Abstract
Individualized acupuncture treatment has been practiced for pain therapy. This study used acupuncture treatment for lateral elbow pain (LEP) as an example to study the diagnostic practice of individualized acupuncture treatment. A provisional version of LEP pattern questionnaire was developed based on a recent systematic review on TCM pattern diagnosis for LEP. A Delphi panel of 33 clinical experts from seven different countries was formed, and the Delphi survey was conducted in Chinese and English language for two rounds. Consensus was achieved from all 26 panelists who responded to the second round on 243 items of the instrument, which included a 72-question-long questionnaire. The mean level of expert consensus on the items of the final questionnaire was 85%. Consensus was found on four TCM patterns that could underlie LEP, namely, the wind-cold-dampness pattern, the qi stagnation and blood stasis pattern, the dual deficiency of qi and blood pattern, and the retained dampness-heat pattern. A list of signs and symptoms indicating one of the four TCM patterns and a list of preferred treatment modalities for each pattern were also generated. Our instrument shows considerable content validity. Further validity and reliability studies are under way.
Highlights
Personalized medicine has become the new trend in modern medical care [1,2,3]
In a previous systematic review, we have identified major Traditional Chinese medicine (TCM) patterns associated with lateral elbow pain (LEP)
All 28 experts had a minimum experience of five years in the treatment of lateral elbow pain with acupuncture and had frequently been using pattern differentiation in their acupuncture practice
Summary
Personalized medicine has become the new trend in modern medical care [1,2,3]. Traditional Chinese medicine (TCM) has developed and used a sophisticated system of individualized medicine in the form of pattern diagnosis and classification for hundreds if not thousands of years already. There has been much variation in clinical practices even guided by the same TCM theory [4,5,6]. These variations are problematic when one tries to validate or replicate the effectiveness of the practice. Methods adopted from the current biomedical research to evaluate the efficacy of TCM interventions are often conceptually incompatible with the theory and clinical practice of TCM [7, 8]. There is much need for standardized, validated instruments which can facilitate Chinese medicine diagnosis and which can be used by practitioners and researchers alike in their diagnostic process
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