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KMID : 0644120190320020029
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Journal of Oriental Gynecology
2019 Volume.32 No. 2 p.29 ~ p.49
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A Clinical Study on the Pattern-Specific Cut-Point for the Pattern Identification Diagnostic Tool for Climacteric and Postmenopausal Syndrome
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Lee In-Seon
Kim Jong-Won
Jeon Soo-Hyung
Chi Gyoo-Yong
Kang Chang-Wan
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Abstract
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Objectives: This study is part of the 'Development of Clinical Practice Guideline for Climacteric and Postmenopausal Syndrome’ supported by Ministry of Health and Welfare and the Korea Health Industry Development Institute (KHIDI). This study was a methodological study to verify the reliability and validity and to make a diagnosis of a pattern identification diagnostic tool for climacteric and postmenopausal syndrome.
Methods: This study was conducted from June 1, 2018 to October 18, 2018 with ○○ University Korean Medicine Hospital IRB’s approval (2018-3). To make a diagnosis using pattern identification diagnostic tool, we decided the cut-points for the tool. Three professors of ○○Korean Medical University conducted pattern identification diagnosis. The result is marked from 0 to 3, 0 is 'No', 1 is 'Slightly Yes', 2 is 'Yes' and 3 is 'Very Yes'. And if two or more professors' diagnoses are the same , we took the diagnoses as a diagnostic criteria. The decision of pattern by three experts converted to 0-1 scores in two ways. In "method 1", if a diagnosis of two or more experts was given zero points, the score was 0(have no such identification), and the rest was 1(have such identification). In "method 2", if two or more experts was given zero or 1 point, the score was 0, and the rest was 1. After that, intraclass correlation was calculated for experts agreement. And logistic regression was conducted. A response variable was the results of the experts’ diagnosis and an explanatory variable was the results of the pattern identification diagnostic tool.
Results: The diagnosis of the three experts showed excellent concordance of more than 0.794 and showed a significant correlation with the diagnostic tool. Both 'Method 1' and 'Method 2' showed statistically significant effects with the diagnosis of 3 experts and the results of the diagnostic tool. The frequency of cumulative pattern identification diagnosis in 'Method 1' and 'Method 2' were found to be 578 occasions and 203 occasions, respectively. The average number of pattern held by participants in 'Method 1' and 'Method 2' were found to be 5.26 and 1.85, respectively. In both "Method 1" and "Method 2," the yield frequency of liver qi depression was the highest, and the frequency of kidney yin deficiency and liver-kidney yin deficiency was relatively high.
Conclusions: Based on the above results, it is thought to make a diagnosis from the perspective of 'method 1' using the developed diagnosis questionnaire could be used for the health diagnosis and prevention of menopausal women. The diagnosis from the perspective of 'method 2' using the questionnaire could be used for the pattern diagnosis of menopausal women. On the conclusion, the results were considered to be indicative of the oriental medical pattern characteristics of menopausal women.
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KEYWORD
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Climacteric Syndrome, Pattern Identification Questionnaire, Intraclass Correlation
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