An Exploratory Study on the Possibility of Quantitative Measurement during Abdominal Examinations - A Preliminary Study on the Development of a Diagnostic Device for Abdominal Examinations

Abstract

Objective. Abdominal examination (AE) is one of the essential diagnostic methods in traditional Korean medicine that has been widely used for deciding treatment, cause, and prognosis of the disease. AE majorly depends on the experience of practitioners; therefore, standardization and quantification of AE are desperately needed. However, few studies have tried to objectify AE and established its standard. We assessed the reliability and validity of newly developed diagnostic device for AE called modified algometer (MA). Methods. Thirty-six subjects with functional dyspepsia were allocated into one of 2 groups according to gold standard of AE: epigastric discomfort without tenderness ( = 23) group or epigastric discomfort with tenderness ( = 13) group. Pressure pain threshold was evaluated at participants' epigastric region with algometer and MA. We assessed reliability and validity (sensitivity and specificity) and calculated optimal cutoff value. Results. MA showed high intertrial reliability (ICC 0.849; 0.703-0.923; < 0.000) and validity (sensitivity: 76.92%; specificity: 60.87%), and cutoff value was 330.0 mmHg. Algometer and MA showed moderate correlation ( = 0.583, ≤ 0.000). Conclusion. MA can be reliable and valid diagnostic device for AE and has the possibility of practical use for quantification and standardization of AE.

Development of a patient-report pressure algometer for the quantification of abdominal examination

“…More recently, a semi-automatically upgraded version of the algometer (MA) was developed that showed more precise ICC (0.849) with 76.9% of sensitivity, 60.9% of specificity and 1.92 kg/cm 2 of optimal cutoff value. 6 According to our pilot study using PA, 20 CC and ICC of PPT by PA was 0.836 and 0.866, respectively, with statistical significance observed in both ( P < 0.001). PA showed elevated test-retest and inter-rater reliability when evaluating PPT compared to the original algometer and MA, possibly due to the more automated process.…”

Abdominal examination using pressure pain threshold algometer reflecting clinical characteristics of complementary and alternative medicine in Korea: A systematic review and a brief proposal

“…All 22 studies measured PPT using a handheld algometer and additionally indentation depth, [ 3 ] conditioned pain modulation (CPM) PPT, [ 9 ] and pressure depth [ 3 ] were also measured in some studies. Measuring tools included FDIX 50, FDK 20, FDK 30, FDN 100, FDN 200 (Wagner instrument, Connecticut), DD-500 (Instrutherm Measuring instruments, São Paulo, Brazil), PTH-AF2 (Pain Diagnostic and Treatment Corporation, New York), and algometers commercially available from Pain Diagnostics and Thermography (NY), Somedic SenseLab AB (Sweden), and J-Tech Commander™ (Wisconsin), and Sauter (Balingen, Germany).…”

“…Pain pressure measurements were acquired for various areas. For studies conducted in Korea, a few studies measured only one location in the abdomen, [ 3 , 5 , 10 ] while other studies compared abdominal measurements with other measurement locations not in the abdomen. [ 13 ] The studies which examined the reliability or validity of algometer measurement methods measured the back, shoulders, arms, and lower limbs alone or in combination depending on the purpose of the study.…”

“…Thus, it is necessary to attempt to acquire objective and quantifiable evaluation indices of abdominal examinations. [ 3 ]…”

“…To acquire objective and quantifiable evaluation indices of abdominal examination, Ko et al (2015) [ 5 ] and Lee et al (2016) [ 3 ] suggested applying pressure algometry during abdominal examination. Pressure algometry estimates the mechanical sensitivity of the muscles under pressure with an algometer.…”