Assessment of Intermingled Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: Development of a Diagnostic Scale

Evid Based Complement Alternat Med. 2018 Oct 24:2018:4683431. doi: 10.1155/2018/4683431. eCollection 2018.

Abstract

Background: Intermingled Phlegm and Blood Stasis Syndrome (IPBSS) is a common feature in patients with coronary heart disease (CHD). In clinical practice, the diagnostic agreement of clinical doctor of Chinese Medicine (CM) is poor. We previously developed a IPBSS diagnostic scale for use by general practitioner.

Objectives: To assess a IPBSS diagnostic scale that we previously developed for use by non-experts.

Methods: This is a multicenter, prospective study involving eight study sites across China. Eligible patients were adults (≥18 years) with CHD as demonstrated by a history of myocardial infarction, stenosis, or past coronary revascularization. IPBSS was assessed using a scale that consisted of 14 items in two domains (e.g., phlegm and blood stasis). The score range for each item was 0 to 3 points. Maximum total score was 72 points. Diagnostic accuracy was verified using consensus opinion by two independent experts as reference.

Results: A total of 1,142 CHD patients were included. IPBSS was established in 729 subjects using the IPBSS diagnostic scale. In ROC curve analyses, at the optimal cut-off of 25.5, the sensitivity and specificity of the IPBSS scale were 67.6% and 72.4%, respectively. The area under the ROC curve was 0.741 (95%CI: 0.711-0.772).

Conclusions: The newly developed IPBSS scoring system showed moderate performance in diagnosing IPBSS in CHD patients. Data from further large-scale diagnostic test accuracy studies are warranted. This trial is registered with ChiCTR-OOC-15006599.