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中医体质问卷简版的研制与评价:探索用于健康管理的新型最佳中医简易工具研究

Development and evaluation of short-form version of the Constitution in Chinese Medicine Questionnaire: study a new and best brief instrument of Chinese medicine for health management.

作者信息

Bai Ming-Hua, Li Zhu-Qing, Wang Huai-Yu, Ma Xiao-Li, Wang Zhong-Li, Li Shi-Jun, Dong Si-Ying, Zhang Zi-Ling, Li Wen-Le, Chen Shun-Qi, Cai Yu-Yang, Zhao Xiao-Shan, Wang Ji, Wang Qi

机构信息

National Institute of TCM, Constitution and Preventive Medicine, Beijing University of Chinese Medicine, Beijing, 100029, China.

College of Nursing, Hebei University, Baoding, 071000, China.

出版信息

Chin Med. 2023 Oct 30;18(1):140. doi: 10.1186/s13020-023-00844-3.

Abstract

BACKGROUND

More efficient instruments for body constitution identification are needed for clinical practice. We aimed to develop the short-form version of the Constitution in Chinese Medicine Questionnaire (CCMQ) and evaluate for health management.

METHODS

First, the short forms were developed through expert survey, classical test theory (CTT), and modern item response (IRT) based on the CCMQ. A combination of e-mail and manual methods was used in expert survey. Then, five indexes of CTT including criteria value-critical ratio, correlation coefficient, discrete tendency, internal consistency, and factor loading were used. And, IRT method was used through analyzing the discrimination and difficulty parameters of items. Second, the three top-ranked items of each constitution scale were selected for the simplified CCMQ, based on the three combined methods of different conditions and weights. Third, The psychometric properties such as completion time, validity (Construct, criterion, and divergent validity), and reliability (test-retest and internal consistency reliability) were evaluated. Finally, the diagnostic validity of the best short-form used receiver operating characteristic (ROC) curve.

RESULTS

Three short-form editions were developed, and retained items 27, 23 and 27, which are named as WangQi nine body constitution questionnaire of Traditional Chinese Medicine (short-form) (SF-WQ9CCMQ)- A, B, and C, respectively. SF-WQ9CCMQ- A is showed the best psychometric property on Construct validity, Criterion validity, test-retest reliability and internal consistency reliability. The diagnostic validity indicated that the area under the ROC curve was 0.928 (95%CI: 0.924-0.932) for the Gentleness constitution scale, and were 0.895-0.969 and 0.911-0.981 for unbalance constitution scales using the cut-off value of the original CCMQ as 40 ("yes" standard) and 30 ("tendency" standard), respectively.

CONCLUSIONS

Our study successfully developed a well short-form which has good psychometric property, and excellent diagnostic validity consistent with the original. New and simplified instrument and opportunity are provided for body constitution identification, health management and primary care implementation.

摘要

背景

临床实践需要更高效的体质辨识工具。我们旨在开发中医体质问卷(CCMQ)的简版,并对其进行健康管理评估。

方法

首先,基于CCMQ通过专家调查、经典测验理论(CTT)和现代项目反应理论(IRT)开发简版。专家调查采用电子邮件和人工相结合的方法。然后,使用CTT的五个指标,包括标准值-临界比、相关系数、离散趋势、内部一致性和因子载荷。并且,通过分析项目的区分度和难度参数使用IRT方法。其次,根据不同条件和权重的三种组合方法,为简化的CCMQ选择每个体质量表排名前三的项目。第三,评估诸如完成时间、效度(结构效度、效标效度和区分效度)和信度(重测信度和内部一致性信度)等心理测量学特性。最后,使用最佳简版的诊断效度绘制受试者工作特征(ROC)曲线。

结果

开发了三个简版,保留的项目分别为27项、23项和27项,分别命名为中医王琦九种体质问卷(简版)(SF-WQ9CCMQ)-A、B和C。SF-WQ9CCMQ-A在结构效度、效标效度、重测信度和内部一致性信度方面表现出最佳的心理测量学特性。诊断效度表明,对于平和质量表,ROC曲线下面积为0.928(95%CI:0.924-0.932),对于偏颇质量表,当使用原始CCMQ的临界值40(“是”标准)和30(“倾向”标准)时,ROC曲线下面积分别为0.895-0.969和0.911-0.981。

结论

我们的研究成功开发了一个具有良好心理测量学特性和与原版一致的优秀诊断效度的简版。为体质辨识、健康管理和基层医疗实施提供了新的、简化的工具和机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2778/10617149/f665c513d8a2/13020_2023_844_Fig1_HTML.jpg

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