The development of a questionnaire for Diagnostic Evaluation of Kidney-Yin Deficiency and Kidney-Yang Deficiency

Abstract

OBJECTIVE: Subjective assessment and interpretation can result in low diagnostic consistency among practitioners. We constructed and evaluated a self-reporting Kidney deficiency syndrome (KDS) questionnaire for diagnostic evaluation of Kidney-Yin deficiency syndrome (KDS-Yin) and Kidney-Yang deficiency syndrome (KDS-Yang). METHODS: We reviewed functional components distinct to the Kidney and associated symptom groups of KDS-Yin and KDSYang from Chinese medical classics. We tested whether the symptom groups which concurrently were specific to KDS-Yin or KDSYang would present in women aged 40-60. The KDS questionnaire consisting of the symptom groups was tested for measurement properties. RESULTS: Kidney-jing deficiency and Kidney-qi deficiency were qualitatively classified to KDS-Yin and KDS-Yang because lack of nourishment or warmth respectively produced various degrees of dry-heat or moist-cold. Symptom groups of the marrows (brain, bones), dry-heat or moist-cold, the ‘openings’ (ears, genitals, anus), water distribution and urine excretion (urinary bladder) were reviewed from the classics. The symptom groups and their diagnostic roles could be consistently identified by factor analysis and discriminant analysis against actual clinical diagnoses of KDSYin and KDS-Yang in 236 subjects. The measurement properties including interpretability of scores, floor or ceiling effects of scores, internal consistency, construct validity, reproducibility and responsiveness tested met with the recommended standards for health measurement scales. The cut-off scores between cases and non-cases were defined against actual clinical diagnoses, respectively. CONCLUSION: The KDS questionnaire could be used for diagnostic evaluation of KDS-Yin and KDS-Yang in middle aged women. Such scales might be developed by integrating classic theory with health measurement scale development techniques.