Meseret Firde
Incidence and root causes of medication errors by anesthetists: a multicenter web-based survey from 8 teaching hospitals in Ethiopia
Patient safety in surgery
objectives recommended clinical trials traditional chinese medicine tcm would ecologically valid characteristic mode diagnostic reasoning integrated design context however also widely held demonstrating high level agreement initial tcm diagnoses necessary replicability biomedical paradigm requires conclusions trials aim review summarize critique quantitative experimental studies interrater agreement tcm underlying assumptions design systematic electronic searches conducted articles reported quantitative measure interrater agreement across number rating choices based examinations human subjects person tcm practitioners published english language peerreviewed journals publications languages english included appearing peerreviewed journals predefined categories information extracted full texts two investigators working independently article scored methodological quality outcome measures design features across studies levels interrater agreement across studies reported type outcome statistic compared results twentyone articles met inclusion criteria fourteen assessed interrater agreement tcm diagnoses two diagnostic signs found upon traditional tcm examination five novel rating schemes derived tcm theory practice raters students tcm colleges graduates tcm training programs 3 years experience licensure type outcome statistic varied mean rates pairwise agreement averaged 57 median 65 range 1996 across 9 studies reporting mean cohens kappa averaged 034 median 034 range 007059 across seven studies reporting metaanalysis possible due variations study design outcome statistics high risks bias confounding deficits statistical reporting common conclusions exceptions levels agreement low moderate studies significant deficits methodology reporting results overall suggest design features might contribute higher levels agreement studied better experimental controls thorough reporting outcomes addition methods complex systems analysis explored adequately model relationship clinical outcomes series diagnoses treatments norm actual tcm practice