Interobserver reliability of four diagnostic methods using traditional korean medicine for stroke patients

Objective. The aim of this study is to evaluate the consistency of pattern identification (PI), a set of diagnostic indicators used by traditional Korean medicine (TKM) clinicians. Methods. A total of 168 stroke patients who were admitted into oriental medical university hospitals from June 2012 through January 2013 were included in the study. Using the PI indicators, each patient was independently diagnosed by two experts from the same department. Interobserver consistency was assessed by simple percentage agreement as well as by kappa and AC1 statistics. Results. Interobserver agreement on the PI indicators (for all patients) was generally high: pulse diagnosis signs (AC1 = 0.66-0.89); inspection signs (AC1 = 0.66-0.95); listening/smelling signs (AC1 = 0.67-0.88); and inquiry signs (AC1 = 0.62-0.94). Conclusion. In four examinations, there was moderate agreement between the clinicians on the PI indicators. To improve clinician consistency (e.g., in the diagnostic criteria used), it is necessary to analyze the reasons for inconsistency and to improve clinician training.