Discrimination of prediction models between cold-heat and deficiency-excess patterns

Maeda-Minami, Ayako; Yoshino, Tetsuhiro; Katayama, Kotoe; Horiba, Yuko; Hikiami, Hiroaki; Shimada, Yutaka; Namiki, Takao; Tahara, Eiichi; Minamizawa, Kiyoshi; Muramatsu, Shin‐ichi; Yamaguchi, Rui; Imoto, Seiya; Miyano, Satoru; Mima, Hideki; Mimura, Masaru; Nakamura, Tomonori; Watanabe, Kenji

doi:10.1016/j.ctim.2020.102353

Cited by 10 publications

(9 citation statements)

References 16 publications

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“…We have reported a statistical model that predicted the specialist's deficiency-excess and cold-heat diagnosis. This machine-learning model showed a high prediction rate (70-90%) of specialists' diagnoses, [7][8][9] and these diagnoses were predicted with the same information set used in this study. The predicted agreement rates for deficiency-excess and cold-heat modules using our model were comparable with the observed inter-rater agreement, and reproducibility between evaluation performed using information documents and diagnosis from patients (data not shown).…”

Section: Discussionmentioning

confidence: 61%

“…These documents contained the results of a 140-item questionnaire that included 133 symptoms, chief complaints, systolic and diastolic blood pressure, age, sex, height, and weight. [7][8][9] Patients' information such as their names, history of present illness, and physical examination findings (including pulse and abdominal examinations) was partially masked to the physicians.…”

Section: Information Documentsmentioning

confidence: 99%

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Inter-Rater Reliability of Kampo Diagnosis for Chronic Diseases

Maeda-Minami

Yoshino

Horiba

et al. 2021

The Journal of Alternative and Complementary Medicine

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This single-center observational study aimed to assess the inter-rater reliability (IRR) of Kampo medicine pattern diagnosis, which is modularized into three modules for chronic diseases, using 64 participants' information documents. The linearly weighted percentage of agreement and Gwet's agreement coefficient (AC) 2 for the deficiency-excess module, among three specialists, were 85.9% and 0.708, respectively. The unweighted percentage of agreement and Gwet's AC1 were 64.6% and 0.542 for the cold-heat, and 35.9% and 0.254 for the qi-blood-fluid modules, respectively. Our findings suggest that our modularization method may improve the IRR of Kampo medicine pattern diagnosis.

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Section: Discussionmentioning

confidence: 61%

Section: Information Documentsmentioning

confidence: 99%

Inter-Rater Reliability of Kampo Diagnosis for Chronic Diseases

Maeda-Minami

Yoshino

Horiba

et al. 2021

The Journal of Alternative and Complementary Medicine

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“…The Cold-Heat pattern was originally suggested by the Yellow Emperor's Classic of Internal Medicine and Discussion on Cold-Induced Disease and has been the widely used pivotal clinical differentiation pattern of East-Asian traditional medicine until the ICD-11 [ 23 , 35 – 37 ]. The Cold-Heat pattern of traditional East-Asian medicine refers to momentary and transient clinical manifestations of the patients including cold and fever, absence and presence of thirst, loose stool and constipation, and preference for heat and cold, [ 38 ] which might be the subjective perception of cold or heat [ 23 , 35 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the Cold-Heat subgroup of the Sasang typology denotes intrinsic and sustained biopsychological and pathophysiological predispositions, and previous studies showed that actual body temperature [ 39 ], BMI [ 23 , 40 , 41 ], and activated digestive function [ 39 , 41 , 42 ] and biopsychological activity [ 8 , 23 ] might be the representative clinical measure. The BMI was suggested as the most important clinical feature for both Cold-Heat and Deficiency-Excess pattern identification by clinicians [ 35 ], and the pathological problem of urination (SUI) in the current study [ 22 ] was suggested to be related to the Pediatric Weak Scale-GN subscale representing Blood Heat pattern [ 24 ]. The Heat subgroup of the Sasang typology would be defined as a person with activated bodily and mental function [ 23 ] with the characteristics of Heat and Excess clinical patterns altogether, while the Cold subgroup has the inhibited or less activated biopsychosocial functioning with Cold and Deficiency patterns.…”

Section: Discussionmentioning

confidence: 99%

Urinary Function of the Sasang Type and Cold‐Heat Subgroup Using the Sasang Urination Inventory in Korean Hospital Patients

Lee

Han

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Introduction. The Sasang type-specific pathophysiological symptom is pivotal for the Sasang type classification and pattern identification. The Sasang Urination and Defecation Inventory (SUDI) for urinary function analysis was developed; however, the clinical usefulness of urination-related subscales of SUDI in the Sasang type and Cold-Heat subgroup was not reported with acceptable validation analysis. Methods. The clinical diagnosis of the Sasang type and Cold-Heat subgroup, responses to SUDI items, and weight and height of the 350 hospital patients were acquired retrospectively. The Sasang Urination Inventory (SUI) with SUI-CHR (problematic physical characteristics of urine), SUI-HSS (hypersensitivity of urinary urgency and high frequency), and SUI-DIS (urinary discomfort of hesitancy and residual urine sense) subscales using 12 items of SUDI were improvised. The item and construct validity of the SUI were examined using item response theory and confirmatory factor analysis, and the clinical usefulness of the SUI in Sasang type and Cold-Heat subgroup differentiation was attested. Results. The SUI and its subscales showed acceptable structural validity and have clinical usefulness in the Tae-Eum type. The Tae-Eum type has a significantly higher SUI-CHR score than did the So-Yang type, and the Heat subgroup has a significantly higher SUI-HSS score than did the Cold subgroup in the Tae-Eum type. Discussion. The distinctive Sasang type- and Cold-Heat subscale-specific pathological symptoms in urinary function were revealed using the SUI. The SUI combined with objective Sasang typology measures might be useful for integrative precision medicine combining Eastern and Western practice and for evidence-based clinical education for medical professions.

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“…In addition, another study found that BMI is an important factor in determining the deficiency-excess pattern of the human body; the risk of the deficiency pattern also increased with lower BMI [ 35 ]. In a recent study using a prediction model, the BMI was an important item for predicting the “deficiency–excess” syndrome in TEAM practice [ 38 ]. We can anticipate that BMI will affect the therapeutic effect of herbal medicine.…”

Section: Discussionmentioning

confidence: 99%

Gyejigachulbutang (Gui‐Zhi‐Jia‐Shu‐Fu‐Tang, Keishikajutsubuto, TJ‐18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo‐Controlled Double‐Blind Clinical Trial

Kim

Leem

Kim

et al. 2020

Evidence-Based Complementary and Alternative Medicine

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Background. Gyejigachulbutang (GUI-ZHI-JIA-SHU-FU-TANG, GCB) is an herbal formula widely prescribed in traditional East Asian medicine practice for arthritis and muscle pain. We evaluated the efficacy and safety of GCB for degenerative knee osteoarthritis (KOA). Methods. Eighty patients with KOA were randomly assigned to the GCB group or the placebo group in a 1 : 1 ratio in two Korean medicine hospitals. Patients took GCB or placebo three times a day for 4 weeks. Primary outcome was the change in the visual analogue scale (VAS) score for knee pain from baseline to 4th week. Secondary outcomes were the change in the VAS score from baseline to 2nd week and 8th week, Korean Western Ontario and McMaster Universities Osteoarthritis Index (K-WOMAC), European Quality of Life Five Dimensions questionnaire (EQ-5D), and safety. Results. There was no significant difference between the compared indicators of the GCB and placebo groups. However, in subgroup analysis, GCB was effective for subjects with a BMI lower than 25 kg/m2. The dose of pain medication was significantly lower in the GCB group than in the placebo group after four weeks ( p = 0.016 ). There were no serious adverse events in the GCB group. Conclusions. GCB was not effective in primary outcome analysis. In exploratory subgroup analysis, GCB might be effective for individuals with BMI lower than 25 kg/m2 for the treatment of degenerative KOA. GCB may also help reduce the consumption of pain medication. Furthermore, research is required for our hypothesis. This trial is registered with KCT0003024.

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Discrimination of prediction models between cold-heat and deficiency-excess patterns

Cited by 10 publications

References 16 publications

Inter-Rater Reliability of Kampo Diagnosis for Chronic Diseases

Inter-Rater Reliability of Kampo Diagnosis for Chronic Diseases

Urinary Function of the Sasang Type and Cold‐Heat Subgroup Using the Sasang Urination Inventory in Korean Hospital Patients

Gyejigachulbutang (Gui‐Zhi‐Jia‐Shu‐Fu‐Tang, Keishikajutsubuto, TJ‐18) in Degenerative Knee Osteoarthritis Patients: Lessons and Responders from a Multicenter Randomized Placebo‐Controlled Double‐Blind Clinical Trial

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