Agreements among traditional Chinese medicine practitioners in the diagnosis and treatment of irritable bowel syndrome

• Published in: Alimentary pharmacology & therapeutics Vol. 20; no. 10; pp. 1205 - 1210
• Main Authors: Sung, J. J. Y., Leung, W. K., Ching, J. Y. L., Lao, L., Zhang, G., Wu, J. C. Y., Liang, S. M., Xie, H., Ho, Y. P., Chan, L. S., Berman, B., Chan, F. K. L.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 15.11.2004; Blackwell
• Subjects: Adult; Allied Health Personnel - standards; Biological and medical sciences; Consensus; Digestive system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Irritable Bowel Syndrome - diagnosis; Irritable Bowel Syndrome - therapy; Male; Medical sciences; Medicine, Chinese Traditional - standards; Middle Aged; Observer Variation; Pharmacology. Drug treatments; Physical Examination; Asia; China; Treatment; Folk medicine; General practitioner; Irritable bowel syndrome; Digestive diseases; Intestinal disease; Diagnosis
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2004.02242.x

Summary Background : Traditional Chinese Medicine was frequently used by patients with irritable bowel syndrome. Aim : To evaluate the agreement on diagnoses and prescription of irritable bowel syndrome among Traditional Chinese Medicine practitioners. Methods : Consecutive irritable bowel syndrome patients were interviewed independently by four Traditional Chinese Medicine practitioners. The study was divided into three phases: (i) blinded individual assessment, (ii) discussion to achieve consensus on diagnosis and treatment, (iii) individual assessment based on consensual diagnostic criteria. Patients with other causes of diarrhoea were recruited as controls in phase (iii). Percentage agreement and kappa‐value in diagnosis, treatment principle and regime were determined. Results : Thirty‐nine irritable bowel syndrome patients were assessed in phase (i) whereas 65 irritable bowel syndrome patients and 17 non‐irritable bowel syndrome controls were studied in phase (iii). The mean agreement rates in diagnosis, treatment principle and regimen were: 57, 58 and 52% for phase (i) and 80, 81 and 80% for phase (iii) (P = 0.002). Accordingly, there was significant improvement in the mean kappa‐values in diagnosis (0.11–0.34, P = 0.015) and treatment principle (0.16–0.37, P = 0.002) but not in treatment regime. Conclusions : Variations in diagnosis and treatment principles do exist among Traditional Chinese Medicine practitioners. Concordant diagnosis can be reached by mutual understanding and converging opinion among Traditional Chinese Medicine practitioners.