Context: Making correct diagnoses is the foundation of clinical practice in traditional Chinese medicine (TCM). The diversity in making diagnoses is one of the leading handicaps for the proper use of TCM.
Objective: This study explores the key components for the diagnosis of qi deficiency among TCM experts.
Design: A modified Delphi process was used to draw opinions from TCM experts. A total of five rounds of questionnaires were carried out over 2 years. Open-ended questions were used to uncover the detailed issues that the Chinese doctors experienced in diagnosing qi deficiency. Content analysis was used to explore qualitative data and generated new statements, which were incorporated into the next round of questionnaires as feedback for participants.
Setting: The questionnaires were mailed to the participants who were from mainland China and from Taiwan. The participants administered questionnaires in their natural setting.
Participants: Thirteen participants were from mainland China: three from Beijing, five from Sichuan, one from Shandong, two from Jiangsu, one from Hunan, and one from Shanghai. For the 17 Taiwanese experts, nine came from north Taiwan, seven from mid-south Taiwan, and one from east Taiwan. Participants included diagnostic professors, TCM theoretical experts, and specialists in TCM formulae and pharmacy.
Outcome measurement: The selection rates for each item were calculated in the five questionnaires. Mean and standard deviation were used to identify the degree of the experts' agreement and disparity for each item. The trend of divergence for the items determined if a consensus was reached.
Results: Twenty-eight out of 30 experts completed all five rounds of the survey. In the first questionnaire, the research team identified 74 symptoms and signs and 39 risk factors as the preliminary elements in the diagnosis of qi deficiency. Analyses of the five rounds of questionnaires identified two definitions, 19 symptoms and signs, and 15 risk factors as the key components of qi deficiency in TCM.
Conclusions: The results show that TCM doctors use a set of complicated methods to diagnose qi deficiency rather than simply relying on the enacted symptoms and disease characteristics.