Establishment And Preliminary Application Of Qi Stagnation Syndrome Patient Reported Outcome Scale's Quantitative Diagnostic Criteria

Objective:Establishing diagnostic model and diagnostic criteria of Qi Stagnation Syndrome Patient Reported Outcome Scale,to identify whether patient with qi stagnation or not and where is it stagnate?How sick is it?Researching ideas and methods about generic scale's quantitative diagnosis in syndrome of traditional chinese medicine.Methods:1.Data set ready.Collecting clinical cases with Qi Stagnation Syndrome Patient Reported Outcome Scale,combine with delphy expert consulting and the health status identification system do dialectic,identificate the patient with qi stagnation or not and its location.Summarizing and adopting the majority voting of 3 field experts and the health status identification system's dialectical results,as the initial standard of the case,that is "gold standard".According to research purpose,set up two database,a training data set,and a testing data set.2.Establishment of diagnostic criteria.Do exploratory factor analysis to the training data set,utilizing factor spin matrix's factor loading coefficient and communality's contribution size to weight scale items,building integration's diagnostic model,and determing the best diagnostic threshold of qi stagnation and seven qi stagnation location dimensions about liver,gallbladder,stomach,intestine,heart,lung and uterus by ROC curve analysis,determinating classification of the severity by percentile method.3.Diagnostic test.Reference methods of diagnostic tests in clinical epidemiology,with the "gold standard" as the control,do retrospective and prospective validation to Qi Stagnation Syndrome Patient Reported Outcome Scale's quantitative diagnostic criteria we haven establish,using sensitivity,specificity,correct diagnostic index,accuracy,positive likelihood ratio and negative likelihood ratio,a total of six indexs to evaluatiing diagnostic ability of scale.Results:1.Establishing diagnostic model of qi stagnation syndrome and seven location dimensions,areas under the ROC curve among 0.832?1.000,P<0.05.2.Determing the best diagnostic threshold and severity classification of qi stagnation syndrome and seven qi stagnation location dimensions.The best diagnostic threshold of qi stagnation syndrome is 127,and the best diagnostic threshold about location dimensions about liver,gallbladder,stomach,intestine,heart,lung and uterus's qi stagnation are 48,16,40,46,48,18,11.3.The diagnostic test to qi stagnation syndrome's quantitative diagnostic criteria,show high sensitivity,specificity,correct diagnostic index,accuracy,positive likelihood ratio and negative likelihood ratio.4.Location dimensions's quantitative diagnostic criteria,retrospective testing show diagnosing performan about liver,stomach,intestine and lung are good,gallbladder,heart,and uterus show more general,prospective validation testing show diagnosing performan about stomach,intestine and uterus are stable,other location dimensions's index have different decline compare to retrospective testing.Conclusions:1.For the first time combine with delphy expert consulting and the health status identification system do dialectic,building qi stagnation's "gold standard" diagnosis data set.2.Comparisons were made between patients with different sources of training data set and testing data set,qi stagnation syndrome has obvious different location distribution between different diseases,but all show that liver,stomach,intestine's qi stagnation are very common,and lung's qi stagnation syndrome is seldom.3.Initially establishing diagnostic models and the best diagnostic thresholds of qi stagnation syndrome and seven location dimensions,areas under the ROC show that every diagnostic model has relatively high diagnostic value.4.Initially establishing qi stagnation syndrome and seven location dimensions's severity classification.5.The diagnostic test to qi stagnation syndrome's quantitative diagnostic criteria,shows that,its diagnostic model and threshold can sensitive diagnosis a patient has qi stagnation or not,with high specificity,not easy to cause misdiagnosis,missed diagnosis,has good diagnostic performance and be stable,can be tried in clinical application.6.Diagnosis about seven location.dimensions,only stomach and intestine has good diagnostic performance and be stable,other dimensions's quantitative diagnosis still need further optimization and modification.