46 Current researches on the SCM in Korea Voice Analysis Oriental medical doctors generally have evaluated the patient’s voice from the view of the ‘five phases’ to understand the characteristics of diseases (23). Indeed, the vocal tract characteristics are related to body shape, and the voice can differ according to the variations in the vocal tract. Lee Je-ma stressed careful observation of the patient’s way of speaking as an important factor in constitutional classification. In addition, it is well-known that, due to state-of-the-art signal-processing techniques, it is possible to diagnose some diseases and identify an individual with a basic frequency and resonance components (24,25). In early research, Kim et al. recorded and analyzed the voice focusing on the pitch, several elements of basic frequency and talking speed (26). After this, many researches have been conducted to evaluate pitch, shim- mer, harmonics, formant and energy of voice for consti- tution diagnosis, using CSL (computerized speech laboratory) and these researches have revealed that several factors differed significantly among constitutions (25–27). On the basis of these results, KIOM and Sangji University research teams have developed a voice analysis system, the PSSC-2004 (Phonetic System for Sasang Constitution-2004, VoiceOne Inc., Wonju, Korea). The PSSC-2004 can bring out the estimated membership degrees to each constitution by analyzing recorded voices. The PSSC-2004 has been used to evaluate voice param- eters such as pitch, APQ, octave, shimmer, energy, code and peak sum to determine constitutions (28,29). Although PSSC-2004 was used as a Sasang constitution diagnosis method (25), its diagnosis accuracy is not suffi- cient for widespread use in clinical practice (Table 4). Questionnaires When SCM doctors diagnose a patient’s constitution, it is very important to understand the patient’s temperament. In the psychological field, questionnaires such as MBTI (Myers–Briggs Type Indicator) and TCI (Temperament and Character Inventory) have been widely used to analyze the patient’s temperament. In the SCM field, there were also a lot of attempts to adopt questionnaire methods to Sasang constitution diagnosis (Table 5). Table 5. Questionnaire-related researches First author Questionnaire Koh BH Lee EJ Kim SH Kim SH KimYW Kim SB Sul YK Kim YW Basic questionnaire (I) Questionnaire for identifying Sasangin (I) QSCC QSCC II QSCC III QSCC II+ SSCQ or SDQ TS-QSCD JKOM: Journal of Korean Oriental Medicine; N: number of participants. The first questionnaire developed for Sasang constitu- tion diagnosis was the Constitution Diagnosis Question- naire (I), which consists of various questions that have been commonly asked by SCM doctors in clinical prac- tice (30). Following this, the QSCC (Questionnaire for Sasang Constitution Classification) was systematically developed by a group of experts comprised of oriental medical doctors and psychologists, which contained ques- tions regarding the contents of Donguisusebowon. The answers provided by 241 constitution confirmed partici- pants were then analyzed to develop optimal discriminant equations for constitution diagnosis (31). However, continued use of QSCC revealed that too many individ- uals were diagnosed as Taeyangins and its correspon- dence with the other (Sasang constitution diagnosis) questionnaires was quite low (32,33). To overcome the shortcomings of QSCC, the QSCC II was developed by oriental medical doctors, clinical psy- chologists, linguists and philosophers. They re-analyzed the contents of Donguisusebowon and Gyeokchigo (manu- script on science by Lee Je-ma), and then added questions to QSCC that had been proven to be statistically signifi- cant. The accuracy of QSCC II was initially reported to be 70.8% (31). However, subsequent researches revealed that QSCC II had a lower accuracy rate than claimed by the developers (34,35). Furthermore, it was later revealed that QSCC II could not diagnose Taeyangins (36). Some researchers have reported that many of the ques- tions in QSCC II pertaining to temperament had minor roles, and those pertaining to external features such as body shape had decisive roles (36,37). Therefore, there Table 4. Voice analysis researches First author Instrument Year N Diagnosis method Yang SH CSLa 1996 66 Questionnaire JSCM Kim DL CSL 1998 134 Questionnaire JSCM Shin MR CSL 1999 140 Questionnaire, expert JSCM Yang SM CSL 2001 30 Questionnaire JSCM Park SJ CSL 2004 71 Questionnaire, expert JSCM Kim SH PSSC-2004b 2005 217 Expert JSCM Kim DJ PSSC-2004 2005 231 Expert JSCM Bae HS PSSC-2004 2007 529 PSSC-2004 JSCM Journal N: number of participants. aCSL—Computerized Speech Lab bPSSC-2004—PSSC-2004, EMC-909 Samsung Sound Card. Model 4300B (KAY (JAPAN), Computer USA); with Year 1987 1995 1993 1996 1999 2001 2003 2006 N 670 328 241 1366 692 57 836 160 Diagnosis method – Expert Expert Expert Questionnaire, expert Questionnaire Expert, drug response Questionnaire, expert Journal JKOM JSCM JSCM JSCM JSCM JSCM JSCM JSCM