Measuring Practitoner Opinion on Adverse Reactions to Acupuncture

摘要

Background: The terminology associated with the categorisation and reporting of adverse reactions to acupuncture (ARA) does not necessarily fit well with other universal adverse reaction reporting systems. Evaluation of practitioners' interpretation of ARA concepts and associated terminology is needed to ensure high quality reporting. This study reports the survey of acupuncture practitioners' opinion regarding ARA terminology, using a custom- designed Adverse Reactions to Acupuncture Questionnaire (ARAQ). The questionnaire was administered on two separate occasions to examine the consistency of question response in the context of usual clinical practice over time. Method: Twelve female acupuncturists (11 physiotherapists and one general practitioner), mean age 46.83 (+ -8.3) years completed the initial and follow-up ARAQ administered eight months apart. Analysis: Incra-rarer agreement analysis was performed using intra-class coefficients (ICCs) for the visual analogue scales (VASs) and linear weighted Cohen's K coefficients for the ranked questions. A systematic decision rule process analysed the repeated responses for the word categorisation task. Results: A statistical level of intra-rater agreement (P < 0.05) was achieved in 77% of the VAS questions (0.76-0.88) on repeated administration of the ARAQ. In the word categorisation task, 41% of acupuncture-related symptoms attained entry to identical adverse event domains on repeated responses. Whilst overall hierarchical weighting of preference responses were predominantly unchanged for the ranking questions the majority of kappa coefficients for individual ranking tasks were low. Conclusion: The levels of practitioner intra-rater agreement in the VAS questions and word categorisation task relating to ARA performed most consistently over time. It is suggested that the styles of questions be carefully considered in future questionnaire development of this nature. The variation in agreement may be as a result of th...