맥진기 판독의 신뢰도 및 파형의 재현성 연구 = Study on Reliability of Interpretation and Reproducibility of a Pulse Analyser

다국어 초록 (Multilingual Abstract)

Objectives : This study was performed to evaluate inter-rater and intra-rater reliability of interpretation and reproducibility of a pulse analyser (MAXMAC27-Plus). Methods : 38 of 40 volunteers completed the pulse analysis consecutively. Three Korean medical doctors who had at least 2 years of clinical experience interpreted the pulse waves for 3 aspects of size, depth and shape, then inter-rater reliability and crude agreement was obtained. Reinterpretation was done 2 weeks later and intra-rater reliability and crude agreement was obtained. Intra-rater reliability and crude agreement between 1st and 2nd measurement was calculated. Cohen's weighted kappa for size, Cohen's kappa for depth and shape were used as statistical analysis. Results : Inter-rater reliability of size, depth and shape among 3 raters was 0.598, 0.604, and 0.312, respectively, showing moderate to substantial agreement. Average intra-rater reliability between 1st and 2nd interpretation of size, depth and shape was 0.806, 0.705, and 0.638, respectively, showing substantial to almost perfect agreement. However, intra-rater reliability between consecutive measurements of size, depth and shape was 0.221, 0.121, and 0.194, respectively, which showed only poor to fair agreement. Conclusions : Intra-rater and inter-rater reliability of one pulse wave showed relatively high concordance. Training by a clinical expert may effect better concordance among raters. Test-retest reliability showed poor agreement. Improvement of measurement technique and device performance will be needed.

참고문헌 (Reference)

1 김은혜, "희수식 전자맥진기의 재조명" 18 (18): 37-45, 2009

2 박동일, "희수식 맥진기를 이용한 소화기 환자의 비위간담맥의 맥증에 대한 고찰" 4 : 88-119, 1999

3 박동일, "희수식 맥진기를 이용한 감모환자의 폐맥에 대한 고찰" 4 : 120-140, 1999

4 채우석, "한의학 개론" 대성문화사 310-, 1997

5 경희대학교 한의과대학 제45기 졸업준비위원회 학술부, "한방진단의 실제적 접근" 일중사 47-, 1997

6 하예진, "펜타입 압저항 센서를 활용한 연령별 맥파 특성 및 맥파의 대사증후군에의 적용 가능성 평가" 대한한방내과학회 33 (33): 257-271, 2012

7 원재균, "침자극이 좌관맥상과 심박수 미세변화에 미치는 영향" 대한동의병리학회 23 (23): 237-244, 2009

8 김석하, "전자맥진기의 맥상과 고전의 제맥체상에 관한 연구(I)" 13 (13): 36-44, 2009

9 백광철, "알기쉬운 맥진학" 논장 9-16, 1995

10 나창수, "비접촉식 광생체단층촬영 기술을 이용한 맥진 연구 -맥의 빠르기, 크기 및 맥력을 중심으로-" 경락경혈학회 26 (26): 1-13, 2009

11 김종열, "맥진기의 문제점과 개선방안에 관한 연구" 3 (3): 28-36, 1999

12 신병철, "맥진기를 이용한 중풍환자의 임상적 고찰" 13 (13): 123-127, 1999

13 강세영, "맥진기 결과에 대한 판독자간의 판독 일치율 비교 연구" 경락경혈학회 28 (28): 91-99, 2011

14 하인영, "맥의 빠르기, 크기, 깊이에 관한 전통맥진과 기기측정 맥진의 비교 연구" 경락경혈학회 28 (28): 23-37, 2011

15 장원석, "두통 및 어지럼증 입원환자의 맥진기를 이용한 통계적 고찰" 196-207, 2011

16 윤석희, "동의보감" 동의보감출판사 935-, 2005

17 O'Brien KA, "Understanding the reliability if diagnostic variables in a Chinese medicine examination" 15 (15): 727-734, 2009

18 King E, "The reliable measurement of radial pulse characteristics" 20 : 150-159, 2002

19 Landis JR, "The measurement of observer agreement for categorical data" 33 : 159-174, 1977

20 Light RJ, "Measures of response agreement for qualitative data: Some generalizations and alternatives" 76 (76): 365-377, 1971

21 O'Brien KA, "A review of the reliability of traditional east asian medicine diagnoses" 15 (15): 353-366, 2009