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乳癌攝影篩檢制度之統計議題 = A Study of Statistic...

國立高雄大學統計學研究所

乳癌攝影篩檢制度之統計議題 = A Study of Statistics Problems in the Screening of Mammography

Record Type:	Language materials, printed : monographic
Paralel Title:	A Study of Statistics Problems in the Screening of Mammography
Author:	黃建銓,
Secondary Intellectual Responsibility:	國立高雄大學
Place of Publication:	[高雄市]
Published:	撰者;
Year of Publication:	民99[2010]
Description:	41面圖，表 : 30公分;
Subject:	乳房X光攝影檢查
Subject:	mammography screening
Online resource:	http://handle.ncl.edu.tw/11296/ndltd/62664533556179021112
Summary:	為了讓乳癌病患能夠即早發現並加以接受治療，乳房X光攝影檢查是目前可行且有效發現早期癌症的檢測方法。然而不同於一般可經由檢測機器提供具體數據作為判斷依據，因此醫師的判讀能力在此檢測上扮演著重要角色。國民健康局於民國91年分階段實施50歲到69歲婦女每兩年一次的免費乳房X光攝影篩檢，同時也對參與協助檢測的醫師建立覆判機制，以求維持醫師判讀能力。在民國92年，針對篩檢為陽性個案的醫師進行判讀準確度分析，目的是希望能將偽陽性控制在合理範圍，降低不必要的醫療資源及病患的困擾。由於前幾年在此覆判機制下的成效略有小成，因此在民國96年，再針對篩檢結果判斷為陰性個案的醫師部份做分析，目的是為了降低偽陰性比率。根據前幾年的分析已有穩定結果，到了民國97年，便同時分別針對篩檢結果判斷為陽性個案與陰性個案的醫師實行判讀分析，在覆判階段總共約有1萬張攝影片接受覆判醫師判讀。由於民國96、97年總篩檢量分別約有13萬、15萬人，為了讓醫療資源能有效的被使用，因此利用recall rate作為抽陽性攝影片或抽陰性攝影片的準則。此一覆判機制，主要目的是想要維持覆判醫師在判讀準確度能夠具有一致性且有效提升初判醫師的判讀能力。在本研究中，主要是針對覆判的檢測機制來探討其統計性質。 In order to be diagnosed immediately and treated for breast cancer patients. So far, mammography screening is the most reliable method for early detection of breast cancer and it is useful. However, this detection method can not directly supply a specific data as the basis for determining, so the ability of breast cancer diagnosing of doctor plays an important role in detection. Department of Health, ROC, in year 2002, supplies free mammography screening every two years for 50-year-old to 69-year-old females in stages. At the same time, they establish a re-diagnosing mechanism for the participating doctors which are used to maintain the ability of breast cancer diagnosing of doctor. In year 2003, in order to reduce the waste of medical resources and avoid patient anxiety, the project aim to control the false-positive rate in a reasonable range. Due to the control of the false-positive rate reaches the target, in year 2007, the project change the policy to maintain the false-negative rate. According to the experiment of previous years, the control of the rate of both false-positive and false-negative has been stabilized. In year 2008, the re-diagnosing pay attention in both sides simultaneously. There are about 10,000 photographic films which is used to determine by re-diagnosing doctors. In order to effectively use the medical resources, the recall rate is considered as the principle of sampling. In the thesis, we review the knowledge of mammography screening and study the statistical properties of the re-diagnosing mechanism.

乳癌攝影篩檢制度之統計議題 = A Study of Statistics Problems in the Screening of Mammography
黃, 建銓

乳癌攝影篩檢制度之統計議題 = A Study of Statistics Problems in the Screening of Mammography / 黃建銓撰 - [高雄市] : 撰者, 民99[2010]. - 41面 ; 圖，表 ; 30公分.
參考書目：面.
乳房X光攝影檢查mammography screening

乳癌攝影篩檢制度之統計議題 = A Study of Statistics Problems in the Screening of Mammography
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330 $a 為了讓乳癌病患能夠即早發現並加以接受治療，乳房X光攝影檢查是目前可行且有效發現早期癌症的檢測方法。然而不同於一般可經由檢測機器提供具體數據作為判斷依據，因此醫師的判讀能力在此檢測上扮演著重要角色。國民健康局於民國91年分階段實施50歲到69歲婦女每兩年一次的免費乳房X光攝影篩檢，同時也對參與協助檢測的醫師建立覆判機制，以求維持醫師判讀能力。在民國92年，針對篩檢為陽性個案的醫師進行判讀準確度分析，目的是希望能將偽陽性控制在合理範圍，降低不必要的醫療資源及病患的困擾。由於前幾年在此覆判機制下的成效略有小成，因此在民國96年，再針對篩檢結果判斷為陰性個案的醫師部份做分析，目的是為了降低偽陰性比率。根據前幾年的分析已有穩定結果，到了民國97年，便同時分別針對篩檢結果判斷為陽性個案與陰性個案的醫師實行判讀分析，在覆判階段總共約有1萬張攝影片接受覆判醫師判讀。由於民國96、97年總篩檢量分別約有13萬、15萬人，為了讓醫療資源能有效的被使用，因此利用recall rate作為抽陽性攝影片或抽陰性攝影片的準則。此一覆判機制，主要目的是想要維持覆判醫師在判讀準確度能夠具有一致性且有效提升初判醫師的判讀能力。在本研究中，主要是針對覆判的檢測機制來探討其統計性質。 In order to be diagnosed immediately and treated for breast cancer patients. So far, mammography screening is the most reliable method for early detection of breast cancer and it is useful. However, this detection method can not directly supply a specific data as the basis for determining, so the ability of breast cancer diagnosing of doctor plays an important role in detection. Department of Health, ROC, in year 2002, supplies free mammography screening every two years for 50-year-old to 69-year-old females in stages. At the same time, they establish a re-diagnosing mechanism for the participating doctors which are used to maintain the ability of breast cancer diagnosing of doctor. In year 2003, in order to reduce the waste of medical resources and avoid patient anxiety, the project aim to control the false-positive rate in a reasonable range. Due to the control of the false-positive rate reaches the target, in year 2007, the project change the policy to maintain the false-negative rate. According to the experiment of previous years, the control of the rate of both false-positive and false-negative has been stabilized. In year 2008, the re-diagnosing pay attention in both sides simultaneously. There are about 10,000 photographic films which is used to determine by re-diagnosing doctors. In order to effectively use the medical resources, the recall rate is considered as the principle of sampling. In the thesis, we review the knowledge of mammography screening and study the statistical properties of the re-diagnosing mechanism.
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