Interpretation of a Quantitative Diagnosis Model of Traditional Chinese Medicine Syndromes Based on Computer Adaptive Testing.

The aim of this study is to interpret a quantitative diagnosis model of traditional Chinese medicine (TCM) syndromes based on computer adaptive testing (CAT), from the perspective of both patients and clinicians. In this cross-sectional study, patients with postprandial distress syndrome completed the CAT model of TCM syndromes and the Chinese version of the Quality of Life Questionnaire for Functional Digestive Disorders (Chin-FDDQL); the clinicians' diagnosis was concurrently recorded. The patients completed this questionnaire again after 14 ± 2 days. The kappa test and paired chi-square test were used to evaluate the consistency between the CAT model and clinical diagnosis. Minimal clinically important differences (MCID) of the Chin-FDDQL scores were used to assess clinical efficacy from the patients' perspective. Logistic regression was used to examine the association between changes in the CAT model syndrome domain scores and changes in clinical outcomes. Changes in the CAT model syndrome domain scores may affect the clinical outcomes of patients with the total scores of Chin-FDDQL (all P < 0.05). There was a correlation between changes in the CAT model syndrome domain scores and the patients' clinical outcomes. Different syndrome elements had different effects on various Chin-FDDQL domains, which was consistent with the theory of TCM. This study proposes a method for the clinical interpretation of the CAT model of TCM syndromes, including evidence derived from the application. It may provide a reference for future interpretation of other CAT models.

本研究旨在从患者和临床医生的角度阐释一种基于计算机自适应测试（CAT）的中医证候定量诊断模型。 在这项横断面研究中，餐后不适综合征患者完成了中医证候CAT模型以及中文版功能性胃肠病生活质量量表（Chin - FDDQL）；同时记录临床医生的诊断结果。患者在14±2天后再次填写该问卷。采用kappa检验和配对卡方检验评估CAT模型与临床诊断之间的一致性。采用Chin - FDDQL评分的最小临床重要差异（MCID）从患者角度评估临床疗效。采用逻辑回归分析检验CAT模型证候领域评分的变化与临床结果变化之间的关联。 CAT模型证候领域评分的变化可能影响患者Chin - FDDQL总分的临床结果（所有P < 0.05）。CAT模型证候领域评分的变化与患者的临床结果之间存在相关性。不同的证候要素对Chin - FDDQL的各个领域有不同的影响，这与中医理论相符。 本研究提出了一种中医证候CAT模型的临床阐释方法，包括应用所产生的证据。它可能为未来其他CAT模型的阐释提供参考。