Repeatability of pulse diagnosis and body constitution diagnosis in traditional Indian Ayurveda medicine

In Ayurveda, pulse and body constitution diagnosis have a long historical use; still there is lack of quantitative measure on e.g. reliability of this diagnostic method. Reliability means consistency of information. Consistent diagnosis leads to consistent treatment and is important for clinical practice, education and research.
The objective of this study is to study the methodology to evaluate the test-retest reliability (repeatability) of pulse and body constitution diagnosis. A double-blinded, controlled, clinical trial was conducted in Copenhagen. The same doctor, expert in Ayurvedic pulse diagnosis, examined the pulse and body constitution of 17 healthy subjects twice, in a random order without seeing them. A metric on pulse and body constitution variables was developed. Cohen's weighted kappa statistic was used as a measure of intra-rater reliability. Permutation tests were used to test the hypothesis of homogeneous diagnosis (that is, the doctor’s diagnosis does not depend on the subject).
The hypothesis of homogeneous classification was rejected on the 5% significance level (p-values of 0.02 and 0.001 respectively for pulse and body constitution diagnosis). According to the Landis and Koch scale values of the weighted kappa for pulse diagnosis (0.42) and body constitution diagnosis (0.65) correspond to respectively ‘moderate’ and ‘substantial’ agreement.
There was a reasonable level of consistency between two pulse and body constitution diagnosis. Further studies are required to quantify inter-subject and intra-subject agreement for greater understanding of reliability of pulse and body constitution diagnosis.