以不同統計方式建構精神分裂症療效之早期預測模式的優劣性比較

Comparing the Superiority of Early Prediction Model for Treatment Response of Schizophrenia Established by Different Statistical Methods

吳姿頤(Tzu-I Wu)

指導教授 ： 張玉坤

淡江大學/理學院/數學學系碩士班/碩士(2007年)

https://doi.org/10.6846/TKU.2007.00883

摘要

精神分裂症的治療療程至少需持續4-8週，因為疾病的複雜性與病人對藥物反應的差異性，醫師很難在治療前依據病人臨床症狀與個人特質來評估病人對藥物反應的結果，為了避免病人接受無療效的藥物治療，建構一個可靠的療效預測模式顯得很重要。
精神分裂症的治療療效是根據一些評估量表分數的變化做評估，例如簡短精神症狀評量表與活性與退化性症狀評量表。本文即比較兩種統計方法建構預測模式的優劣性，第一種是用Multiple Linear Regression直接對量表分數建構預測模式，然後再根據病人的預測分數判斷其是否有達到比治療前分數下降超過20%，依此預測出病人是否有療效。第二種是先判斷若治療後的量表分數比治療前下降20%為有效，否則為無效，然後利用Multiple Logistic Regression建立預測模式。再利用Chang et al [2006]所提出的方法預測出病人的療效。
我們在幾種不同的情況下比較兩種預測方式的診斷準確度，結果顯示，用線性迴歸預測時會出現將量表分數預測偏低的情況，造成sensitivity高但是specificity很低的結果。而用邏輯式迴歸做出的預測結果，specificity比另外一種方法高但是sensitivity較低。比較兩種預測方法的ROC曲線下面積，邏輯式迴歸預測法都高於線性迴歸預測法

關鍵字

精神分裂症 ； 線性迴歸 ； 邏輯式迴歸

並列摘要

The therapeutic period of schizophrenia needs to last at least for 4 to 8 weeks. Because of the complexity of the disease and the diversity medical responses of patients, it is hard for doctors to evaluate the results of medical response of patients by clinical symptoms and individualities before the treatments. It is intensely important to establish an authentic remedy prediction model in order to avoid the patients to accept ineffective medical treatments.
The evaluation of the therapeutic effects on schizophrenia is based on the score variation of the certain evaluated scales, for example, Brief Psychiatric Rating Scale and Positive and Negative Syndrome Scale. In the present study, we compared two statistic methods to establish the pros and cons of prediction model. The first statistic method used multiple linear regression to establish prediction model directly by the scores of the scale. The second method determined its effectiveness first. If the scale score after the treatment decreases 20% or more compared with the baseline scale score, the result represents the treatment is effective; otherwise, the treatment is ineffective. Thereafter, we used multiple logistic regression to establish prediction model and then used the method which is brought up by Chang et al. [2006] to predict the effectiveness of the treatment for patients.
We compared the diagnostic accuracy of two different prediction methods under various circumstances. As the results from the study, when multiple linear regression was used, the predicted scores of the scale tended to be underestimated. The results represented that multiple linear regression has higher sensitivity but lower specificity. However, the predicted results done by logistic regression has higher specificity but lower sensitivity compare to the results of multiple linear regression.And we compared the areas under the ROC curve of two prediction methods, the area is larger when we use multiple logistic regression to establish a prediction model.

並列關鍵字

Schizophrenia ； Multiple Linear Regression ； Multiple Logistic Regression

參考文獻

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