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Table 3 Evidence Tables

From: The clinical utility of routine spinal radiographs by chiropractors: a rapid review of the literature

Diagnostic Studies
Author(s), Year Design,
Sample size (n)
Case definition Index test Reference Standard Validity
McAviney, 2005 [45] Study of criterion validity
(Phase 1 for AWB and Phase 2 for ARA)
n = 277
Cervical x-rays from randomly selected patients from Summer Hill Chiropractic Outpatient Clinic (Macquarie University, Australia), over 7 years
Exclusion: moderate to severe degenerative changes; cervical spine with obvious lordosis and kyphosis; history of trauma.
Sagittal cervical alignment on x-ray films using posterior tangent method: ARA of cervical lordosis from C2-C7, AWB of the head (horizontal distance of posterior superior body of C2 compared to vertical line from posterior inferior body of C7)
Partitioned into categories with increments of 5°
Presence/Absence of cervical complaints: patients’ records, history in intern’s radiology report and x-ray referral slip ARA:
Cervical complaint: 9.6°
Non-cervical complaint: 23.4°
ARA < 20° (to identify cervical complaint)
Sn: 0.724
Sp: 0.737
AUC: 0.803
Cervical complaint: 21.3 mm
Non-cervical complaint: 21.1 mm
NS difference between groups
McGregor, 1995 [46] Phase 2 study
n = 512
New patients, > 18 YO, Canadian Memorial Chiropractic College outpatient clinic, neck and/or head pain, excluding patients diagnosed with pathology
Asymptomatic subjects from small normative group from a different study
Assessed for intersegmental clinical hypermobility: mobility of a given motion unit in the cervical spine which is excessive and is accompanied by local and/or peripheral symptoms
AP, lateral, AP open-mouth, forward flexion and extension cervical radiographs
Including history and physical examination findings summarized in a standardized case report form
AP, lateral, AP open-mouth cervical radiographs
Including history and physical examination findings summarized in a standardized case report form
With flexion-extension radiographs (3 raters):
Sn: 0.65–0.89
Sp: 0.49–0.92
Without flexion-extension radiographs (3 raters):
Sn: 0.11–0.91
Sp: 0.64–0.99
  1. AP anteroposterior; ARA absolute rotation angle; AWB anterior weight bearing; DDD degenerative disc disease; DJD degenerative joint disease; LR+ positive likelihood ratio; LR- negative likelihood ratio; NS no significant; PPV positive predictive value; NPV negative predictive value; ROC receiver operating characteristic; Sn Sensitivity; Sp Specificity; VAS visual analog scale