Strender L E, Sjöblom A, Sundell K, Ludwig R, Taube A
Department of Clinical Neuroscience and Family Medicine, Division of Family Medicine, Huddinge, Sweden, Karolinska Institute, Ryggkliniken, Stockholm, Sweden.
Spine (Phila Pa 1976). 1997 Apr 1;22(7):814-20. doi: 10.1097/00007632-199704010-00021.
Seventy-one patients with low back pain were examined by two physiotherapists (50 patients) and two physicians (21 patients). The two physiotherapists had worked together for many years, but the two physicians had not. The interexaminer reliability of the clinical tests included in the physical examination was evaluated.
To evaluate the interexaminer reliability of clinical tests used in the physical examination of patients with low back pain under ideal circumstances, which was the case for the physiotherapists.
Numerous clinical tests are used in the evaluation of patients with low back pain. To reach the correct diagnosis, only tests with an acceptable validity and reliability should be used. Previous studies have mainly shown low reliability. It is important that clinical tests not be rejected because of low reliability caused by differences between examiners in performance of the examination and in their definition of normal results.
Two examiners, either two physiotherapists or two physicians, independently examined patients with low back pain.
In approximately half of the clinical tests studied, an acceptable reliability was demonstrated.
On the basis of the physiotherapists series, the reliability was acceptable for a number of clinical tests that are used in the evaluation of patients with low back pain. The results suggest that clinical tests should be standardized to a much higher degree than they are today.
71名腰痛患者由两名物理治疗师（50名患者）和两名医生（21名患者）进行检查。这两名物理治疗师已经合作多年，但两名医生之前没有合作过。对体格检查中包含的临床检查的检查者间可靠性进行了评估。
在理想情况下（物理治疗师的情况就是如此）评估用于腰痛患者体格检查的临床检查的检查者间可靠性。
在评估腰痛患者时会使用大量临床检查。为了得出正确诊断，应仅使用有效性和可靠性可接受的检查。先前的研究主要显示可靠性较低。重要的是，临床检查不应因检查者在检查操作和正常结果定义方面的差异导致可靠性低而被摒弃。
两名检查者，要么是两名物理治疗师，要么是两名医生，独立检查腰痛患者。
在所研究的大约一半临床检查中，显示出可接受的可靠性。
基于物理治疗师的系列研究，用于评估腰痛患者的一些临床检查的可靠性是可接受的。结果表明，临床检查应比目前更高程度地实现标准化。
