The AcuGraph PIE Score: how do you explain it? 4.97/5 (37)

First of all, thanks to all of you who responded and commented on my last post. I really appreciate your input and the lively conversation. This is exactly what I wanted to see.

For today’s post, I’m using a question posed by Dr. Jerry Nesseler:

“How can I quickly explain the new graph/pie chart on the updated Acugraph?”

Here’s a bit of background. The chart he’s referring to is our patent-pending P.I.E. (personal integrated energetics) chart and score, included in AcuGraph 3.

PIE Chart and Score
PIE Chart and Score

This chart was developed in response to those who requested a fast, easy indicator of patient progress. The advantage of the PIE is that it summarizes the energetic status of the meridians in a single number. So, though a patient may not understand the significance of split meridians, deficiencies, excesses, yin or yang, they can readily understand that their last score was a 61 and the new score of 75 shows improvement.

The other feature of the chart is the color-coded “Pie Slices” representing each meridian. Green is healthy. Non-green is not. The more green, the better. Patients get that.

For the very curious, the non-green pie slices are color coded by the type of imbalance (deficient, excess, split) and sized according to the magnitude of the imbalance. The smaller the slice, the worse the imbalance.

So the point is fast, easy patient communication.

Now, to answer Dr. Nesseler’s question, here’s the language I like to use:

“Mr. Patient, as you can see, your score today is 75. That’s significantly better than the 61 you scored last time, and it shows you’re making good progress. Clearly, we’re on the right track.”

If I’m feeling particularly verbose, I might also add,

“As you can see, 9 of your 12 meridians are testing as normal. Your last graph only had 6 normal meridians. This is exactly the kind of progress we want to see.”

So it’s really that simple. Stick to the numbers–both numbers. The PIE score and the number of normal meridians give the patient something concrete and simple to summarize their progress.

One More Thing

So how’s that score calculated and what does it really mean? As always, some are content just to drive the car, others want to peek under the hood. So for you hood peekers out there, the score considers a variety of markers including the following:

  • Number and severity of splits, excesses and deficiencies
  • Yin and yang balance
  • Energy stability
  • Left/right balance
  • Overall qi level

It’s quite a long calculation, and it’s been derived over years of experience with thousands of graphs. It’s so unique that we’ve actually applied for a patent on it, and others have already tried to copy it. Overall, it’s been my experience that the PIE score greatly improves patient communication and confidence.

Remember, the score truly uses the whole range of 0-100. It’s not like grades in school where anything below a 70 is failing. Scores of 20, 30, 40 are common, and scores of 80, 90, 100 are uncommon without treatment. So if your patient scores a 35 on the first visit, don’t worry. That’s exactly what we expect to see.

How do you use the PIE score and chart in your practice?

Do you (and your patients) find it helpful?

And perhaps most importantly, What do you say if the score goes down?

I love your input. If you have a question or comment you’d like to see in a future blog posting, please drop me a line at


-Dr. Larsen

Please rate this



Dr. Adrian Larsen

Adrian P. Larsen, D.C., F.A.S.A., C.Ac. Dr. Larsen is President of Miridia Technology Inc., and one of the developers of the AcuGraph Digital Meridian Imaging system. He currently divides his time between research, product development, and teaching. Dr. Larsen also holds certifications in Applied Kinesiology and CPK, and has specialized training in SOT and craniopathy. He, his wife, and 7 children reside in Meridian, Idaho.

39 Replies to “The AcuGraph PIE Score: how do you explain it?

  1. what can I answer if the paciente is better phisical and psiquis but the pie is going down every time I control with the agraph

    1. Oscar,

      If the patient is feeling better physically, it may be at the expense of overall balance. It is possible to offset the symptoms in one meridian with an equal imbalance in another meridian. This is a precarious position to try to maintain. In a situation like this, I would continue to treat to restore balance to the overall system.

  2. Thank you Adrian for starting these blogs, I really appreciate the opportunity for dialoge. If these acugraph readings are a snapshot/representation of what a patients overall and meridian/organ specific chi levels are at a particular point in time. Recognizing that these levels are variable in inumerable ways (time of day, patients diet, stress level, etc.) and is not necessarily linear. How would explain to a patient that from time to time it is nearly a guarantee that they see drops in their overall “scores”? Also it would still be fantastic for a Chinese diagnosis to accompany a reading. Thank you again.

    1. Hi Aaron,

      Good point. Generally the patient improves gradually until they reach a plateau. At that plateau, there will be minor ups and downs based on the factors you mentioned. Different patients are capable of different plateaus–some higher, some lower.

      As you mentioned, if the score goes down, the patient will want to know why. The answer to that question could be any number of things, and you may not be able to come up with the correct reason “why” the score dropped. Remember, the score only reflects the energy balance. Why is the patient more imbalanced? Could be any number of things.

      The better question is “so what will you do about it?” And the answer is to treat what you find. I’ve generally found that if the score takes a dip, and I treat what is indicated, the next graph is right back where it should be.

  3. How do you explain the splits to the clients? I’m a non-acupuncturist and I’m not sure I have the split thing figured out. Curious: Have you ever seen a solid green pie chart on any of your clients?

    1. Karen,

      A split is simply a large difference in the energy level of a meridian between its left and right sides. For example, if the PC meridian reads 65 on the left and 122 on the right, this is a split.

      In patient terms, I generally just explain that each meridian has a left and right side. And just like your left and right legs should be nearly identical to each other if you want to keep your balance, so should your meridians.

      If the left and right sides of a meridian are energetically different, that meridian’s ability to perform its functions is compromised.

  4. Dear doctor,
    i have try to patient which come to our University, i see many variation in result when i give different variation of pressure to the meridian give point.So when can you say that you are giving same pressure in all point.Regarding PIE chart i see that at first day for example 50 and after giving of one week of yoga class it come around 60 2nd measurement and 2nd week end 3rd measurement continuous with same yoga class it come 55 PIE. how you say, is it improve or not improved.I have seen many time happen in my reading. i want know your opinion.

    1. Dear Ranjit Singh,

      Regarding pressure variation, I find it most reliable to simply rest the probe on the point in question and let the weight of the probe be the only pressure used. This standardizes pressure and produces good results.

      Regarding the PIE score, as you noted, the meridian system was not directly treated, but rather only addressed through yoga. This may not effectively address underlying imbalances, and therefore we would not expect to see much score improvement.

  5. I have to share two things
    1)Some one gave me a disc which is supposed to improve ones health after drinking water poured on it. It is supossed to decrease the surface tension of water. She showed me some demo to prove that the disc works but it was not satisfactory. So i called her up and graphed her and told to drink taht water everyday. I found that the graph went up and up and she was on the platau soon within one week. She also felt very healthy. It proved that the disc is good and the graphing is also good to demo such things like energy medicine.
    2) I will be very happy if some one does homeopathy with graph so that in india we could get effective medicine insted of acupuncture for those who do not want needles.
    3) Some times i see that while taking the readings the readings the sound wobbels. Can it be an earthing problem?

    1. Hi Kiran,

      1. Yes, AcuGraph is very useful to evaluate the effect of other interventions on the meridian energy system. We’ve evaluated several “energy” devices using AcuGraph as the testing method.

      2. I’m not sure why the sound would wobble unless you have a bad connection in your probe wires, or the patient is not holding the grounding bar properly.

  6. Karen,

    I have been using the system for the last two years or more and pateint’s love it. As far as can a solid green pie (balanced graph be obtained) absolutely, I see it often and patients who have seen their graph ballanced then go to imbalance often know it wasn’t what I did or did not do, its what they have been up to. For example if they are told to avoid sugar and wheat and feel better, it’s seen in the graph, and when they come back after vacation and get graphed and see that the little sugary reward treats they had really impacted the previously balanced graph, they’re sold, they confess thier sins, and get back onto a good diet and healthier lifestyle.

  7. I’ve done only about 20 readings so far, but two of my seemingly unhealthy patients (overweight, arthritic, asthmatic, recovering from cancer, etc.) patients, have received the highest scores so far (aside from my 17 year old daughter). They received 75 and 76, and had many “normal” channels. I can’t explain this, except to say their overall energy is similar in all channels so it rates a higher score.

    One of these patients, with the ting point test, did score a 100–all her channels were within normal range. Then I did a source point test and her score was 76. Some others whose pie chart showed green on about 75 percent of the chart, only scored 56. Do some channels score higher, or is it the overall amount of energy scored in each channel that makes the difference in scoring? It’s very hard to explain to patients.

    1. Hi Marcy,

      A couple of thoughts: First, if all the readings are low, it’s important to make sure you have activated proportional measurement (in preferences, under measurement). Otherwise, you’ll likely see all green, because everything is equally low. But if you activate proportional measurement, the imbalances will still appear. If my guess is correct, these unhealthy patients likely scored very low readings in nearly all meridians. Is my guess correct?

      As for Tsing vs. Source, you are measuring two different systems. One can be well balanced while the other is not. And again, one could be reading in the normal range, while the other reads very low and therefore doesn’t show much imbalance. The solution here is as above; make sure you have activated proportional measurement for BOTH source and tsing.

  8. Hello Dr. Larsen,

    I would like to add the following:

    In the case of split meridians, sometimes it is hard to explain, while other times it fits in exactly with the symptoms, especially in pain situations. When I have someone with unilateral pain in the arm or shoulder I will almost always get meridian splits on the arm meridians. When there is excessive type pain, stabbing, shooting pain, the split will be higher on that side. When there is deficient type pain, general aches, numbness or tingling, the split will be lower on that side. The Acugraph confirms the TCM diagnosis more often than not.

    As for the PIE score going down, I see this a lot in patients on a second or third visit when the acupuncture triggers a slight detox situation in their body. This usually only applies to people who are on medications, or are very unhealthy in all aspects of their life. In healthier patients, when the score recedes I look at recent stresses, emotions, diet, holidays, birthday parties, traums, even the weather. Like Dr. Larsen mentioned, it all ties in.

    Finally, I have gotten a few patients who have had a full green PIE. But I’ve only seen this happen when their overall qi level is very low. To me this indicates that all systems, and the patient are extremely fatigued.

    Thank you,

    Jim Pederesn

    1. Excellent comment Jim.

      You’ll want to make sure you have activated proportional measurement to avoid getting all greens in very low energy readings.


      1. What is the activated proportional measurement and how do you turn it on? I have been using the Acugraph for years and did not know about it.

  9. Hi everybody, if we use the therapy points showed by Acugraph, patients’ conditions and the new chart will improve everytime we check. but of course it also depends on patients’ lifestyle, foods, exercises, etc.So it’s all up to us how to make the patients understand how to keep their score better everytime.

  10. Dr. Larsen.
    Dear Adrian:
    In my one year experience can say that PIE is very objective for patient, they now the start point and most important for me is what I said in first evaluation appointment. I used to collect general information follow the TCM history, after pulses mesure, tongue view, and finally Acugraph, and after test which always have closed coincidence, explain patient situation seeing PIE and graphs. Next step is treatment according to Acugraph. Until now more than 80% of my patient are succesful and happy using this way. Of course I’m open to better ways of use it.



  11. I use the PIE chart just as Adrian does, comparing the score and the “green” with previous scans. The patients just love it. We do re-exams every 12th visit and the patients are often asking about when I am going to retest them. The PIE score really helps as most patients have no concept of excesses, deficiencies, “splits”, etc. And they especially have no understanding of other exam results like pulse, tongue or hara. They understand a simple score.

    Yes, occasionally I see a lower score. But except for a couple of exceptions I could blame it on missed appointments, infrequent treatment, high stress situations, holiday binging and other factors. I point this out to them and they usually do more to comply.

  12. Would people being treated with the Miridiatech on auricular points only, and not take any of the TCM products still have good results?

  13. Your explanation of the Acugraph sounds interesting. Indeed, patients appreciate seeing improvement, in addition to feeling improvement. Thanks for the update, and I’ll be keeping an eye on this product, perhaps to see more at an upcoming conference.

    Kindly, Dr. Brendan Armm – Founder/Director of Lotus East-West Medical Center in Santa Monica, California (Holistic, Primary Care Medicine – acupuncture and acupuncturists, naturopathic medicine, medical doctors, and psychotherapy)

  14. Dr. Larsen,

    I have seen in quite a few patients, readings that seem to be counter to what one might expect to find after evaluating their pulse, body types, and symptoms. The most clear cut example I can think of with this is in patients who are fairly Kidney deficient, I have seen graph readings of excess in the Kidney Meridian. Do you have any thoughts as to why that might be? Thank you.

  15. when patient’s readings take a dip I often use the Socratic method and ask them what happened .
    If they have a difficult time coming up with something I ask them about their recent stress levels .
    Then I enquire about the emotions associated with the most imbalanced meridians . Loss and grief for lungs etc.

    Other times dips in readings can be associated with drug or alcohol consumption or major dietary mistakes in judgement .

  16. Yesterday I measured a 35 year old patient using Source Points and Proportional calculations who has longstanding MS, currently stable, with a PIE of 34 and a mean of 67 compared to her measurements a week ago at the same time of the day with a PIE of 38 and a mean of 113. The number of splits, deficiencies, and excesses were about the same, but in different medidians. The most notable is the split in the heart meridian which was not there last week. What surprises me is why the PIE does not show a bigger decrease with such a dramatic drop in overall meridian energy with about the same # of splits, excesses and deficiencies. Why is this so? Clinically, she is extremely fatigued which is consistent with overall low energy. She was not fatigued last week. She said it does not feel like an exacerbation of her MS. “This is different.” I think she hit a wall with the birth control pills she began taking 2 weeks ago. Nothing had changed in her personal life in terms of family, finances, etc. Comments and suggestions as to what this means and what to tell this patient would be appreciated. I assume one should just treat the points recommended. Thanks, Linda

    1. Hi Linda,

      The PIE score is a complex calculation that not only encompasses the number of splits, excesses, deficiencies, etc., but also the severity of each of these imbalances. It also includes other factors, such as left/right, upper/lower, yin/yang, stability, and so forth. So the mean is only one factor that can change the PIE. And really, a change from 34 to 38 is really not much of a change at all. Yes, I would treat the points indicated and expect great results.

      -Dr. Larsen

  17. Dr. Larsen :
    I am starting my practice in acupuncture
    I am Medical – Urologist
    I want to know if the application of electro without needles or the application of laser in points have similar effects to the use of needles.
    She also wondered whether a patient is carrying protesisi hip can be applied electroacupuncture

    1. Yes, electroacupuncture and laser often have similar effects to use of needles. I don’t know of any problem using electroacupuncture with a prosthetic hip.

      –Dr. Larsen

  18. in this graph themeridans should have light lines of demarcation. also it would be more quantitative if you had a “very normal” or “optimal” circle and then the greens which would have an ok range should show the actual demarcation from say “optimal”. and the excess slices should show how much excess by their extension beyond the good? range and sorter slices for the deficient slices. = more info at a glance.

  19. Dr. Larson,

    Could Acugraph be used to measure the effects of supplements on a client? Since it is working on the same principles as BioMeridian (forgive me if the comparision is wrong), would repeated testing on the same meridian results in wrong readings? Having read the information on BioMeridian’s site, I am given the idea that it is possible to do repeated diagnostic tests on the same client within the same day to check the effects of supplements. What is your take on this?

    1. Certain points can be reliably retested. Most notably, jing-well points tend to be stable enough for this type of testing. Source (yuan) points cannot be retested easily. They tend to become electrically charged very easily.

  20. dear larsen
    though I have not purchased Acugraph system due to my financial limitations but I am great admirer of your product.I regularly read your blog and visit your website and gets lot of information and utilize it in my acupuncture practice.In fact Iwas taking help of dr sadashiv to take Acograph test.
    What I will like to suggest you that Please incorporate HOMEOPATHY AND AYURVEDA in your upcoming version which will make enormous demand to your product.

  21. Hi. I have been using acugraph for 2 years now. I am seeing a patient who on their last acugraph 2 years ago (at the age of 50) they measured a mean of 41 and showed 2 excesses in HT and ST, relative chi level was 41 considered to be low, energy stability 71% considered to be normal, ying/yang 19%. They came back to see me a few weeks ago. worst for wear, now in menopause and very tired. they also said they had just finished delivering a 2 hour lecture in a cold room. When i started the measurements on their feet the pointer would not make a noise. i had to literally rub their feet to warm them up so that the pointer would take a reading. when i had finished it showed all green but the mean was 13 which was considered very low. there were no splits, excesses or deficiencies although their spl was only showing 6, their energy stability was in normal limits. i was perplexed as to how it show all green yet they were all very low with the highest – the LIV showing only 28. when I asked what she had been up to she said she was really suffering in the menopause with hot flushes and extreme fatigue and towards the time of the day that we took the readings she was normally feeling washed out. any suggestions of how i can interpet this reading?

    1. Hello Audrey,

      When the patient has an all green graph and the averages are really low I have a few different approaches to take.

      1) Take a look at what the highest and the lowest numbers are and then edit the graph accordingly. Example: You said the the Liver was the highest. Click on the Liver channel then look in the box to the upper right where it says channel status. Right now the “normal” is checked. You can change that to “high” and the graph will show high. Take a look at the borderline highs and the borderline lows then adjust and treat accordingly.

      2) You can also click on the divergent channel treatment and treat what is suggested. We recently did a couple of webinars on the divergent channel which you can find in your user account. “Patient’s are Getting Faster–Part 1 and Part 2”

      3) You could do the Kidney return protocol. WE talked more about that in “Patient’s are Getting Faster–Part 2”. This protocol is really good for low energy levels. It helps to build the source energy and the graph levels tend to rise after treatment so you can get a better analysis of the true underlying problems.

      4) Think about Liver Qi Stagnation. When Liver Qi is stagnant, energy gets stuck in the middle, the limbs become cold and deficient. So as a branch treatment to any of the suggestions above, I would treat Liver 14 and or Liver 3.

      I hope some of these suggestions help. Let us know how things go. Also, I’d suggest the patient come in for a series of visits so you can help get her body regulated again. Treatment closer together will allow for better longterm results. I’d do at least 3 visits within a two week period.

  22. hi,

    I am using Acugraph 4, plz tell why does the pie score show 82 and graph has green bars, even when highest graph value is 47 and lowest is 10.

    Proportional preference selected.

    vighnesh dixit

    1. Hi,

      The PIE score shows overall balance between the meridians. Therefore, if the graph has mostly green bars, the balance is very good, and the score will be high. The overall balance is far more important than the range of the readings. For example, a graph with higher readings, like between 80 and 120 everywhere, may still be very unbalanced with lots of high, low, and split meridians, and therefore may have a bad score. Likewise, even a graph that is low overall, can have a good pie score if everything is balanced.

      Here’s a link to a blog post about PIE score that will also be helpful:

      And, if you upgrade to AcuGraph 5, you’ll have access to our current trainings, including our webinars. We did a webinar on PIE score specifically, called “PIE in the Face: What the AcuGraph Scores Really Mean”

      1. Thank u for prompt and apt reply.
        i believe Acugraph is a continuous learning phenomena.
        Thanks again for support.

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