Clinical outcome measures + CM

Question 1

What are outcome measures?

Answer 1

Outcome measures are tools used to assess or measure a patients current status of health
A clinical outcome assessment is a measure of a patients health status that comes directly from the patient (patient-reported outcome) or a measurement of how a patient functions in daily life or during normal activities

Question 2

What are the four main categories of outcome measures?

Answer 2

Outcome measures: four main categories
Patient-reported outcome measures
Performance based outcome measures
Observer reported outcome measures
Clinical reported-measures

Question 3

What does PROMs stand for?

Answer 3

Patient reported outcome measures.
Standardised, validated questionnaires completed by the patient to measure their perception of their functional wellbeing and health status

Question 4

What are performance based measures?

Answer 4

Performances based measures: requires the patient to perform a set of movements or tasks

Question 5

What are observer reported based measures?

Answer 5

Observer reported: assessment made by someone other than the patient

Question 6

What are clinician reported measures?

Answer 6

Reported by the clinician

Question 7

What are the benefits of using outcome measures?

Answer 7

Benefits of using outcome measures: guide medical decision making, evaluate treatment effectiveness, monitor natural history of selected health-related conditions

Question 8

What are the risks and limitations of outcome measures?

Answer 8

Risks and limitations: sensitivity, specificity, relevance of results for patient

Question 9

What is Chinese internal medicine?

Answer 9

Focuses on assessment, diagnosis and holistic management (including prevention of illness) of internal diseases / disorders
Internal disorders encompasses a wide range of internal organs and vital substances (Qi, Xue, Jinye, Jing)-related disorders

Question 10

What is TCM diagnosis based on?

Answer 10

TCM diagnosis is usually based on its aetiology pathogenesis and pathological results, disease location, symptoms and signs of a condition but mostly the diagnostic disease / condition is named after the patients main complaint.

Question 11

What is pattern diagnosis?

Answer 11

Pattern diagnosis is a summary of the mechanism of a phase in a disease. e.g. main complaint: dry cough for two weeks, disease condition: cough (Ke sou), pattern diagnosis: lung yin xu from wind-dryness attack
Each treatment prescription should be formulated according to the differential pattern/syndrome
The best treatment is prevention of illness

Question 12

What is prevention of illness in CM?

Answer 12

Prevention in CM involves two principles: 1. Preventing illness by keeping the Yin-Yang balance of the body, 2. Preventing the disease further progressing worse or deterioration
In treatment for chronic conditions or remission phase, address the root/ben of the illness first and in treatment for acute conditions address the branch/biao of the illness first
In treatment for a combined pattern of a disease, address the root and branch simultaneously (root deficiency and branch excess)

Question 13

What are internal disorders?

Answer 13

It includes respiratory disorders, gastrointestinal disorders, cardiovascular disorders, endocrine disorders, autoimmune diseases, neurological disorders and psychological disorders from a western perspective.

Question 14

What are some classical texts for internal medicine?

Answer 14

Shanghai Lun (treatise on cold damage) complied by Zhang Zhongjing: provides detailed explanations of the six-meridian syndrome diagnosis and differential diagnosis, progression. Of externally contracted diseases and the corresponding herbal formula treatments.
Jingo Yaolue: builds on the concepts introduced in the Shang Han Run with emphasis on the treatment of internal diseases, esp those related to ZangFu Kidneys and Bladder pathologies.
Qian Jin Fang: encompasses a vast collection of herbal formulas from various sources (6000 herbal formulas). It addresses internal diseases, external conditions, gynaecological disorders and pediatric conditions
Wen Bing Xue: Two diagnosis methods, 1. Four levels, 2. San Jiao Bian Zheng.

Question 15

What are some core texts for TCM principles?

Answer 15

Classical texts for TCM core theory and philosophy:
Huangdi Neijing is divided into two parts Suwen (basic questions or plain questions and the LingShu (spiritual pivot)
Suwen elucidates the fundamental theories of CM, including the concepts of Yin and Yang, the five elements and the meridian system
The LingShu focuses on acupuncture, discussing the functions of the meridians, needling techniques and the application of acupuncture in the treatment of various diseases

Question 16

What is Etiology?

Answer 16

Refers to the study of causes and origins of disease. It includes both internal and external factors that disrupt the body’s equilibrium and contribute to the development of specific patterns of disharmony.

Question 17

What are external etiological factors?

Answer 17

External etiological factors: Six evils (wind, cold, heat, dampness, dryness and fire). These factors can invade the body and cause imbalances in the flow of Qi and blood leading to disease manifestation
Injury or trauma from external damage are also a special type of external etiological factor

Question 18

What are internal etiological factors?

Answer 18

Internal etiological factors: involve imbalances within the body such as emotional disturbances, improper diet, overwork, constitutional weaknesses and pre-exisiting illness or wrong treatments.

Question 19

What is pathogenesis in TCM?

Answer 19

Pathogenesis in TCM refers to the mechanism of the development and progression of diseases. It involves the identification of factors that disrupt the balance of Yin and Yang, the flow of Qi and the harmony of organ systems.

Question 20

What does a complete TCM diagnosis include?

Answer 20

A complete TCM diagnosis includes disease diagnosis and pattern diagnosis
TCM disease / condition diagnosis is usually determined by the patient’s main complaint which is very different from Western medicine disease diagnosis.

Question 21

What does pattern diagnosis refer to?

Answer 21

Pattern diagnosis refers to the identification and differentiation of pathogenesis for mechanism of disharmony or imbalances in a stage of disease. It focuses on understanding the underlying mechanisms of symptoms associated with a particular stage of disease progression.

Question 22

What are the pattern diagnosis methods?

Answer 22

Eight principles (Ba Gang): yin and yang, interior and exterior, cold and heat, deficiency and excess
Zang Fu (internal organs): based on the ZangFu physiology and pathologies to identify the patterns
Vital substance imbalance / disharmony diagnosis: Qi, Xue, Jinye and Jing pattern: Qi Xu, Qi stagnation (Liver), Qi rebellious (Lung Qi, Stomach Qi), Qi Sinking (Spleen Qi), Blood stag, Qi and Blood stag, Blood Xu, Qi and Blood Xu, Yin Xu, Yang Xu, Phlegm-damp, Kidney essence Xu.
Zhang Zhongjing: six meridian identification
Meridian identification or 6 divisions
Wen Bing (Four levels and San Jiao Bian Zheng

Question 23

What is the point combination theory pattern differentiation?

Answer 23

Acupuncture prescriptions are based on the specific pattern of disharmony diagnosed in the patient. The selection of points is tailored to address the underlying pattern and restore balance.

Question 24

What is the point combination theory of local and distal points?

Answer 24

Acupuncture treatments involve a combination of local and distal points. Local points are selected near the affected area or target region, whilst distal points are located away from the site of discomfort and have a therapeutic relationship to the condition.

Question 25

What is the point combination theory of channels and meridians?

Answer 25

Channels or meridians are selected based on their relevance to the pattern of disharmony. Each channel has a specific pathway and connection to the different organs and body systems. By choosing the appropriate channel, the treatment can target the underlying imbalance.

Question 26

What is the point combination theory of principle of point energetics and categories?

Answer 26

Acu points have specific energetic properties such as Yin or Yang, they can be tonifying and reducing in nature. The selection of points considers their individual qualities to harmonise and balance the patients energy.

Question 27

What is the point combination theory of principle of complementary points?

Answer 27

include a combination of points that complement each others actions. This means selecting points with similar therapeutic effects or points that address aspects of the pattern disharmony to enhance the overall treatment outcome.

Question 28

What is the point combination theory of principle of individualisation?

Answer 28

Tailored to each patients unique presentation and constitution. This involves considering the patients overall health, constitution, and specific symptoms to create a personalised treatment plan.