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Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists.
Complement Ther Med. 2001 Sep; 9(3):154-66.CT

Abstract

OBJECTIVES

To assess interrater reliability of Traditional Chinese Medicine (TCM) diagnosis and treatment of chronic low back pain.

DESIGN

Under a Latin square design, six TCM acupuncturists evaluated the same six patients on the same day.

SETTING

Northwest Institute of Acupuncture and Oriental Medicine, Seattle, Washington.

INTERVENTIONS

Assessment only.

OUTCOME MEASURES

TCM diagnosis, acupoint prescriptions, auxiliary treatment recommendations.

RESULTS

Twenty diagnoses and 65 acupoints were used at least once. The diagnosis of Qi/Blood Stagnation with Kidney Deficiency and the acupoint UB23 were used for every patient by most acupuncturists. However, consistency across acupuncturists regarding diagnostic details and other acupoints was poor. No diagnoses, and only one acupoint, were used preferentially for a subgroup of patients. Some diagnoses and treatment recommendations were dependent more on the practitioner than on the patient. Fine-grained diagnoses and most acupoints were unrelated to either patient or practitioner.

CONCLUSIONS

TCM diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely across practitioners. Acupuncture clinical trials using an individualized treatment arm may be difficult to replicate or evaluate because of low concordance among acupuncturists. Comparison of individualized treatment with a thoughtfully developed standardized approach is warranted to determine which, if either, is superior.

Authors+Show Affiliations

Department of Epidemiology & Biostatistics, University of California-San Francisco, 94118, USA. hogeboom@dnai.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

11926429

Citation

Hogeboom, C J., et al. "Variation in Diagnosis and Treatment of Chronic Low Back Pain By Traditional Chinese Medicine Acupuncturists." Complementary Therapies in Medicine, vol. 9, no. 3, 2001, pp. 154-66.
Hogeboom CJ, Sherman KJ, Cherkin DC. Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. Complement Ther Med. 2001;9(3):154-66.
Hogeboom, C. J., Sherman, K. J., & Cherkin, D. C. (2001). Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. Complementary Therapies in Medicine, 9(3), 154-66.
Hogeboom CJ, Sherman KJ, Cherkin DC. Variation in Diagnosis and Treatment of Chronic Low Back Pain By Traditional Chinese Medicine Acupuncturists. Complement Ther Med. 2001;9(3):154-66. PubMed PMID: 11926429.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Variation in diagnosis and treatment of chronic low back pain by traditional Chinese medicine acupuncturists. AU - Hogeboom,C J, AU - Sherman,K J, AU - Cherkin,D C, PY - 2002/4/3/pubmed PY - 2002/5/15/medline PY - 2002/4/3/entrez SP - 154 EP - 66 JF - Complementary therapies in medicine JO - Complement Ther Med VL - 9 IS - 3 N2 - OBJECTIVES: To assess interrater reliability of Traditional Chinese Medicine (TCM) diagnosis and treatment of chronic low back pain. DESIGN: Under a Latin square design, six TCM acupuncturists evaluated the same six patients on the same day. SETTING: Northwest Institute of Acupuncture and Oriental Medicine, Seattle, Washington. INTERVENTIONS: Assessment only. OUTCOME MEASURES: TCM diagnosis, acupoint prescriptions, auxiliary treatment recommendations. RESULTS: Twenty diagnoses and 65 acupoints were used at least once. The diagnosis of Qi/Blood Stagnation with Kidney Deficiency and the acupoint UB23 were used for every patient by most acupuncturists. However, consistency across acupuncturists regarding diagnostic details and other acupoints was poor. No diagnoses, and only one acupoint, were used preferentially for a subgroup of patients. Some diagnoses and treatment recommendations were dependent more on the practitioner than on the patient. Fine-grained diagnoses and most acupoints were unrelated to either patient or practitioner. CONCLUSIONS: TCM diagnoses and treatment recommendations for specific patients with chronic low back pain vary widely across practitioners. Acupuncture clinical trials using an individualized treatment arm may be difficult to replicate or evaluate because of low concordance among acupuncturists. Comparison of individualized treatment with a thoughtfully developed standardized approach is warranted to determine which, if either, is superior. SN - 0965-2299 UR - https://www.unboundmedicine.com/medline/citation/11926429/Variation_in_diagnosis_and_treatment_of_chronic_low_back_pain_by_traditional_Chinese_medicine_acupuncturists_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0965-2299(01)90457-1 DB - PRIME DP - Unbound Medicine ER -