*Department of Orthopedics, Korea University Ansan Hospital, Ansan, South Korea †Department of Orthopedics, Korea University Guro Hospital, Seoul, South Korea; and ‡Department of Orthopedics, Korea University Anam Hospital, Seoul, South Korea.
Spine (Phila Pa 1976). 2013 Dec 15;38(26):E1684-90. doi: 10.1097/BRS.0b013e3182a18486.
Observational study with 3 examiners.
To compare the reliability of shoulder balance measurement methods.
There are several measurement methods for shoulder balance. No reliability analysis has been performed despite the clinical importance of this measurement.
Whole spine posteroanterior radiographs (n = 270) were collected to compare the reliability of the 4 shoulder balance measures in patients with adolescent idiopathic scoliosis. Each radiograph was measured twice by each of the 3 examiners using 4 measurement methods. The data were analyzed statistically to determine the inter- and intraobserver reliability.
Overall, the 4 radiographical methods showed an excellent intraclass correlation coefficient regardless of severity in intraobserver comparisons (>0.904). In addition, the mean absolute difference values in all methods were low and were comparatively similar (<1.73°). However, in interobserver comparisons, reliabilities were significantly decreased in the less severe radiographs, firstly on radiographical shoulder height measures (intraclass correlation coefficients >0.445, mean absolute difference <3.91°). However, the intraclass correlation coefficients in the coracoid height difference and clavicular angle methods were in the excellent range (>0.810 and >0.787, respectively) regardless of severity. In addition, the mean absolute difference values in the clavicular angle method were lower (<0.62°) than others.
The higher reliability of the clavicular angle and coracoid height difference methods indicate the clinical usefulness of these methods. Physicians should selectively use the shoulder balance measurement method clinically.
观察者研究，3 位观察者。
比较肩平衡测量方法的可靠性。
肩平衡有几种测量方法。尽管该测量方法在临床上很重要，但尚未进行可靠性分析。
收集了 270 例特发性脊柱侧凸青少年的全脊柱前后位 X 线片，以比较 4 种肩平衡测量方法的可靠性。每位观察者用 4 种测量方法对每张 X 线片进行了两次测量。对数据进行了统计学分析，以确定观察者内和观察者间的可靠性。
总体而言，4 种影像学方法在观察者内比较中表现出极好的组内相关系数（>0.904），无论严重程度如何。此外，所有方法的平均绝对差值均较低且较为相似（<1.73°）。然而，在观察者间比较中，在较不严重的 X 线片中，可靠性显著降低，首先是在影像学肩高测量方面（组内相关系数>0.445，平均绝对差值<3.91°）。然而，喙突高度差和锁骨角方法的组内相关系数均处于优秀范围（>0.810 和>0.787），无论严重程度如何。此外，锁骨角方法的平均绝对差值较低（<0.62°）。
锁骨角和喙突高度差方法的可靠性较高，表明这些方法具有临床实用性。医生应在临床上有选择地使用肩平衡测量方法。
3。
