Solution Proposal for 5 Challenges to be Resolved in Formalizing the Logical Format of Kampo-Based Diagnosis by Building Consensus Among 6 Medical Institutions Specialized in Kampo Herbal Medicine / 日本東洋医学雑誌

We are planning a study focused on the gathering of clinical data for the purpose of formalizing diagnostic logic at 6 institutions specialized in Kampo-based medical examinations. However, during the planning stage, it has been recognized that there are a large number of Kampo formulas to be studied, and differences among faculties and individuals exist regarding how to identify each Kampo formula, methods of gathering findings, and the evaluation of efficacy. Here we report the solution proposal reached after building consensus among all participating faculties on these issues. After raising the issues, conferences were held for each of them, until a unanimous consensus was obtained. As a result, the following conclusions were reached. Thirty-three Kampo formulas were selected as targets for the formalization of diagnostic logic. In addition, the range of dosage forms, crude drug ingredients, and permissible dosages for each Kampo formula were determined. Regarding clinical findings for these Kampo medicines, the items to be collected and evaluation criteria were also established. The criteria for evaluating the validity and safety of each Kampo medicine were decided, together with the grading and timing of evaluation. We hope that our solution proposal reached after building consensus becomes the basis for Kampo research in the future.

Prediction Model for Deficiency-Excess Patterns, Including Medium Pattern / 日本東洋医学雑誌

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.

Problem Extraction of Browser-Based Questionnaire System and its Solution for a Patient-Centered System / 日本東洋医学雑誌

We have developed and operated a browser-based questionnaire system for Kampo medicine based on conventional questionnaires and review of systems to reveal implicit Kampo wisdom both in patients' questionnaire data and in some Kampo specialists' examination data. However, the questionnaire data were found to be inaccurate because too many questions were included and cumbersome input steps were required. The purpose of the present study was to solve these problems and to develop a new patient-centered questionnaire system with fewer questions and an easier input method. After analyzing inquiry database from collaborating institutes and hospitals, we deleted, combined, and added questions. We changed the evaluation method of symptoms from a visual analogue scale to a simple staged evaluation, and introduced another method to evaluate the main symptoms in each time of visit using a visual analogue scale. At the same time, a tool for predicting Kampo pattern diagnoses based on the questionnaire data was implemented. We have already started collecting more accurate and reliable data using the new questionnaire system. It is expected to support routine practices and facilitate more precise clinical research on Kampo medicine.

<b>Japanese Literature Survey of Tongue Findings for the Purpose of Creating a Unified Multicenter Description of Clinical Tongue Diagnoses</b> / 日本東洋医学雑誌

In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).<br>Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.

List of Serials indexed in MEDLINE from the Han-character-using Sphere / 日本東洋医学雑誌

A survey was done of the serials from the countries/areas in the Han-character-using sphere that are indexed in MEDLINE, the global medical data base created by National Library of Medicine of the United States of America. One hundred eighty serials were found to be from eight different countries/areas, which are, in alphabetical order: China (32 periodicals), Hong Kong (2), Japan (124), Republic of Korea (6), Malaysia (2), Singapore (4), Taiwan (8) and Thailand (3). Of these, 28 of the serials from China are in the Chinese language (88%), 66 of the Japanese serials are in Japanese (53%), one of the serials from Republic of Korea is in Korean (17%) and five of the serials from Taiwan are in Chinese (63%). As for traditional medical serials only China had three such publications. In order to correctly transmit the Oriental Medicine of Japan, efforts are needed to have this serials, <i>Nihon Toyo Igaku Zasshi</i> (Japanese Journal of Oriental Medicine), indexed in MEDLINE.

Starting Year of Indexing and Number of Articles in the 54 Serials in the Field of "Toyo-Igaku" (Oriental Medicine) indexed in JMEDCINE / 日本東洋医学雑誌

For its 1993 activity, the Data base Subcommittee, Editorial Committee, the Japan Society for Oriental Medicine (JSOM) made a survey of: (1) the starting year of publication; (2) the starting year of indexing; and (3) the number of articles in the 54 serials indexed in JMEDICINE. (The names, pablication Codes, etc are reported in the <i>Nihon Toyo Igaku Zasshi</i>, 45: 571-575, 1993, as the 1992 activity of the Subcommittee's A general picture of the period covered and the number of articles indexed in JMEDICINE were revealed in the survey. In view of the recent improvement in the accessibility to JMEDICINE, further use of it in research and clinical work is recommended.