Traditional and Integrative Medicine 2017. 2(3):113-118.

An Assessment of the Agreement between Persian Medicine Experts on Mizaj Identification
Seyyed Ali Mozaffarpur, Roshanak Saghebi, Soraya Khafri, Morteza Mojahedi


Although Mizaj (temperament) as a basic concept is introduced by ten criteria in Persian Medicine (PM), methods of assessment and priorities of these criteria are unclear. Having expert teams with an acceptable consensus in clinical diagnosis is one of the basic requirements to design and standardize Mizaj diagnostic scales. In this cross-sectional study, three PM specialists assessed the Mizaj of 150 healthy volunteers. At the first step of this study, each participant was separately visited by raters to determine warmness-coldness and wetness-dryness. To assess the agreement between experts, Intraclass Correlation Coefficient (ICC), weighted kappa (wk) and Spearman correlation Coefficient (r) were calculated. At the second step in an expert panel discussion, agreed criteria in 10 criteria of Mizaj identification were extracted. ICC between expert was 0.62 (CI: 0.53-0.73) in warmness-coldness and 0.64 (CI: 0.56-0.72) in wetness-dryness. Wk and r between every two experts were in the range of 0.41-0.60 and 0.58-0.67, in warmness-coldness and in the range of 0.49-0.61 and 0.58-0.69 in dryness-wetness, respectively. In determining warmness-coldness of Mizaj, psychic function, impressibility speed, muscle and fat mass, physical functions and touch condition were mostly used. In addition, muscle and fat mass, touch and sleep condition were mostly used in regard with dryness-wetness aspect of Mizaj. The agreements between three experts seem acceptable. It can be concluded that the weights of 10 criteria for Mizaj assessment in PM are not equal. The aims of the future studies in this field can be weighing these criteria.


Traditional Medicine; Reliability; Iranian medicine; Temperament

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Bates S. Progress towards personalized medicine. Drug Discov Today Biosilico 2010;15:115.

Roses AD. Pharmacogenetics and the practice of medicine. Nature 2000;405:857.

Rezaeizadeh H, Alizadeh M, Naseri M, Ardakani MRS. The Traditional Iranian Medicine point of view on health and disease. Iran J Public Health 2009;38:169-72.

Ibn Sina(Avicenna) H. al-Qanoon fi'l-tibb (The Canon of Medicine). Alaalami library. Beirut 2005.(Arabic).

Mojahedi M, Naseri M, Majdzadeh R, Keshavarz M, Ebadini M, Nazem E. Reliability and validity assessment of Mizaj questionnaire: a novel self-report scale in Iranian traditional medicine. Iran Red Crescent Med J 2014;16:E15924.

Mojahedi M, Naseri M, Majdzadeh R, Keshavarz M, Ebadiani M, Nazem E. A Review on Identification Mizaj (Temperament) Indices in Iranian Traditional Medicine (ITM). His Med J 2014;4:37-76. (Persian)

Ansari AH, Zulkifle M, Ali M. An analytical study of concordance between Mizaj and diseases in adult patients of MUM Hospital, Bangalore. Anc Sci Life 2010;30:7.

Emtiazy M, Keshavarz M, Khodadoost M, Kamalinejad M, Gooshahgir S, Bajestani HS. Relation between body humors and hypercholesterolemia: an Iranian Traditional Medicine perspective based on the teaching of Avicenna. Iran Red Crescent Med J 2012;14:133-138.

Feyzabadi Z, Jafari F, Feizabadi PS, Ashayeri H, Esfahani MM, Aval SB. Insomnia in Iranian Traditional Medicine. Iran Red Crescent Med J 2014;16:E15981.

Zhang GG, Lee W, Bausell B, Lao L, Handwerger B, Berman B. Variability in the traditional Chinese medicine (TCM) diagnoses and herbal prescriptions provided by three TCM practitioners for 40 patients with rheumatoid arthritis. J Altern Complement Med 2005;11:415-421.

Lin JD, Lin JS, Chen LL, Chang CH, Huang YC, Su YC. BCQs: A body constitution questionnaire to assess stasis in traditional chinese medicine. Eur J Integr Med 2012;4:379-391.

Zhang GG, Singh B, Lee W, Handwerger B, Lao L, Berman B. Improvement of agreement in TCM diagnosis among TCM practitioners for persons with the conventional diagnosis of rheumatoid arthritis: effect of training. J Altern Complement Med 2008;14:381-386.

Grant JS, Davis LL. Selection and use of content experts for instrument development. Res Nurs Health 1997;20:269-274.

Johnson WD, Koch GG. Intraclass correlation coefficient. International Encyclopedia of Statistical Science. Springer. 2014; pp 685-687.

Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 2005;85:257-268.

Mojahedi M, Mozaffarpur SA, Isfahani MM, Naseri M, Kamalinejad M, Khodadoust M, et al. Research Priorities in Traditional Persian Medicine. Res Hist Med 2016;5:99-108. (Persian)

Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med. 2005;37:360-363.

Okitsu R, Iwasaki K, Monma Y, Takayama S, Kaneko S, Shen G, et al. Development of a questionnaire for the diagnosis of Qi stagnation. Complement Ther Med 2012;18:207.

Ryu H, Lee H, Kim H, Kim J. Reliability and validity of a cold–heat pattern questionnaire for traditional chinese medicine. J Altern Complement Med 2010;16:663-667.

Zhang G, Lee W, Lao L, Bausell B, Berman B, Handwerger B. The variability of TCM pattern diagnosis and herbal prescription on rheumatoid arthritis patients. Altern Ther Health Med 2004;10:58.

Traditional and Integrative Medicine(Quarterly)
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Tehran University of Medical Sciences, Tehran, Iran. 
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