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Levels of inter-rater agreement on factors pertaining to TCM diagnosis in published studies are generally low to moderate, conclude the authors of a systematic review carried out in America. Analysing data from 21 trials, they found that the mean rates of pairwise agreement between raters averaged 57% across the nine studies that reported on this statistical comparator. With a few exceptions, the levels of agreement were low to moderate. Most studies had significant deficits of both methodology and reporting. The authors suggest a few design features that might contribute to higher levels of agreement and recommend that methods of complex systems analysis should be explored to more adequately model the relationship between clinical outcomes and the series of diagnoses and treatments that are the norm in actual TCM practice.

Experimental Studies of Inter-Rater Agreement in Traditional Chinese Medicine: A Systematic Review. J Altern Complement Med. 2019 Nov;25(11):1085-1096.