Lee Jin-Hyun, Woo Hyeonjun, Jang Jun-Su, Kim Joong Il, Na Young Cheol, Kim Kwang-Ryeol, Cho Eunbyul, Lee Jung-Han, Park Tae-Yong
Institute for Integrative Medicine, Catholic Kwandong University International St. Mary's Hospital, 25 Simgok-ro 100 beon-gil, Seo-gu, Incheon 22711, Korea.
Department of Korean Medicine Rehabilitation, College of Korean Medicine, Wonkwang University, 460 Iksan-daero, Iksan-si 54538, Korea.
Diagnostics (Basel). 2022 Nov 8;12(11):2732. doi: 10.3390/diagnostics12112732.
Before Chuna manual therapy (CMT), a manual therapy applied in Korean medicine, CMT spinal diagnosis using palpation or X-ray is performed. However, studies on the inter-rater concordance of CMT diagnostic methods, concordance among diagnostic methods, and standard CMT diagnostic methods are scarce. Moreover, no clinical studies have used artificial intelligence (AI) programs for X-ray image-based CMT diagnosis. Therefore, this study sought a feasible and standard CMT spinal diagnostic method and explored the clinical applicability of the CMT-AI program. One hundred participants were recruited, and the concordance within and among different diagnostic modalities was analyzed by dividing them into manual diagnosis (MD), X-ray image-based diagnosis (XRD) by experts and non-experts, and XRD using a CMT-AI program by non-experts. Regarding intra-group concordance, XRD by experts showed the highest concordance (used as a gold standard when comparing inter-group concordance), followed by XRD using the AI program, XRD by non-experts, and then MD. Comparing diagnostic results between the groups, concordance with the gold standard was the highest for XRD using the AI program, followed by XRD by non-experts, and MD. Therefore, XRD is a more reasonable CMT diagnostic method than MD. Furthermore, the clinical applicability of the CMT-AI program is high.
在实施中医手法治疗（CMT）之前，需先采用触诊或X光进行CMT脊柱诊断，CMT是一种应用于韩医学的手法治疗。然而，关于CMT诊断方法的评分者间一致性、诊断方法之间的一致性以及标准CMT诊断方法的研究却很匮乏。此外，尚无临床研究使用人工智能（AI）程序进行基于X光图像的CMT诊断。因此，本研究旨在寻找一种可行的标准CMT脊柱诊断方法，并探索CMT-AI程序的临床适用性。招募了100名参与者，将其分为手法诊断（MD）、专家和非专家基于X光图像的诊断（XRD）以及非专家使用CMT-AI程序的XRD，分析不同诊断方式内部及之间的一致性。关于组内一致性，专家进行的XRD显示出最高的一致性（在比较组间一致性时用作金标准），其次是使用AI程序的XRD、非专家进行的XRD，然后是MD。比较组间诊断结果，使用AI程序的XRD与金标准的一致性最高，其次是非专家进行的XRD和MD。因此，与MD相比，XRD是一种更合理的CMT诊断方法。此外，CMT-AI程序的临床适用性很高。
