在現代的社會裡，偏頭痛屬於一種常見的病症，為了提升診斷的精確性，在偏頭痛的治療過程中需要病患作頭痛日記，醫師便可依據日記的內容作後續的診斷以及追蹤，但由於醫院所提供的為紙本頭痛日記，對於長期頭痛的患者來說，大量的日記反而不易攜帶且容易出現保存不易等問題，所以本研究提出建構一套用於偏頭痛的行動醫療應用程式，雖然在市面上也有許多類似的頭痛日記的應用程式，但實際被運用在醫院的應用程式非常少，美國的FDA有特別針對行動醫療應用程式立出相關法規，而台灣也有相關的參考指引，利用電子頭痛日記將病患的日記資料化，可將其上傳並保存至資料庫，除了智慧型行動裝置上可以顯示記錄頭痛記錄，也支援Web前端介面顯示，方便數據儲存及可供為後續研究需要，利用電子頭痛日記內自動統計的數據，方便醫師閱讀並減少閱讀日記時間進而提高醫師看診效率及提升下診斷時的準確度；研究後期則利用問卷調查的方式來驗證此電子日記App是否有達到本論文的研究目的以及後續的分析結果。

In this modern society, migraine belongs to a kind of common disease. In order to improve the accuracy of diagnosis, the patients need to keep diaries of headache in the treatment of migraine. The physicians can make a diagnosis and keep tracking according to the diaries. Some of hospitals may provide patients with paper diary to record but paper diary is not easy to be carried and be saved for patients who have long time headache. As a result, this research constructs a special mobile medical application (APP or App) for migraine and cooperates with the Neurology Department in Taipei Veterans General Hospital. Though there are many APPs in Google Play or APP Store which functions are similar to headache diary, the small number of APPs which can be used authentically in hospitals. The App diary can transform patients’ headache diaries to electronic data which will be uploaded to database to be saved. The diary records are displayed not only on mobile platforms (e.g. smartphones, tablet computers) but also on user interface which is the web server. It can be used to help doing other researches about migraine which need to collect heavy headache data in the future. On the other hand, the physicians improve the efficiency of treatment and the accuracy of diagnosis, because they can use the data which have been automatically counted in the App diary. The purpose in this research: time of reading diary reduced and improving efficiency of diagnosis, solving problems of paper diary for example not easy to keep, read and carry outside, uploading headache diary to database and providing these data to be analyzed. The later part of research, using questionnaires to corroborate the APP is whether to affect the purpose in this paper and other analyses.

Chapter 1. Introduction ............................... 1
1.1 General Background Information .................... 1
1.2 Research Motive ................................... 5
1.3 Research Purpose .................................. 6
Chapter 2. Literature Review .......................... 9
2.1. eHealth .......................................... 9
2.2. Mobile Medical App .............................. 15
2.3. Migraine ........................................ 23
2.4. Biostatistics ................................... 32
Chapter 3. Research Methods .......................... 34
3.1. Research Process ................................ 34
3.2. App Diary ....................................... 37
3.3. The Usage Survey Investigation of App Diary ..... 42
Chapter 4. Results ................................... 47
4.1. App Diary ....................................... 47
4.2. The Results of Usage Survey Investigation of App Diary ................................................ 62
Chapter 5. Conclusion & Future Research .............. 80
5.1 Conclusion ....................................... 80
5.2 Future Research .................................. 82
References ........................................... 83
Appendix ............................................. 90


List of Figures
Figure 1 Conceptual Framework of Thesis ............................................................... 8
Figure 2 The Situation of ERH Pursued [24] .......................................................... 12
Figure 3 Headache Diary from Taiwan Headache Society .................................... 30
Figure 4 Research Process Flowchart ...................................................................... 35
Figure 5 The System Framework of App Diary ...................................................... 40
Figure 6 The Flow Chart of Collecting Research Questionnaire .......................... 43
Figure 7 The System Functions Chart in App Diary .............................................. 49
Figure 8 The Main User Interface in App Diary .................................................... 50
Figure 9 Light Signals of Headache Levels and Other Conditions ....................... 50
Figure 10 The Record Page of Headache ................................................................. 51
Figure 11 The Page of Drug Management ............................................................... 54
Figure 12 The Page of Statistical Analysis ............................................................... 56
Figure 13 The Flow Chart of “Upload Data” .......................................................... 58
Figure 14 The Page of "Week Chart" ...................................................................... 60
Figure 15 The Page of "7-Days Chart".................................................................... 60
Figure 16 The Page of "Form View" ....................................................................... 60
Figure 17 The Age Distribution of Participants ...................................................... 63
Figure 18 The Brands of Smart Phones Which Are Used by Participants........... 65
VI
Figure 19 The Statistics of the Time of Physicians Read Diary on App and Paper.............................................................................................................................. 71


List of Tables
Table 1 Specifications and Examples on FDA [8] ................................................... 17
Table 2 Descriptions and Examples about Low Risk Medical Devices [8] ........... 18
Table 3(a) Descriptions and Examples about Nine Software [10] ......................... 20
Table 3(b) Descriptions and Examples about Nine Software [10] ....................... 21
Table 4 Classification of Migraine............................................................................ 25
Table 5 Standard of Migraine with Aura and Migraine without Aura Diagnosis [39] ....................................................................................................................... 26
Table 6 Classification and Descriptions in Questionnaire ..................................... 45
Table 7 Return Messages of Checking Conditions of Sign in ................................ 53
Table 8 Descriptions of Warning Message in Checking Basic Information ......... 54
Table 9 Sex Ratio of Participants ............................................................................. 63
Table 10.The Job Distribution of Participants ........................................................ 64
Table 11 Descriptive Statistics of MIDAS (one month version) ............................ 65
Table 12 Rate of Participants Who Think Recording Headache in the Diary Is an Important Thing................................................................................................. 67
Table 13 Rate of Participants Think How the Accuracies of Headache Diaries Which Are Recorded by Themselves ............................................................... 68
Table 14 Rate of Participants Think App Diary Is Used More Conveniently Than Paper Diary or Not............................................................................................. 68
Table 15 Rate of the Speed of Physicians Read Diaries on App Is Faster Than Read on Paper or Not ........................................................................................ 69
Table 16 Cross-Tabulation of "Gender" * "Which Time You Record Headache?" ........................................................................................................ 72
Table 17 Chi-Square Tests of "Gender" * "Which Time You Record Headache?" ........................................................................................................ 73
Table 18 Cross-Tabulation of "Ages" * "If You Spend Long Time Using Smart Phone, Your Headache Becomes More Serious or Not" ................................ 75
Table 19 Chi-Square Tests of "Ages" * "If You Spend Long Time Using Smart Phone, Your Headache Becomes More Serious or Not" ................................ 75
Table 20 Cross-Tabulation of "Ages" * "The Accuracies of Headache Diaries" 77
Table 21 Chi-Square Tests of "Ages" * "The Accuracies of Headache Diaries" 77
Table 22 Descriptive Statistic of "MIDAS" * "Using App Diary to Record Headache Is Convenient or Not" ...................................................................... 79
Table 23 The ANOVA of "MIDAS" * "Using App Diary to Record Headache Is Convenient or Not" ............................................................................................ 79

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