Abstract

Objective The aims of this study were to extract clinical indicators related to metabolic diseases using the Blood Stasis Questionnaires I and II (BSQ-I and II) developed in 2013 and 2014, respectively, and to develop a BSQ on metabolic syndrome (BSQ-MS). Methods A total of 2,158 patients, comprising 1,214 from 7 traditional Korean medical hospitals in 2013 and 944 from 3 traditional Korean medical hospitals in 2014, were asked to complete the BSQ-I and BSQ-II. For the 370 patients who met the metabolic syndrome criteria, reliability and validity of the BSQ-MS were assessed using Cronbach's alpha, while prediction accuracy was determined by logistic regression. Results The BSQ-MS included a total of 15 clinical signs and symptoms. It showed satisfactory internal consistency (Cronbach's α coefficient=0.70) and validity, with significant differences in mean scores between the blood stasis (14.09±6.14) and non-blood stasis (9.09±5.60) subject groups. The cut-off value of BSQ-MS score was 9 points, the area under the receiver operating characteristic curve was approximately 77%, the sensitivity and specificity of the diagnostic accuracy according to the cut-off value were 82.9% and 49.7%, respectively, and the sensitivity and specificity of the prediction accuracy by logistic regression were 72.2% and 71.6%, respectively. Conclusion These results suggest that the BSQ-MS is an appropriate instrument for estimating blood stasis in patients with metabolic syndrome, although its sensitivity for diagnosis according to the cut-off value is low.

Highlights

  • In Oriental Medicine, blood stasis is a disease symptom in which blood becomes stagnant in certain parts of the body

  • Clinical data were collected by classifying each subject into either blood stasis (BSS) or non-blood stasis (Non-BSS) groups using a simple survey in order to homogenize the distribution of BSS and non-BSS by age and gender in each hospital

  • There is currently a lack of a BSQ on metabolic syndrome (BSQ-MS) developed with Oriental Medicine clinical indicators

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Summary

Introduction

In Oriental Medicine, blood stasis is a disease symptom in which blood becomes stagnant in certain parts of the body. A blood stasis symptom questionnaire was developed by Yang et al [4], followed by the publication of the revised questionnaire after confirmation of its reliability and validity [5]; it is not actively used in clinical practice. The Korea Institute of Oriental Medicine combined the blood stasis diagnostic questionnaires developed in Korea, China, and Japan [4, 6, 7]. Due to the systematic differences in traditional medicine between Korea, China, and Japan, diagnostic standardization related to blood stasis has not been established. The reliability and validity of the BSQ-II, which was expanded to include additional items from blood stasis research, were tested on 942 subjects recruited from gynecology, cardiovascular, and musculoskeletal areas in 2014 [9]

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