Study on traditional Chinese medicine syndrome differentiation of cerebral palsy in children based on modified Delphi method and analytic hierarchy process
Objective To conduct a study on the syndrome differentiation and related syndrome items of cere-bral palsy in children using the modified Delphi method and analytic hierarchy process(AHP).Methods We searched the literature in CNKI,VIP,Wanfang,and PubMed databases from July 1,2005,to September 30,2022,fo-cusing on diagnostic and treatment approaches,clinical symptoms,and signs of cerebral palsy in both traditional Chinese medicine(TCM)and Western medicine,guidelines,clinical observations,and expert experience.After pre-liminary literature integration,systematic evaluation by the research team,and expert panel discussion,items with a frequency greater than 20 were included in the item pool.Three preliminary TCM syndromes were identified:spleen deficiency with liver hyperactivity,phlegm and blood stasis obstruction,and yin deficiency with wind agitation.A consultation questionnaire,Recognition of Syndrome Differentiation Items for Cerebral Palsy in Traditional Chinese Medicine,was developed and subjected to three rounds of Delphi expert surveys to determine the syndrome differen-tiation indicators.The survey results were evaluated from multiple angles,including mean values,rank sums,coeffi-cients of variation,and percentages of items deemed unimportant.Items were revised based on expert evaluations.AHP was used to calculate the weights of syndrome clusters,thereby preliminarily establishing an expert consensus on TCM syndrome differentiation of cerebral palsy.Results A total of 183 articles were included in the analysis,leading to the identification of three TCM syndromes with 33 items:11 items for spleen deficiency with liver hyper-activity syndrome,12 items for phlegm and blood stasis obstruction syndrome,and 10 items for yin deficiency with wind agitation syndrome.Sixty renowned domestic experts were invited to participate in the questionnaire survey,with an expert authority score of 17.9.The response rates for the first and second rounds of the survey were 95.24％and 75.00％,respectively.The overall coordination coefficient for the third round was 0.348.Based on the mean val-ues,coefficients of variation,and clinical experience,items were appropriately deleted or modified,and the final syn-drome differentiation items were determined.The AHP results showed that the primary indicators of cerebral palsy,in descending order of importance,were spleen deficiency with liver hyperactivity syndrome,phlegm and blood stasis obstruction syndrome,and yin deficiency with wind agitation syndrome.The weights of secondary indicators were ranked according to their relative importance within each syndrome.Conclusion A preliminary TCM syndrome dif-ferentiation model for cerebral palsy in children was established based on the Delphi method and AHP,encompass-ing primary and secondary indicators for each syndrome.This model facilitates clinicians in grasping the key points of syndrome differentiation.
cerebral palsysyndrome differentiation and treatmentDelphi methodanalytic hierarchy processexpert questionnaire
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