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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 24499

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Special Issue Editor

Prof. Dr. Bo-Young Youn

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Guest Editor

Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Korea
Interests: integrative medicine; complementary and alternative medicine; digital health; global health; big data and artificial intelligence; neurological conditions; cancer

Special Issue Information

Dear Colleagues,

Since the 2000s, increasing attention has been paid to integrative medicine. Integrative medicine focuses on the prevention and treatment of illness in the least invasive and most productive way. More importantly, integrative medicine tailors individualized treatment plans to address the root causes of medical issues. Utilizing an integrative methodology, treatments focus on the causes of these symptoms and the correction of underlying issues.

Various integrative diagnostic approaches have been introduced, such as symptom classification, pulse diagnosis, tongue diagnosis, constitution diagnosis, etc. In addition, new diagnostic devices or biomarkers for pattern identification, diagnostic approaches to predict treatment responses, and the use of diagnostic devices in education have been explored recently. Hence, it is vital to find ongoing evidence-based research on integrated diagnostic approaches to optimize diagnostic validity and utility.

This Special Issue aims to highlight new diagnostic models and approaches that might play future roles in more precise diagnosis and more accurate prognosis and treatment response for various symptoms. Original research articles, reviews, or commentaries/perspectives covering new diagnostic or prognostic markers are welcome.

Specifically, the following topics are also covered in this Special Issue.

The development and validation of symptom classification (pattern identification) using classical or novel approach;
Pulse diagnosis, tongue diagnosis, stomach diagnosis, constitution diagnosis, etc.;
New diagnostic devices, algorithms, biomarkers for pattern identification;
Diagnostic approaches to predict responder or treatment responses;
The use of diagnostic devices or software in integrative medicine education.

Prof. Dr. Bo-Young Youn
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

integrative medicine
integrative diagnostics
clinical diagnosis
diagnostic models
holistic diagnosis

Published Papers (11 papers)

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Editorial

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4 pages, 185 KiB

Open AccessEditorial

Integrative Medicine in Diagnostics: Current Advances and Future Prospects

by Bo-Young Youn

Diagnostics 2023, 13(19), 3052; https://doi.org/10.3390/diagnostics13193052 - 25 Sep 2023

Viewed by 697

Abstract

Integrative medicine (IM) has recently gained significant attention from patients and healthcare professionals worldwide [...] Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

Research

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13 pages, 769 KiB

Open AccessArticle

Reliability Analysis of Vertebral Landmark Labelling on Lumbar Spine X-ray Images

by Jun-Su Jang, Joong Il Kim, Boncho Ku and Jin-Hyun Lee

Diagnostics 2023, 13(8), 1411; https://doi.org/10.3390/diagnostics13081411 - 13 Apr 2023

Cited by 2 | Viewed by 1314

Abstract

Vertebral landmark labelling on X-ray images is important for objective and quantitative diagnosis. Most studies related to the reliability of labelling focus on the Cobb angle, and it is difficult to find studies describing landmark point locations. Since points are the most fundamental geometric feature that can generate lines and angles, the assessment of landmark point locations is essential. The aim of this study is to provide a reliability analysis of landmark points and vertebral endplate lines with a large number of lumbar spine X-ray images. A total of 1000 pairs of anteroposterior and lateral view lumbar spine images were prepared, and 12 manual medicine experts participated in the labelling process as raters. A standard operating procedure (SOP) was proposed by consensus of the raters based on manual medicine and provided guidelines for reducing sources of error in landmark labelling. High intraclass correlation coefficients ranging from 0.934 to 0.991 verified the reliability of the labelling process using the proposed SOP. We also presented means and standard deviations of measurement errors, which could be a valuable reference for evaluating both automated landmark detection algorithms and manual labelling by experts. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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10 pages, 595 KiB

Open AccessArticle

Resting Metabolic Rate for Diagnosing Tae-Eum Sasang Type and Unraveling the Mechanism of Type-Specific Obesity

by Jieun Park, Seul Lee, Yongjae Lee, Jeongyun Lee and Han Chae

Diagnostics 2023, 13(4), 672; https://doi.org/10.3390/diagnostics13040672 - 10 Feb 2023

Cited by 1 | Viewed by 2405

Abstract

Increased resting metabolic rate (RMR), representing augmented energy expenditure, is a preferred physical characteristic; however, the Tae-Eum Sasang type, with a high incidence of obesity and metabolic diseases, has a higher RMR. This study scrutinized the physical characteristics of Sasang typology, a traditional Korean personalized medicine, to resolve this discrepancy, which can unravel the mechanism of Tae-Eum-type-specific obesity and improve the Tae-Eum Sasang-type diagnosis. A total of 395 healthy participants provided Sasang-type diagnosis using Sasang Constitutional Analysis Tool and physical features, including skeletal muscle mass, body fat mass, and RMR, along with those standardized using body weight. The Tae-Eum-type group showed significantly higher body weight, body mass index, body fat mass, and unstandardized RMR (kcal/day) than others, while their standardized measures of RMR per weigh (RMRw, kcal/day/kg) and percent skeletal muscle (PSM, %) were significantly lower. The logistic regression model revealed that the RMRw is pivotal for discriminating Tae-Eum type from others and explaining the developmental mechanism of Tae-Eum-type obesity. The aforementioned might provide a theoretical framework for Sasang-type diagnosis and Sasang-type-specific health promotion using bodily exercise and medical herbs. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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14 pages, 4416 KiB

Open AccessArticle

An Ancillary Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling Is Difficult

by Akira Yamamoto, Takeshi Fukunaga, Mitsuru Takeuchi, Hiroki Nakamura, Akihiko Kanki, Atsushi Higaki and Tsutomu Tamada

Diagnostics 2023, 13(4), 649; https://doi.org/10.3390/diagnostics13040649 - 09 Feb 2023

Cited by 1 | Viewed by 1258

Abstract

Catheterization of the right adrenal vein (rt.AdV) to obtain blood samples can often be difficult. The aim of the present study was to investigate whether blood sampling from the inferior vena cava (IVC) at its juncture with the rt.AdV can be an ancillary to sampling of blood directly from the rt.AdV. This study included 44 patients diagnosed with primary aldosteronism (PA) in whom AVS with adrenocorticotropic hormone (ACTH) was performed, resulting in a diagnosis of idiopathic hyperaldosteronism (IHA) (n = 24), and patients diagnosed with unilateral aldosterone-producing adenoma (APA) (n = 20; rt.APA = 8, lt.APA = 12). In addition to regular blood sampling, blood was also sampled from the IVC, as the substitute rt.AdV [S-rt.AdV]. Diagnostic performance with the conventional lateralized index (LI) and the modified LI using the S-rt.AdV were compared to examine the utility of the modified LI. The modified LI of the rt.APA (0.4 ± 0.4) was significantly lower than those of the IHA (1.4 ± 0.7) (p < 0.001) and the lt.APA (3.5 ± 2.0) (p < 0.001). The modified LI of the lt.APA was significantly higher than those of the IHA (p < 0.001) and rt.APA (p < 0.001). Likelihood ratios to diagnose rt.APA and lt.APA using the modified LI with threshold values of 0.3 and 3.1 were 27.0, and 18.6, respectively. The modified LI has the potential to be an ancillary method for rt.AdV sampling in cases in which rt.AdV sampling is difficult. Obtaining the modified LI is extremely simple, which might complement conventional AVS. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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18 pages, 1749 KiB

Open AccessArticle

Comparison of Concordance between Chuna Manual Therapy Diagnostic Methods (Palpation, X-ray, Artificial Intelligence Program) in Lumbar Spine: An Exploratory, Cross-Sectional Clinical Study

by Jin-Hyun Lee, Hyeonjun Woo, Jun-Su Jang, Joong Il Kim, Young Cheol Na, Kwang-Ryeol Kim, Eunbyul Cho, Jung-Han Lee and Tae-Yong Park

Diagnostics 2022, 12(11), 2732; https://doi.org/10.3390/diagnostics12112732 - 08 Nov 2022

Cited by 3 | Viewed by 1501

Abstract

Before Chuna manual therapy (CMT), a manual therapy applied in Korean medicine, CMT spinal diagnosis using palpation or X-ray is performed. However, studies on the inter-rater concordance of CMT diagnostic methods, concordance among diagnostic methods, and standard CMT diagnostic methods are scarce. Moreover, no clinical studies have used artificial intelligence (AI) programs for X-ray image-based CMT diagnosis. Therefore, this study sought a feasible and standard CMT spinal diagnostic method and explored the clinical applicability of the CMT-AI program. One hundred participants were recruited, and the concordance within and among different diagnostic modalities was analyzed by dividing them into manual diagnosis (MD), X-ray image-based diagnosis (XRD) by experts and non-experts, and XRD using a CMT-AI program by non-experts. Regarding intra-group concordance, XRD by experts showed the highest concordance (used as a gold standard when comparing inter-group concordance), followed by XRD using the AI program, XRD by non-experts, and then MD. Comparing diagnostic results between the groups, concordance with the gold standard was the highest for XRD using the AI program, followed by XRD by non-experts, and MD. Therefore, XRD is a more reasonable CMT diagnostic method than MD. Furthermore, the clinical applicability of the CMT-AI program is high. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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13 pages, 4720 KiB

Open AccessArticle

“3D Counterpart Analysis”: A Novel Method for Enlow’s Counterpart Analysis on CBCT

by Michele D’Attilio, Antonino Peluso, Giulia Falone, Rossana Pipitone, Francesco Moscagiuri and Francesco Caroccia

Diagnostics 2022, 12(10), 2513; https://doi.org/10.3390/diagnostics12102513 - 17 Oct 2022

Cited by 2 | Viewed by 1801

Abstract

The aim of this study was to propose a novel 3D Enlow’s counterpart analysis traced on cone-beam computed tomography (CBCT) images. Eighteen CBCT images of skeletal Class I (ANB = 2° ± 2°) subjects (12 males and 6 females, aged from 9 to 19 years) with no history of previous orthodontic treatment were selected. For each subject, a 2D Enlow’s counterpart analysis was performed on lateral cephalograms extracted from the CBCT images. The following structures were identified: mandibular ramus, middle cranial floor, maxillary skeletal arch, mandibular skeletal arch, maxillary dento-alveolar arch, mandibular dento-alveolar arch. The differences between each part and its relative counterpart obtained from the 2D analysis were than compared with those obtained from a 3D analysis traced on the CBCT images. A Student’s t-test did not show any statistical significant difference between the 2D and 3D measurements. The landmarks proposed by this study identified the cranio-facial structures on the 3D images in a way that could be superimposed on those described by Enlow in his analysis performed on 2D lateral cephalograms. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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15 pages, 830 KiB

Open AccessArticle

Mandibular Clinical Arch Forms in Iraqi Population: A National Survey

by Munther A. Ali and Yassir A. Yassir

Diagnostics 2022, 12(10), 2352; https://doi.org/10.3390/diagnostics12102352 - 28 Sep 2022

Cited by 2 | Viewed by 1327

Abstract

Background: This study aims to identify mandibular clinical arch forms and dimensions in the Iraqi population. Materials and methods: The study sample consisted of pre-treatment mandibular study models of the Iraqi population. The most labial aspect of 13 proximal contact areas was digitized using AutoCAD software to determine the clinical bracket point for every tooth. The dental arches were classified into three types: tapered, ovoid, and square. The arch dimensions were identified using four linear and two proportional measurements. Results: A total of 1005 study models were collected. The arch forms were distributed as ovoid (47%), tapered (36.2%), and square (16.8%), with no significant difference in the distribution between Arabs and Kurds. The ovoid arch form was predominant in class I and class III malocclusion, while the tapered arch form was predominant in class II. All the linear measurements were greater in the males than in the females. The arch widths decreased as the arch form shifted from square to ovoid to tapered, while the arch depths showed the reverse relation. Conclusions: According to this study, ovoid and tapered archwires should suit the majority of Iraqi patients. The ovoid arch form was the most predominant in the subjects with class I and class III malocclusion, while the tapered arch form was the most predominant in the class II subjects. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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18 pages, 4690 KiB

Open AccessArticle

Comparison of Metabolites and Gut Microbes between Patients with Ulcerative Colitis and Healthy Individuals for an Integrative Medicine Approach to Ulcerative Colitis—A Pilot Observational Clinical Study (STROBE Compliant)

by Cheol-Hyun Kim, Young-Ung Lee, Kwang-Ho Kim, Sunny Kang, Geon-Hui Kang, Hongmin Chu and Sangkwan Lee

Diagnostics 2022, 12(8), 1969; https://doi.org/10.3390/diagnostics12081969 - 15 Aug 2022

Cited by 5 | Viewed by 1691

Abstract

Ulcerative colitis (UC) is an intractable disease associated with high morbidity and healthcare costs. Metabolites and gut microbes are areas of interest for mainstream and complementary and alternative medicine. We, therefore, aimed to contribute to the discovery of an integrative medicine for UC by comparing and analyzing gut microbes and metabolites in patients with UC and in healthy individuals. This was an observational case-control study. Blood and stool samples were collected from the participants, and metabolite and gut microbial studies were performed. Among metabolites, formate, glycolate, trimethylamine, valine, and pyruvate levels were significantly different between the two groups. Among gut microbes, the abundance of Bacteroidetes at the phylum level; Bacteroidia at the class level; Bacteroidales and Actinomycetales at the order level; Prevotellaceae, Acidaminococcaceae, and Leptotrichiaceae at the family level; and Prevotella, Roseburia, Paraprevotella, Phascolarctobacterium, Ruminococcus, Coprococcus, Clostridium_XIVB, Atopobium, and Leptotrichia at the genus level was also significantly different. Most of the metabolites and gut microbes significantly different between the two groups were involved in energy metabolism and inflammatory processes, respectively. The results of this study could be helpful for the identification of targets for integrative medicine approaches for UC. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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12 pages, 1359 KiB

Open AccessArticle

Implementation of Objective Structured Clinical Examination on Diagnostic Musculoskeletal Ultrasonography Training in Undergraduate Traditional Korean Medicine Education: An Action Research

by Eunbyul Cho, Young-Min Han, Yeonseok Kang, Jae-Hyo Kim, Min-Seop Shin, Myungjin Oh, Nam-Geun Cho, Hyun-Jong Jung and Jungtae Leem

Diagnostics 2022, 12(7), 1707; https://doi.org/10.3390/diagnostics12071707 - 13 Jul 2022

Cited by 3 | Viewed by 1717

Abstract

This study aimed to report the specific methods and investigate the educational effects of diagnostic musculoskeletal ultrasound training and the Objective Structured Clinical Examination (OSCE) for traditional medicine students. Scanning volar wrist and diagnosing carpal tunnel syndrome were selected for musculoskeletal ultrasound to train students to use the basic functions of the ultrasound device and scan various structures including tendons, nerves, and arteries. The students were divided into two groups: one group had 8 weeks of training with mock OSCE experience and received feedback about their scan images, and the other group had 3 weeks of training with flipped learning. The OSCE was implemented on the last day of the training. The subjective learning outcomes were analyzed as students’ evaluation with a 5-point scale, and the objective learning outcomes were analyzed using OSCE scores evaluated with a pre-validated checklist. Of the 111 students, 60 (54.1%) responded to the questionnaire. Overall satisfaction with this ultrasound training was high (4.5 ± 0.60). The average OSCE score in the 8-week group was significantly higher than that in the 3-week group. The students’ self-assessment showed no significant differences between the two groups. Proficiency in using ultrasound is affected by the practice time and feedback. Ultrasound training should be further expanded as a required curriculum to meet students’ needs and achieve learning objectives in the clinical skills education of Korean medicine colleges. Further studies are needed on ultrasound education, especially guided interventions for traditional medicine students. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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Review

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19 pages, 2494 KiB

Open AccessReview

Smart Consumer Wearables as Digital Diagnostic Tools: A Review

by Shweta Chakrabarti, Nupur Biswas, Lawrence D. Jones, Santosh Kesari and Shashaanka Ashili

Diagnostics 2022, 12(9), 2110; https://doi.org/10.3390/diagnostics12092110 - 31 Aug 2022

Cited by 17 | Viewed by 7382

Abstract

The increasing usage of smart wearable devices has made an impact not only on the lifestyle of the users, but also on biological research and personalized healthcare services. These devices, which carry different types of sensors, have emerged as personalized digital diagnostic tools. Data from such devices have enabled the prediction and detection of various physiological as well as psychological conditions and diseases. In this review, we have focused on the diagnostic applications of wrist-worn wearables to detect multiple diseases such as cardiovascular diseases, neurological disorders, fatty liver diseases, and metabolic disorders, including diabetes, sleep quality, and psychological illnesses. The fruitful usage of wearables requires fast and insightful data analysis, which is feasible through machine learning. In this review, we have also discussed various machine-learning applications and outcomes for wearable data analyses. Finally, we have discussed the current challenges with wearable usage and data, and the future perspectives of wearable devices as diagnostic tools for research and personalized healthcare domains. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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Other

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16 pages, 1356 KiB

Open AccessSystematic Review

Assessment of the Diagnostic Methods of Mizaj in Persian Medicine: A Systematic Review

by Mostafa Ahmadi, Hoda Shirafkan and Seyyed Ali Mozaffarpur

Diagnostics 2023, 13(5), 818; https://doi.org/10.3390/diagnostics13050818 - 21 Feb 2023

Cited by 3 | Viewed by 1918

Abstract

The concept of mizaj corresponds to the idea of personalized medicine and is the main diagnostic principle of Persian medicine (PM). This study aims to investigate diagnostic tools for the detection of mizaj in PM. In this systematic review of articles published before September 2022, articles were searched for in the Web of Science, PubMed, Scopus, Google Scholar, SID databases, and gray literature. The titles of the articles were screened by researchers and relevant articles were selected. Abstracts were reviewed by two reviewers to select final articles. Subsequently, the articles found were critically evaluated by two reviewers according to the CEBM method. Finally, article data were extracted. Of the 1812 articles found, 54 were included in the final evaluation. Of these, 47 articles were related to the diagnosis of whole body mizaj (WBM). WBM was diagnosed in 37 studies using questionnaires and 10 using expert panels. In addition, six articles examined the mizaj of organs. Only four of these questionnaires were found with reported reliability and validity. There were two questionnaires for assessing WBM, but neither had sufficient reliability and validity. Questionnaires that assess organs had weak designs and lacked sufficient reliability and validity. Full article

(This article belongs to the Special Issue Advances in Diagnostic Approaches for Integrative Medicine)

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