Concordance of Diagnosis Based on Zangfu-Organs Syndrome Differentiation by Clinicians of Traditional Chinese Medicine

Objective: We aimed to assess concordance of Zangfu-organs Syndrome Differentiation by evaluating the concordance of successive diagnosis by the same clinician of traditional Chinese medicine (TCM) and that of diagnosis by different clinicians of TCM. Methods: Twenty-five cases were randomly selected and 2 copies were made from the numerical data collected through Inquiry Scale for Diagnosis of Heart System Syndromes made by our research team. The copies were disorganized and renumbered form 1 to 50. In order to evaluate the concordance of successive diagnosis by the same clinician, 2 TCM experts were invited to differentiate the syndrome and diagnose for the 50 cases by double-blind method. Fifteen cases were randomly selected. Three TCM clinicians were invited to make a diagnosis basing on Zangfu-organs syndrome differentiation, in order to evaluate the concordance of diagnosis by different clinicians. Kappa test was adopted. Results: For the same case scale, the results of successive diagnosis by the same clinician showed that, Kap concordance coefficient for syndrome of deficiency of heart qi was 0.69, that for syndrome of deficiency of heart yang was 0.80, that for syndrome of deficiency of heart yin was 0.28, that for syndrome of deficiency of heart blood was 0.33, that for syndrome of turbid phlegm was 0.78, that for syndrome of blood stasis was 0.33, that for syndrome of qi stagnation was 0.54, that for syndrome of hyperactivity of heart fire was 0.52, and that for syndrome of cold coagulation was 0.72. The results of diagnosis by different clinicians showed that, Kap concordance coefficient for syndrome of deficiency of heart qi was 0.63, that for syndrome of deficiency of heart yang was 0.72, that for syndrome of deficiency of heart yin was 0.48, that for syndrome of turbid phlegm was 0.03, that for syndrome of blood stasis was 0.14, and that for syndrome of qi stagnation was 0.17. Conclusion: Diagnosis by the same clinician and different clinicians varied, indicating a poor concordance of diagnosis basing on Zangfu-organs syndrome differentiation.