Quantifying traditional Chinese medicine patterns using modern test theory: an example of functional constipation

Area of Science:

• Traditional Chinese Medicine
• Psychometrics
• Gastroenterology

Background:

• Functional constipation is a common condition.
• The "Yin deficiency, intestine heat" pattern is a specific diagnosis in Traditional Chinese Medicine (TCM).
• Validating assessment scales is crucial for accurate diagnosis and treatment.

Purpose of the Study:

• To validate a scale assessing the severity of the "Yin deficiency, intestine heat" pattern of functional constipation.
• To apply modern test theory principles to TCM pattern assessment.
• To evaluate the psychometric properties of the scale.

Main Methods:

• Utilized pooled longitudinal data from 237 patients with the specified constipation pattern.
• Employed exploratory factor analysis to identify underlying item factors.
• Applied a multidimensional item response model to assess scale properties.

Main Results:

• The scale demonstrated good reliability (Cronbach's alpha 0.79–0.89).
• Exploratory factor analysis revealed two factors, supporting a bidimensional model.
• Multidimensional item response theory indicated moderate to high item discrimination, differentiating "intestine heat" and "Yin deficiency" traits.

Conclusions:

• Multidimensional item response theory is a robust method for validating TCM pattern assessment scales.
• The validated scale effectively measures the severity of "Yin deficiency, intestine heat" in functional constipation.
• The findings support the use of advanced psychometric models in TCM research.