Jackson B L, Harrison D D, Robertson G A, Barker W F
Bloomsburg University, PA.
J Manipulative Physiol Ther. 1993 Jul-Aug;16(6):384-91.
To determine the degree to which the geometric line drawings used in Chiropractic Biophysics Technique (CBP) on lateral cervical radiographs are reliable.
A blind, delayed repeated measures design was used. Three examiners were presented radiographs in random order. All identifying marks were removed prior to each examiner's individual marking and measurement. Each examiner was blinded as to how the previous examiners marked and measured the radiographs.
Primary care private chiropractic clinic.
Sixty-five subject films were provided from the patient records of a primary care private chiropractic clinic. The 65 radiographs qualified for inclusion in the study based on two criteria: C1 through C7 had to be clearly visible, and there had to be no identifying artifacts.
Anterior head translation in millimeters, atlas plane to horizontal, Ruth Jackson's cervical stress lines, and five relative rotation angles for C2-C3, C3-C4, C4-C5, C5-C6, C6-C7. Inter- and intrareliability of the three examiners were statistically analyzed.
Intraexaminer for a) C1 to horizontal reliability was .98-.99 with confidence intervals of .96-.99, b) absolute rotation angle from C2 to C7 reliability was .82-.95 with confidence intervals of .80-.99, c) anterior head translation [+Sz] reliability was .86-.99, with confidence intervals of .74-.99, d) relative rotation angle reliability ranges were (C2-C3) .99, and (C3-C4) .98-.99, (C4-C5) .88-.99, (C5-C6) .80-.99, and (C6-C7) .94-.98. Interexaminer reliabilities across examiners ranged from a) Winer:.89-.99 and b) Bartko: .72-.96.
The reliabilities for intra- and interexaminer were all greater than .70, indicating that these measurements in CBP technique would be considered accurate enough to provide measurements for future clinical studies. The data indicated that the C6-C7 relative rotation angle was the least reliable measurement. This might be due to the very small angles found at this level.
确定脊椎矫正生物物理学技术（CBP）用于颈椎侧位X线片的几何线条图的可靠程度。
采用盲法、延迟重复测量设计。三位检查者以随机顺序查看X线片。在每位检查者进行单独标记和测量之前，去除所有识别标记。每位检查者对于之前的检查者如何标记和测量X线片并不知情。
初级保健私人脊椎按摩诊所。
从一家初级保健私人脊椎按摩诊所的患者记录中提供了65份受试者的X线片。这65份X线片符合纳入研究的两个标准：C1至C7必须清晰可见，且不得有识别伪影。
以毫米为单位的头部前移位、寰椎平面与水平线的夹角、鲁思·杰克逊颈椎应力线，以及C2 - C3、C3 - C4、C4 - C5、C5 - C6、C6 - C7的五个相对旋转角度。对三位检查者的内部和相互间可靠性进行了统计学分析。
检查者内部，a）C1与水平线夹角的可靠性为0.98 - 0.99，置信区间为0.96 - 0.99；b）C2至C7绝对旋转角度的可靠性为0.82 - 0.95，置信区间为0.80 - 0.99；c）头部前移位[+Sz]的可靠性为0.86 - 0.99，置信区间为0.74 - 0.99；d）相对旋转角度的可靠性范围为（C2 - C3）0.99，（C3 - C4）0.98 - 0.99，（C4 - C5）0.88 - 0.99，（C5 - C6）0.80 - 0.99，（C6 - C7）0.94 - 0.98。检查者之间的相互可靠性范围为：a）维纳法：0.89 - 0.99；b）巴特科法：0.72 - 0.96。
检查者内部和相互间的可靠性均大于0.70，表明CBP技术中的这些测量结果足够准确，可为未来的临床研究提供测量数据。数据表明，C6 - C7相对旋转角度是最不可靠的测量指标。这可能是由于该水平的角度非常小。
