Troyanovich S J, Robertson G A, Harrison D D, Holland B
University of Alabama, Huntsville, USA.
J Manipulative Physiol Ther. 1995 Oct;18(8):519-24.
To determine the intra- and interexaminer reliability of a specific method of mensuration commonly used to evaluate the positional configuration of the lumbopelvic spine viewed on lateral lumbar radiographs.
A blind, repeated-measures design was used. Lateral lumbopelvic radiographs were presented to each of three examiners in random order. Each film was marked and measurements were recorded. The films were cleaned of all markings and randomized again for a second run by each examiner. Each examiner's measurements were unavailable to the other examiners.
Private, primary-care chiropractic clinic.
Anterior/posterior thoracic translation in millimeters, Ferguson's sacral-plane angle to horizontal, arcuate line angle to horizontal, L1 to L5 absolute rotation angle and four relative rotation angles for L1-L2, L2-L3, L3-L4 and L4-L5. Intra- and interrelibility of the three radiographic examiners were analyzed.
Intraexaminer reliability for (a) L1-L5 absolute rotation angle was .98, with confidence intervals included in the range of 0.95-0.99, (b) anterior/posterior thorax translation [+/- Sz] was .97-.99, with confidence intervals included in the range of 0.94-1.00, (c) arcuate angle (AA) .40-.81, with confidence intervals included in the range of 0.07-0.90, (d) Ferguson's angle (FA) was .91-.97, with confidence intervals included in the range of 0.82-0.98, (e) relative rotation angle reliability ranges were L1-L2, .84-.94; L2-L3, .80-.85; L3-L4, .78-.89; L4-L5, .87-.92. Interexaminer reliabilities for the three examiners ranged from .66-.98.
With the exception of the arcuate angle measurement, the reliabilities for all other measurements were at least .78. Those measurements with reliabilities approaching .80 or better would be considered accurate enough for use in future clinical studies. The arcuate angle measurement may have been least reliable because of the subjective nature of the method of affixing a best-fit line to a radiographic landmark that often takes on the appearance of a mild curvature. Establishing reliability is an important first step toward evaluating these and other similar radiographic measurements that have yet to be examined for their validity.
确定一种常用于评估腰椎侧位X线片上腰骶椎位置构型的特定测量方法在检查者内和检查者间的可靠性。
采用盲法重复测量设计。将腰骶椎侧位X线片以随机顺序呈现给三位检查者中的每一位。每张片子都做了标记并记录测量数据。片子上的所有标记被清除后再次随机排序，供每位检查者进行第二轮测量。每位检查者的测量数据对其他检查者保密。
私人初级保健脊椎按摩诊所。
以毫米为单位的胸段前后移位、弗格森骶骨平面与水平面的夹角、弓状线与水平面的夹角、L1至L5的绝对旋转角度以及L1-L2、L2-L3、L3-L4和L4-L5的四个相对旋转角度。分析了三位X线片检查者的检查者内和检查者间可靠性。
检查者内可靠性方面，（a）L1-L5绝对旋转角度为0.98，置信区间在0.95-0.99范围内；（b）胸段前后移位[±Sz]为0.97-0.99，置信区间在0.94-1.00范围内；（c）弓状角（AA）为0.40-0.81，置信区间在0.07-0.90范围内；（d）弗格森角（FA）为0.91-0.97，置信区间在0.82-0.98范围内；（e）相对旋转角度可靠性范围为：L1-L2，0.84-0.94；L2-L3，0.80-0.85；L3-L4，0.78-0.89；L4-L5，0.87-0.92。三位检查者的检查者间可靠性范围为0.66-0.98。
除弓状角测量外，所有其他测量的可靠性至少为0.78。那些可靠性接近或高于0.80的测量结果在未来临床研究中可认为足够准确。弓状角测量可能最不可靠，因为将最佳拟合线应用于通常呈轻度弯曲外观的X线片标志的方法具有主观性。确定可靠性是评估这些及其他尚未检验其有效性的类似X线测量的重要第一步。
