Research hotspots andfrontiersanalysisoftraditional Chinese medicine constitution identification:Avisual analysis of literature based on CiteSpaceand vosviewer

Objective:To explore the development and hotspots in the field of traditional Chinese medicine(TCM)constitution identification since the year 2000.Methods:Using CiteSpace and VOSviewer software,literature from five prominent databases including VIP,WanFang,China National Knowledge Infrastructure(CNKI),PubMed,and Web ofScience was analyzed.Visual methods were used to examine the annual publications,keywords,authors,and collaborative networks.Results:After deduplication with EndNotes,a total of 5,747 articles meeting the criteria were included.Since 2000,the publications of TCM constitution identification shown three major stages:a significant increasing trend with the year before 2016,a fluctuating trend from 2016 to 2021,and a decreasing trend with the year after 2021.The co-occurrence analysis ofkeywords revealed health management,hypertension,and constitution as hot directions in this field of research.CiteSpace was used for keyword clustering and burst analysis,health management,medical life,and constitution emerged as the latest hotspots in the past three years,which will be the main development directions in the future.Clusters such as hypertension,preventive treatment,and health management were identified,representing the main research themes at present.VOSviewer and CiteSpace were used for co-occurrence and clustering analysis of authors,revealing collaborative research networks,with prominent groups represented by WANG Qi,WANG Ji,LI Lingru,HOU Shujuan,ZHU Yanbo,etc.Conclusion:Research related to TCM constitution identification is developing rapidly,involving various aspects of medical care and daily life.However,there is still a need to build an extensive academic platform,strengthen the dissemination of Chinese medicine culture,standardize,intellectualize and universalize the identification of TCM constitution assessments,and construct a health service system with Chinese characteristics.

Inter-observer Reliability of Indicators and Decision of Pattern Identification Using Diagnostic Flowchart with Traditional Korean Medicine

Objective： To evaluate the consistency of patterns and pattern identification（PI）, and the improvement in the diagnosis of blood stasis after the standard operating procedures（SOPs） were enhanced by using a diagnostic flowchart. Methods： A total of 358 subjects who were admitted by the Jaseng Hospital of Korean Medicine between June 2013 and December 2014 were included in the study. Each patient was independently diagnosed by two experts from the same department. In 2014, the SOPs included the use of a diagnostic flowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics. Results： The improvements in inter-observer agreement for the indicators（for al patients） and PI were greater in 2014 than in 2013. In 2013, the j-value measure of agreement between the two experts ranged from ＂poor＂（κ=–0.051） to ＂good＂（κ=0.968）. The AC1 measure of agreement between the experts was generally high for the indicators and ranged from –0.010 to 0.978. In most cases, agreement was considerably lower when it was assessed by the j-values compared with the AC1 values. In 2014, the j-value measure of agreement on the indicators（for the subjects） general y ranged from poor to good, with the values ranging from –0.007 to 0.994. Moreover, the AC1 measure of agreement between the experts was general y high for al of the indicators and ranged from ＂moderate＂（AC1=0.408） to ＂excel ent＂（AC1=0.996）. Conclusions： In four examinations, there was moderate agreement between the clinicians on the PI indicators of blood stasis. To improve clinician consistency（e.g., in the diagnostic criteria used）, it is necessary to analyse the reasons for inconsistency and to improve clinician training.（Trial registration No. KCT0000916）