Objective evaluation of tongue diagnosis ability using a tongue diagnosis e-learning/e-assessment system based on a standardized tongue image database.

Background: In Kampo medicine, tongue examination is used to diagnose the pathological condition "Sho," but an objective evaluation method for its diagnostic ability has not been established. We constructed a tongue diagnosis electronic learning and evaluation system based on a standardized tongue image database. Purpose: This study aims to verify the practicality of this assessment system by evaluating the tongue diagnosis ability of Kampo specialists (KSs), medical professionals, and students. Methods: In the first study, we analyzed the answer data of 15 KSs in an 80-question tongue diagnosis test that assesses eight aspects of tongue findings and evaluated the (i) test score, (ii) test difficulty and discrimination index, (iii) diagnostic consistency, and (iv) diagnostic match rate between KSs. In the second study, we administered a 20-question common Kampo test and analyzed the answer data of 107 medical professionals and 56 students that assessed the tongue color discrimination ability and evaluated the (v) correct answer rate, (vi) test difficulty, and (vii) factors related to the correct answer rate. Result: In the first study, the average test score was 62.2 ± 10.7 points. Twenty-eight questions were difficult (correct answer rate, <50%), 34 were moderate (50%-85%), and 18 were easy (≥85%). Regarding intrarater reliability, the average diagnostic match rate of five KSs involved in database construction was 0.66 ± 0.08, and as for interrater reliability, the diagnostic match rate between the 15 KSs was 0.52 (95% confidence interval, 0.38-0.65) for Gwet's agreement coefficient 1, and the degree of the match rate was moderate. In the second study, the difficulty level of questions was moderate, with a correct rate of 81.3% for medical professionals and 82.1% for students. The discrimination index was good for medical professionals (0.35) and poor for students (0.06). Among medical professionals, the correct answer group of this question had a significantly higher total score on the Kampo common test than the incorrect answer group (85.3 ± 8.4 points vs. 75.8 ± 11.8 points, p < 0.01). Conclusion: This system can objectively evaluate tongue diagnosis ability and has high practicality. Utilizing this system can be expected to contribute to improving learners' tongue diagnosis ability and standardization of tongue diagnosis.

[Gender related problems in medicine--an analysis of questionnaire to male anesthesiologists].

BACKGROUND: There is little information on gender related problems in medicine from a point of view of the male anesthesiologists. METHODS: A questionnaire was sent in January 2001 to 300 male anesthesiologists. The questionnaire asked for information on personal and professional demographics, gender inequity, and family responsibility. RESULTS: Of the 186 responding male anesthesiologists (62.0% response rate), 62.4% of them felt a gender inequity. They felt a gender inequity the most in family responsibility (40% of them). In contrast, those who felt a gender inequity in working ability and promotion were small in number (4.1%, 14.1%, respectively). More than 80% of male anesthesiologists agreed on the need of consideration about night-duty for the female anesthesiologists. On the other hand, 66.7% of them felt that taking place of the female anesthesiologists was a burden on them. CONCLUSIONS: More than half of male anesthesiologists felt a gender inequity especially in family responsibility. In addition, it is impressive that most of male anesthesiologists were unaware of gender inequity in promotion in face of the fact that the number of the female professors was very small. Systemic effort is required to grapple with gender inequity problems to change the social organization in the field of medicine.