Development and Validation of an Assessment Tool to Evaluate the Status of Kapha in Tamaka Swasa

Abstract

Classical textbooks of Ayurveda states that Tamaka Swasa is a Kapha predominant disorder. Since there is a lack of direct assessment tool for assessing the status of Kapha Vridhi in Tamaka Swasa, a study is needed to develop an assessment tool. Methods: Initially, 165 symptoms of Kapha vitiation were collected from different Ayurvedic classics. After comparing the Tamaka Swasa features, 112 items were selected by the researcher in which 54 of them were found repeating. Finally, 58 attributes were scrutinized and presented before 10 experts. 28 items were fixed after analysing expert opinion. Pilot study was conducted in 10 patients using these items as draft tool. 3 items were found skewed and deleted from draft tool. Then it was administered in sample population of 126 subjects in which 63 were with Tamaka Swasa and 63 healthy controls. Later 25 items were subjected to exploratory factor analysis and items were reduced to 21. Result: Under Reliability check, Intraclass correlation coefficient for both Test-retest (0.719) and Inter-rater reliability (0.802) were excellent. KMO (Kaiser-Meyer-Olkin) measure (0.878) and Bartlett’s test of sphericity p-value (0.000) ensured data suitability for factor analysis. Results of Mann-Whitney U test (0.000), Z-score (-9.687) suggested strong discriminant validity for tool. Agreement statistics was done in place of criterion validity due to unavailability of a gold standard. Kappa value of 1.000 indicated perfect agreement between raters. Data reduction was done by checking Cronbach’s alpha, by which 4 items were deleted and 21 items retained as the final tool. Discussion: The developed 21-item Kapha assessment tool demonstrated acceptable validity and reliability, indicating its suitability for standardized clinical assessment in patients with Tamaka Shwasa. It may support the evaluation of Kapha dushti severity and aid therapeutic decision-making in Ayurveda practice. Conclusion: The final tool is available in Sanskrit, Malayalam and English languages and can be used by Ayurveda students or physicians for evaluating Kapha Dosha in a Tamaka Swasa patient.