The Validation of Auricular Diagnosis

Background

The first attempt to validate auricular diagnosis in a blind experimental evaluation was made by Terry Oleson in 1980. Now, a new project was proposed for validating auricular diagnosis by means of three methods: Inspection of the outer ear, Pain Pressure Test (PPT), and Electric Skin Resistance Test (ESRT)

Objectives

To find an answer to the following questions:1. Were the above mentioned diagnostic methods quantitatively equivalent in unveiling the patient's problems?2. Were the different methods equivalent in diagnosing recent and old problems?3. In case of musculoskeletal disorders, were the different methods equally effective in detecting the prevalent side of pain?

Methods

A total of 506 patients were examined in a one-sided blinded trial: 371 females (average age 48.1) and 135 males (average age 46.5). Inspection at first, PPT and ESRT in a random order afterwards, were all performed after having invited every new patient to fill in a form with his old and recent symptoms and diseases in decreasing order of importance.The first assessor transcribed for each method, on different sheets of the Sectogram, all possible symptoms and diseases thought to be related with the topography of ear skin alterations or the location of the points identified with PPT and ESRT.The second assessor had the delicate task of working out the number of consistent symptoms, but was free to interpret them as best he could, also speaking to the patient. He also had to verify if there were symptoms which the patient had neglected to mention in the form.

Results

The three diagnostic methods used had different success rates for the identification of patients' symptoms. Ranging in first place was inspection with 52.2 %, followed by PPT with 33.7 % and ESRT - with 33.2 %. Interestingly, if a symptom was identified by at least one method, the success rate rose to 78.6 %.Regarding the second question, “recent” and “old” problems were defined following the categorization used by Oleson (having occurred < 6 or ≥ 6 months, respectively). The success rates in identifying these two categories of symptoms were very similar for all 3 diagnostic methods.Regarding the third question, the first assessor could, when diagnosing musculoskeletal disorders, further specify the side of pain (right, left and bilateral). If the pain was bilateral or without prevalence of side, the success rates were higher than expected (inspection 85.2 %, PPT 56.2 %, ESRT - 20.7 %), as opposed to the cases of ipsilateral (right or left) pain (inspection 51.7 %, PPT 25.3 %, ESRT - 14.6 %).

Conclusions

Inspection is an essential part of auricular diagnosis, alone or in combination with one or more detection techniques. Its superiority over the other methods confirms the importance given by Chinese authors to this procedure which has been neglected in Western countries. The combination of as many diagnostic methods as possible permits the experienced physician to achieve a relevant diagnostic versatility in detecting health disorders of various origins in his patients.