BACKGROUND: Treatment of patients according to individual pattern diagnoses is an important feature of acupuncture rooted in traditional Chinese medicine (TCM). Little is known about the reliability of TCM pattern diagnoses. OBJECTIVE: To examine in a cross-sectional study the inter-rater reliability of TCM diagnoses and acupuncture point selection. METHODS: 30 infertile and 24 previously pregnant women were examined for TCM patterns by two acupuncturists. An operational interview guide related to gynaecology was used. The acupuncturists independently decided on the TCM patterns (categorised as excess, deficiency and merged patterns) and the prescription of acupuncture points. Kappa Statistics were used in the analyses. RESULTS: 39 different TCM patterns and 36 different acupuncture points were used. For the choice of acupuncture points, poor to no agreement was found. Moderate to fair agreement was seen in excess/deficiency and merged patterns. Perfect match to moderate agreement on treatment was obtained when choosing meridians given certain TCM patterns. CONCLUSIONS: The low agreement on diagnoses indicates that acupuncturists follow individual pattern differentiation processes. The selection of acupuncture points seem to be closely related to the choice of TCM pattern diagnoses. The results indicate that the poor reliability in the diagnoses and thus treatment received by a patient will vary individually, which in turn is a challenge for clinical trials of acupuncture.
BACKGROUND: Treatment of patients according to individual pattern diagnoses is an important feature of acupuncture rooted in traditional Chinese medicine (TCM). Little is known about the reliability of TCM pattern diagnoses. OBJECTIVE: To examine in a cross-sectional study the inter-rater reliability of TCM diagnoses and acupuncture point selection. METHODS: 30 infertile and 24 previously pregnant women were examined for TCM patterns by two acupuncturists. An operational interview guide related to gynaecology was used. The acupuncturists independently decided on the TCM patterns (categorised as excess, deficiency and merged patterns) and the prescription of acupuncture points. Kappa Statistics were used in the analyses. RESULTS: 39 different TCM patterns and 36 different acupuncture points were used. For the choice of acupuncture points, poor to no agreement was found. Moderate to fair agreement was seen in excess/deficiency and merged patterns. Perfect match to moderate agreement on treatment was obtained when choosing meridians given certain TCM patterns. CONCLUSIONS: The low agreement on diagnoses indicates that acupuncturists follow individual pattern differentiation processes. The selection of acupuncture points seem to be closely related to the choice of TCM pattern diagnoses. The results indicate that the poor reliability in the diagnoses and thus treatment received by a patient will vary individually, which in turn is a challenge for clinical trials of acupuncture.
Authors: Eric Jacobson; Lisa Conboy; Dolma Tsering; Monica Shields; Patrick McKnight; Peter M Wayne; Rosa Schnyer Journal: J Altern Complement Med Date: 2019-11 Impact factor: 2.579
Authors: Wendy Wong; Cindy Lo Kuen Lam; Vivian Taam Wong; Zhi Min Yang; Eric T C Ziea; Andrew Ka Lun Kwan Journal: Evid Based Complement Alternat Med Date: 2013-04-24 Impact factor: 2.629
Authors: Suzanne J Grant; Rosa N Schnyer; Dennis Hsu-Tung Chang; Paul Fahey; Alan Bensoussan Journal: Evid Based Complement Alternat Med Date: 2013-05-09 Impact factor: 2.629