肩袖肌腱炎常用激发试验的可靠性。
Reliability of Common Provocative Tests for Shoulder Tendinitis.
机构信息
The University of Utah, Rocky Mountain Center for Occupational and Environmental Health, Salt Lake City, Utah.
出版信息
J Occup Environ Med. 2018 Dec;60(12):1063-1066. doi: 10.1097/JOM.0000000000001430.
OBJECTIVE
Accurate and reliable shoulder tendinopathy examination maneuvers are essential for diagnosing and treating shoulder pain; however, studies have reported varying results as to the accuracy of common maneuvers. Thus, data from a large, cross-sectional study were used to systematically quantify the reliability and accuracy of clinical diagnostic tests.
METHODS
Baseline data from the WISTAH cohort study were used to evaluate inter-tester reliability and accuracy of common provocative shoulder examination tests compared with a case definition of shoulder tendinitis.
RESULTS
Inter-tester reliability showed reliable consistency between providers with kappa coefficients between 89.5% and 94.8% for all tests. However, sensitivity was generally poor (3.0% to 60.6%). Specificity was consistently high (96.2% to 99.6%).
CONCLUSION
Common shoulder provocative tests show low sensitivity but high specificity, which implies that the primary utility of examination maneuvers is for their negative predictive values.
目的
准确可靠的肩部肌腱病检查手法对于肩部疼痛的诊断和治疗至关重要；然而，研究报告显示，常见手法的准确性存在差异。因此，本研究使用来自大型横断面研究的数据，系统地量化了临床诊断测试的可靠性和准确性。
方法
使用 WISTAH 队列研究的基线数据，评估了常见激发性肩部检查试验与肩腱炎病例定义相比的组内可靠性和准确性。
结果
组内可靠性显示提供者之间具有可靠的一致性，所有测试的kappa 系数在 89.5%至 94.8%之间。然而，敏感性通常较差（3.0%至 60.6%）。特异性始终较高（96.2%至 99.6%）。
结论
常见的肩部激发试验的敏感性较低，但特异性较高，这意味着检查手法的主要用途是其阴性预测值。
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