Poor multi-rater reliability in TCM pattern diagnoses and variation in the use of symptoms to obtain a diagnosis

• Published in: Acupuncture in medicine : journal of the British Medical Acupuncture Society 2014-08, Vol.32 (4), p.325-332
• Main Authors: Birkeflet, Oddveig, Laake, Petter, Vøllestad, Nina K
• Format: Article
• Language: English
• Subjects: Adult; Cross-Sectional Studies; Diagnosis, Differential; Female; Humans; Infertility, Female - diagnosis; Medicine, Chinese Traditional - standards; Physicians; Reproducibility of Results; Symptom Assessment - standards; Young Adult
• ISSN: 0964-5284; 1759-9873
• DOI: 10.1136/acupmed-2013-010473

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