Study on Reliability of Interpretation and Reproducibility of a Pulse Analyser

Objectives : This study was performed to evaluate inter-rater and intra-rater reliability of interpretation and reproducibility of a pulse analyser (MAXMAC27-Plus). Methods : 38 of 40 volunteers completed the pulse analysis consecutively. Three Korean medical doctors who had at least 2 years of clinical experience interpreted the pulse waves for 3 aspects of size, depth and shape, then inter-rater reliability and crude agreement was obtained. Reinterpretation was done 2 weeks later and intra-rater reliability and crude agreement was obtained. Intra-rater reliability and crude agreement between 1st and 2nd measurement was calculated. Cohen's weighted kappa for size, Cohen's kappa for depth and shape were used as statistical analysis. Results : Inter-rater reliability of size, depth and shape among 3 raters was 0.598, 0.604, and 0.312, respectively, showing moderate to substantial agreement. Average intra-rater reliability between 1st and 2nd interpretation of size, depth and shape was 0.806, 0.705, and 0.638, respectively, showing substantial to almost perfect agreement. However, intra-rater reliability between consecutive measurements of size, depth and shape was 0.221, 0.121, and 0.194, respectively, which showed only poor to fair agreement. Conclusions : Intra-rater and inter-rater reliability of one pulse wave showed relatively high concordance. Training by a clinical expert may effect better concordance among raters. Test-retest reliability showed poor agreement. Improvement of measurement technique and device performance will be needed.