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Journal of Chinese Integrative Medicine ›› 2009, Vol. 7 ›› Issue (1): 20-24.doi: 10.3736/jcim20090103

Special Issue: Traditional Chinese Medicine

• Original Clinical Research • Previous Articles     Next Articles

Development and evaluation of an inquiry scale for diagnosis of heart system syndromes in traditional Chinese medicine

 Guo-ping Liua, Yi-qin Wanga, Ying Donga, Nai-qing Zhaob, Zhao-xia Xua, Fu-feng Lia, Hai-xia Yana,Peng Qian a, Rui Guoa, Xiao-dan Zhanga, Dan Dia   

  1. a Laboratory of Syndromes of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
    b Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, Shanghai 200032, China
  • Received:2008-07-28 Accepted:2008-09-29 Online:2009-01-20 Published:2009-01-15

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Objective

To develop an inquiry scale for diagnosis of heart system syndromes, and to discuss the provisional standardization of the inquiry method in traditional Chinese medicine (TCM).
Methods

Based on scale-making method, Chinese medicine theory and literature searching, an inquiry scale for diagnosis of heart system syndromes in TCM was developed. Statistics method, frequency counting and Delphi method were used for analysis. The inquiry scale was revised and tested repeatedly to check the test reliability, internal consistency reliability, and content validity, etc.
Results

The inquiry scale for diagnosis of heart system syndromes mainly covered basic data, chief complaint, history of present illness (accompanying symptoms) and past history, with appendix of inspection and palpation information as well as diagnosis made according to traditional Chinese and Western medicine. Among them, general inquiries covered fever and chills, sweating, head-body and chest-belly symptoms, taste and diet, stool and urine, sleep, mood, and gynecologic symptoms, which were scaled in 8 dimensions. And 66 symptom variables were screened finally. The scale had a good content validity and its coefficient alpha was 0.82. For the results of test-retest reliability, the Kappa values of using the scale for diagnosis of heart-qi deficiency, heart-yang deficiency, turbid phlegm, and cold coagulation twice by the same doctor ranged from 0.74 to 1, showing that the consistency of the scale was relatively high. The Kappa values of evaluation of scorer reliability in diagnosis of heart-qi deficiency, heart-yang deficiency, and heart-yin deficiency were also high, which were 0.63, 0.72, 1 and 0.48 respectively. Other results of diagnosis had low-consistency or even no diagnostic agreement.
Conclusion

The research on the scale for inquiry in TCM indicates that it is feasible for the standardization of inquiry scale for diagnosis of heart system syndromes in TCM, offering a reference for research on the inquiry scales for other systems.

Key words: Inquiring, Heart symptom complex, Scale

Table 1

Consistency of syndrome diagnosis in traditional Chinese medicine"

Syndrome Kappa value 95% confidence interval
Heart-qi deficiency 0.69 0.42-0.96
Heart-yang deficiency 0.80 0.52-1.00
Heart-yin deficiency 0.28 0.06-0.50
Heart-blood deficiency 0.33 0.08-0.58
Turbid phlegm 0.78 0.52-1.00
Blood stasis 0.33 0.08-0.58
Qi stagnation 0.54 0.19-0.89
Flaring heart-fire 0.52 0.17-0.86
Cold coagulation 0.72 0.34-1.00

Figure 2

Reliability of the scorer"

Syndrome Kappa value 95% confidence interval
Heart-qi deficiency 0.63 0.26-0.91
Heart-yang deficiency 0.72 0.42-1
Heart-yin deficiency 0.48 0.21-0.77
Heart-blood deficiency 1.00 –
Turbid phlegm 0.03 –0.03-0.12
Blood stasis 0.14 –7.57×10-17-0.33
Qi stagnation 0.17 –0.06-0.46
Flaring heart-fire – –
Cold coagulation – –
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