Vibe Fersum K, O'Sullivan P B, Kvåle A, Skouen J S
Section for Physiotherapy Science, Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway.
Man Ther. 2009 Oct;14(5):555-61. doi: 10.1016/j.math.2008.08.003. Epub 2008 Oct 1.
There is a lack of studies examining whether mechanism-based classification systems (CS) acknowledging biological, psychological and social dimensions of long-lasting low back pain (LBP) disorders can be performed in a reliable manner. The purpose of this paper was to examine the inter-tester reliability of clinicians' ability to independently classify patients with non-specific LBP (NSLBP), utilising a mechanism-based classification method. Twenty-six patients with NSLBP underwent an interview and full physical examination by four different physiotherapists. Percentage agreement and Kappa coefficients were calculated for six different levels of decision making. For levels 1-4, percentage agreement had a mean of 96% (range 75-100%). For the primary direction of provocation Kappa and percentage agreement had a mean between the four testers of 0.82 (range 0.66-0.90) and 86% (range 73-92%) respectively. At the final decision making level, the scores for detecting psychosocial influence gave a mean Kappa coefficient of 0.65 (range 0.57-0.74) and 87% (range 85-92%). The findings suggest that the inter-tester reliability of the system is moderate to substantial for a range of patients within the NSLBP population in line with previous research.
目前缺乏研究来检验基于机制的分类系统（CS）能否可靠地应用于对持续存在的下腰痛（LBP）疾病的生物学、心理和社会维度进行分类。本文的目的是利用基于机制的分类方法，检验临床医生对非特异性下腰痛（NSLBP）患者进行独立分类能力的测试者间信度。26例NSLBP患者接受了4名不同物理治疗师的访谈和全面体格检查。计算了六个不同决策水平的百分比一致性和kappa系数。对于1-4级，百分比一致性的平均值为96%（范围75-100%）。对于激发的主要方向，四名测试者之间的kappa系数和百分比一致性平均值分别为0.82（范围0.66-0.90）和86%（范围73-92%）。在最终决策水平上，检测心理社会影响的得分给出的平均kappa系数为0.65（范围0.57-0.74），百分比一致性为87%（范围85-92%）。研究结果表明，与先前研究一致，该系统在NSLBP人群中的一系列患者中测试者间信度为中等至较高。
