Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
Centre for Biomechanics Research, AECC University College, Parkwood Campus, Parkwood Road, Bournemouth, Dorset, BH5 2DF, UK.
Chiropr Man Therap. 2020 Nov 24;28(1):62. doi: 10.1186/s12998-020-00350-5.
Understanding the mechanisms underlying chronic, nonspecific low back pain (CNSLBP) is essential to advance personalized care and identify the most appropriate intervention. Recently, two intervertebral motion biomarkers termed "Motion Sharing Inequality" (MSI) and "Motion Sharing Variability" (MSV) have been identified for CNSLBP using quantitative fluoroscopy (QF). The aim of this study was to conduct intra- and inter-investigator analytic repeatability studies to determine the extent to which investigator error affects their measurement in clinical studies.
A cross-sectional cohort study was conducted using the image sequences of 30 healthy controls who received QF screening during passive recumbent flexion motion. Two independent investigators analysed the image sequences for MSI and MSV from October to November 2018. Intra and inter- investigator repeatability studies were performed using intraclass correlations (ICC), standard errors of measurement (SEM) and minimal differences (MD).
Intra-investigator ICCs were 0.90 (0.81,0.95) (SEM 0.029) and 0.78 (0.59,0.89) (SEM 0.020) for MSI and MSV, respectively. Inter-investigator ICCs 0.93 (0.86,0.97) (SEM 0.024) and 0.55 (0.24,0.75) (SEM 0.024). SEMs for MSI and MSV were approximately 10 and 30% of their group means respectively. The MDs for MSI for intra- and inter-investigator repeatability were 0.079 and 0.067, respectively and for MSV 0.055 and 0.067.
MSI demonstrated substantial intra- and inter-investigator repeatability, suggesting that investigator input has a minimal influence on its measurement. MSV demonstrated moderate intra-investigator reliability and fair inter-investigator repeatability. Confirmation in patients with CNSLBP is now required.
理解慢性、非特异性下腰痛（CNSLBP）的发病机制对于推进个性化治疗和确定最合适的干预措施至关重要。最近，使用定量荧光透视术（QF）为 CNSLBP 确定了两个称为“运动共享不平等”（MSI）和“运动共享变异性”（MSV）的椎间运动生物标志物。本研究的目的是进行内部和外部调查员分析可重复性研究，以确定调查员误差对其在临床研究中的测量的影响程度。
使用 30 名接受被动卧位屈曲运动 QF 筛查的健康对照者的图像序列进行横断面队列研究。两位独立的研究者在 2018 年 10 月至 11 月期间对 MSI 和 MSV 的图像序列进行了分析。使用组内相关系数（ICC）、测量标准误差（SEM）和最小差异（MD）进行内部和外部调查员重复性研究。
内部调查员 ICC 分别为 0.90（0.81，0.95）（SEM 0.029）和 0.78（0.59，0.89）（SEM 0.020），用于 MSI 和 MSV。内部调查员的 ICC 分别为 0.93（0.86，0.97）（SEM 0.024）和 0.55（0.24，0.75）（SEM 0.024）。MSI 和 MSV 的 SEM 约为其组平均值的 10%和 30%。MSI 的内部和外部调查员重复性的 MD 分别为 0.079 和 0.067，MSV 的 MD 分别为 0.055 和 0.067。
MSI 表现出较大的内部和外部调查员重复性，表明调查员输入对其测量的影响最小。MSV 表现出中等的内部调查员可靠性和适度的外部调查员可重复性。现在需要在患有 CNSLBP 的患者中进行确认。
