Troyanovich S J, Harrison D E, Harrison D D, Holland B, Janik T J
Department of Statistics, Temple University, Philadelphia, PA, USA.
J Manipulative Physiol Ther. 1998 Sep;21(7):460-7.
To investigate the reliability of a specific method of radiographic analysis of the geometric configuration of the lumbopelvic spine in the sagittal plane, and to investigate the concurrent validity of a computer-aided digitization procedure designed to replace the more tedious and time-consuming manual measurement process.
A blind, repeated-measures design was used. The results of radiographic measures derived through the traditional manual marking method were compared with measures derived by computer-aided digitization of lateral lumbopelvic radiographs.
Private chiropractic clinic.
Pearson's product-moment correlation coefficients, paired sample t tests and intraclass correlation co-efficients (ICC) were used to examine intraexaminer reliability, and repeated measures of analysis of variance were used to examine interexaminer reliability for relative rotation angles for T12-L1, L1-L2, L2-L3, L3-L4, L4-L5, L5-S1, overall lordosis measurement [absolute rotation angle (ARA)] from L1-L5 and Cobb angle of overall lordosis measured from the inferior surface of T12 to the superior surface of S1, Ferguson's sacral base angle to horizontal, angle of pelvic tilt (arcuate angle) to horizontal and anteroposterior thoracic translation (Sz) in millimeters.
ICC estimates for intraexaminer reliability were in the range of 0.96-0.98 for the L1-L5 ARA, a range of 0.87-0.99 for the arcuate angle measurement, 0.83-0.94 for the Ferguson's angle measurement, 0.88-0.95 for the Cobb angle measurement from the inferior surface of T12 compared with the superior surface of S1 and 0.98-1.00 for the translation measurement of the lower thoracic spine to S1 (Sz). The intersegmental measurement's (T12-L1, L1-L2, L2-L3, L3-L4, L4-L5, L5-S1) correlations ranged from a low of 0.55 to a high of 0.97. Examination of these findings suggests that the reliability for the three doctors is acceptable with only the T12-L1 intersegmental measure falling below 0.70 for the least experienced examiner. Average ICC of interexaminer reliability for manual and computer-aided digitizing examiners were the following: 0.96 for the L1-L5 ARA; 0.84 for the arcuate angle measurement; 0.82 for the Ferguson's angle measurement; 0.88 for the Cobb angle measurement; 1.00 for the Sz translation measurement; and values of 0.65, 0.73, 0.74, 0.75, 0.89 and 0.81 for relative rotation angle measurements T12-L1, L1-L2, L2-L3, L3-L4, L4-L5 and L5-S1, respectively.
The data tend to support the reliability of this method of radiographic analysis of the geometric configuration of the lumbopelvic spine as viewed on lateral lumbopelvic radiographs. The additional data presented here tend to support the concurrent validity of the computer-aided digitization method of analysis inasmuch as the measures determined by the digitizing examiners are essentially identical to those determined by the manual method plus or minus the average standard error of measure of each value.
研究一种用于腰椎骨盆矢状面几何形态X线分析特定方法的可靠性，并研究一种旨在替代更为繁琐和耗时的手动测量过程的计算机辅助数字化程序的同时效度。
采用盲法重复测量设计。将通过传统手动标记方法获得的X线测量结果与通过腰椎骨盆侧位X线片计算机辅助数字化获得的测量结果进行比较。
私人整脊诊所。
使用Pearson积差相关系数、配对样本t检验和组内相关系数（ICC）来检验检查者内可靠性，使用重复测量方差分析来检验T12-L1、L1-L2、L2-L3、L3-L4、L4-LS、L5-S1的相对旋转角度、L1-L5的整体前凸测量值[绝对旋转角度（ARA）]、从T12下表面到S1上表面测量的整体前凸Cobb角、Ferguson骶骨底角与水平的夹角、骨盆倾斜角（弓形角）与水平的夹角以及以毫米为单位的胸段前后平移（Sz）的检查者间可靠性。
L1-L5 ARA的检查者内可靠性ICC估计值在0.96 - 0.98范围内，弓形角测量值在0.87 - 0.99范围内，Ferguson角测量值在0.83 - 0.94范围内，从T12下表面与S1上表面测量的Cobb角在0.88 - 0.95范围内，胸段下部至S1的平移测量值（Sz）在0.98 - 1.00范围内。节段间测量值（T12-L1、L1-L2、L2-L3、L3-L4、L4-L5、L5-S1）的相关性范围从低的0.55到高的0.97。对这些结果的检查表明，三位医生的可靠性是可接受的，只有经验最少的检查者的T12-L1节段间测量值低于0.70。手动和计算机辅助数字化检查者的检查者间可靠性平均ICC如下：L1-L5 ARA为0.96；弓形角测量为0.84；Ferguson角测量为0.82；Cobb角测量为0.88；Sz平移测量为1.00；T12-L1、L1-L2、L2-L3、L3-L4、L4-L5和L5-S1相对旋转角度测量值分别为0.65、0.73、0.74、0.75、0.89和0.81。
数据倾向于支持这种从腰椎骨盆侧位X线片观察腰椎骨盆矢状面几何形态的X线分析方法的可靠性。此处提供的额外数据倾向于支持计算机辅助数字化分析方法的同时效度，因为数字化检查者确定的测量值与手动方法确定的测量值基本相同，每个值的测量平均标准误差上下浮动。
