated five features selection methods to select the important features. Based on rough set theory (RST), the rules are extracted and compared with other methods in terms of accuracy. The contributions contain: (1) data screening based on specialist opinions, (2) two stage feature selection by analysis of variance (ANOVA) and proposed an integrated feature selection approach (IFSA), and (3) data discretization and rule generation by RST. The proposed model is verified by using three datasets for comparison accuracy. The results can provide a valuable reference for National Health Insurance Bureau (NHI) in establishing the TKA standard.

摘要

TKA 是治疗(晚期膝关节关节炎)退行性关节疾病的一种非常有效的方法。先前的研究表明,全关节置换术的高手术量可降低发病率并改善经济结果,但这些方法本身存在复杂性、不确定性和非线性问题,对于医疗数据集而言,可能无法更准确地找到重要信息。由于医疗数据集通常包含大量特征(属性),其中一些是不相关的,因此无法直观地了解影响医疗保健资源利用的主要因素。为了解决上述问题,本研究采用专家意见来筛选相关病例(记录),并提出了一种综合的五种特征选择方法来选择重要特征。基于粗糙集理论(RST),提取规则并与其他方法进行准确性比较。贡献包括:(1)基于专家意见的数据筛选,(2)基于方差分析(ANOVA)的两阶段特征选择和提出的综合特征选择方法(IFSA),以及(3)通过 RST 进行数据离散化和规则生成。通过比较准确性,使用三个数据集对所提出的模型进行了验证。结果可为国家健康保险局(NHI)制定 TKA 标准提供有价值的参考。

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