Troyanovich S J, Harrison D, Harrison D D, Harrison S O, Janik T, Holland B
Private practice of chiropractic, Normal, IL, USA.
J Manipulative Physiol Ther. 2000 Sep;23(7):476-82. doi: 10.1067/mmt.2000.108818.
To investigate the reliability of a radiographic measurement procedure that uses a computer and sonic digitizer to determine projected spinal displacements from an ideal, normal position.
A blind, repeated-measure design was used. Anteroposterior cervicothoracic spine radiographs were presented in random order to each of 3 examiners. Each film was digitized, and the films were randomized for a second examination.
Private, primary care chiropractic clinic.
Intraclass correlation coefficients for intraexaminer and interexaminer reliability for measures on radiographs comparing the perpendicular distance (T(x)) from a vertical axis line drawn through the center of T4 and the center of C2, the linear distance (vertebra(apex)) from the center of the vertebra most displaced from a line connecting the centers of C2 and T4, the angle (Rz) formed by the intersection of the vertical axis line and the upper thoracic line, and the angle of intersection (CDA) between the upper thoracic line and the cervical line.
Intraexaminer reliability for T(x) distance was 0.99 to 1.00, with confidence intervals from 0.98-1.00; for vertebra(apex) was 0.96 to 0.97, with confidence intervals from 0.92-0.98; for Rz was 0.94 to 0.98, with confidence intervals from 0. 89-0.99; and for CDA was 0.92 to 0.95, with confidence intervals from 0.84-0.97. Interexaminer reliabilities for the 3 examiners ranged from 0.97 to 0.99.
Measures similar to those described in this study are commonly used to quantify and categorize spinal displacements from true vertical alignment (i.e., scoliosis measurements). Intraclass correlation coefficient values >0.70 are considered accurate enough for use in clinical and research applications. The measures tested here would fit within these guidelines of reliability. Establishing reliability is an important first step in evaluating these measures so that future studies of validity may be undertaken.
研究一种利用计算机和声波数字化仪从理想的正常位置确定脊柱投影位移的放射学测量方法的可靠性。
采用盲法重复测量设计。将颈胸段脊柱前后位X线片以随机顺序呈现给3名检查者。每张胶片进行数字化处理，然后对胶片进行随机化以便进行第二次检查。
私立初级保健整脊诊所。
通过T4中心和C2中心绘制的垂直轴线的垂直距离（T(x)）、从C2和T4中心连线最移位椎体中心的线性距离（vertebra(apex)）、垂直轴线与上胸线交点形成的角度（Rz）以及上胸线与颈线之间的交角（CDA），测量X线片上这些指标的组内相关系数，以评估检查者内和检查者间的可靠性。
T(x)距离的检查者内可靠性为0.99至1.00，置信区间为0.98 - 1.00；vertebra(apex)为0.96至0.97，置信区间为0.92 - 0.98；Rz为0.94至0.98，置信区间为0.89 - 0.99；CDA为0.92至0.95，置信区间为0.84 - 0.97。3名检查者的检查者间可靠性范围为0.97至0.99。
本研究中描述的类似测量方法通常用于量化和分类脊柱相对于真正垂直对齐的位移（即脊柱侧弯测量）。组内相关系数值>0.70被认为在临床和研究应用中足够准确。此处测试的测量方法符合这些可靠性指南。确定可靠性是评估这些测量方法的重要第一步，以便未来能够进行有效性研究。
