Positive Health Online

Abstract

HOGEBOOM and colleagues, Department of Epidemiology Biostatistics, University of California-San Francisco, 94118, USA, E: hogeboom@dnai.com, assessed the reliability of diagnosis and treatment of chronic low-back pain using Traditional Chinese Medicine (TCM) among acupuncturists.

Background

Methodology

Six TCM acupuncturists assessed the same six patients on the same day. Outcome measures were TCM diagnosis, acupoint prescriptions and auxiliary treatment recommendations.

Results

The acupuncturists used 20 diagnoses and 65 acupoints at least once. Most acupuncturists gave a diagnosis of Qi/Blood Stagnation with Kidney Deficiency and used the acupoint UB23 for every patient . Consistency of diagnostic details and use of other acupoints were poor among the acupuncturists. For a subgroup of patients, no diagnoses, and only one acupoint, were used preferentially. Some diagnoses and treatment recommendations were practitioner-, rather than patient-, dependent. Fine-grained diagnoses and most acupoints bore no relationship with either the patient or the acupuncturist.

Conclusion

There were wide variations in TCM diagnoses and treatment recommendations for individual patients with low-back pain among the acupuncturists assessed. Lack of consistency among acupuncturists may make it difficult to evaluate or replicate clinical trials of acupuncture that use an individualized treatment. It would be useful to develop a standardized TCM treatment approach and evaluate this in comparison with individualized treatment, to assess which, if any, is superior in terms of inter-rater reliability .

References

Hogeboom CJ et al. Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. Complementary Therapies in Medicine 9 (3): 154-66. Sep 2001.