Abstract
Observation of the tongue, also known as tongue diagnosis, is an important procedure in diagnosis by inspection in Traditional Korean medicine (TKM). We investigated the reliability of TKM tongue diagnosis in stroke patients by evaluating interobserver reliability regarding tongue indicators as part of the project named the Fundamental Study for the Standardization and Objectification of Pattern Identification in TKM for Stroke (SOPI-Stroke). A total of 658 patients with stroke admitted to 9 oriental medical university hospitals participated. Each patient was independently seen by two experts from the same department for an examination of the status of the tongue. Interobserver agreement about subjects regarding pattern identification with the same opinion between the raters (n = 451) was generally high, ranging from “moderate” to “excellent”. Interobserver agreement was nearly perfect for certain signs of special tongue appearance (mirror, spotted, and bluish purple), poor for one of the tongue colors (pale) and moderate for others. Clinicians displayed measurable agreement regarding tongue indicators via both observation and pattern identification consistency. However, interobserver reliability regarding tongue color and fur quality was relatively low. Therefore, it is necessary to improve objectivity and reproducibility of tongue diagnosis through the development of detail-oriented criteria and enhanced training of clinicians.
Highlights
Stroke is the second most common cause of death in developed countries and is a major health problem [1]
In Korea, many stroke patients receive traditional medical care because the country has its own system of traditional alternative medicine called Traditional korean medicine (TKM), the role of which has been emphasized in stroke management [3]
We investigated the reliability of TKM tongue diagnosis in stroke patients by evaluating interobserver reliability regarding tongue indicators as achieved by TKM practitioners
Summary
Stroke is the second most common cause of death in developed countries and is a major health problem [1]. According to the 2009 Annual Public Health Report by the Korean National Statistical Office, cerebrovascular disease, or stroke, was the second-leading cause of disease-related deaths in Korea, after cancer [2]. The Korean medical diagnosis system has unique characteristics similar to the traditional Chinese medical diagnosis system. One such feature is pattern identification (PI), which is based on information obtained from four diagnostic processes including inspection, listening and smelling, inquiry, and palpation [4]. A number of studies have shown that tongue diagnosis plays an important role in clinical prognosis and treatment [8,9,10,11,12,13,14,15], in patients with a history of stroke. The clinical competence of tongue diagnosis was determined by the experience and knowledge
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
