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Poor multi-rater reliability in TCM pattern diagnoses and variation in the use of symptoms to obtain a diagnosis.
MedLine Citation:
PMID:  24809366     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Pattern differentiation and diagnosis are fundamental principles of Traditional Chinese Medicine (TCM). Studies have shown low inter-rater reliability in TCM pattern diagnoses. This variability may originate from both the identification and the interpretation of symptoms and signs.
OBJECTIVE: To examine the inter-rater reliability in TCM pattern diagnoses made in the style of Maciocia for 25 case histories by eight acupuncturists and to explore the impact of demographic factors on the diagnostic conclusion. Further, the association between the diagnosis and the presence of symptoms was examined for a single TCM diagnosis.
METHODS: Eight acupuncturists independently diagnosed 25 women (15 fertile, 10 infertile) based on written case histories. Descriptive statistics, logistic regression and inter-rater reliability (κ) were used.
RESULTS: Poor inter-rater reliability on TCM patterns (κ<0.20) and large variation in the number of TCM pattern diagnoses were found. Sex, duration of practice and education had a highly significant effect (p<0.001) on the use of TCM patterns and working hours had a significant effect (p=0.029). There was considerable intra- and inter-rater variation in the use of symptoms to make a diagnosis. Symptoms occurring frequently as well as infrequently were inconsistently used to diagnose Liver Qi Stagnation. The study was limited by a small sample size.
CONCLUSIONS: The results showed extensive variation and poor inter-rater reliability in TCM diagnoses. Demographic variables influenced the frequency of diagnoses and symptoms were used inconsistently to set a diagnosis. The variability shown could impede individually tailored treatment.
Authors:
Oddveig Birkeflet; Petter Laake; Nina K Vøllestad
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-8
Journal Detail:
Title:  Acupuncture in medicine : journal of the British Medical Acupuncture Society     Volume:  -     ISSN:  1759-9873     ISO Abbreviation:  Acupunct Med     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304117     Medline TA:  Acupunct Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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