Table 4 Evidence Tables
Reliability Studies | ||||
|---|---|---|---|---|
Author(s), Year | Design, Sample size (n) | Sample description | Measurement method | Measure of Reliability |
Troyanovich, 2000 [51] | Intra-rater and inter-rater reliability; 3 chiropractors familiar with Chiropractic BioPhysics® technique of measurement n = 36 antero-posterior cervical spine radiographs | Digitized AP cervical spine radiographs without artifacts or other obvious identifying features with the second cervical vertebra through the fourth thoracic vertebra clearly depicted; from patient files of a private chiropractic office | 2-dimensional coordinates of 30 points selected by each examiner: R and L narrow-waisted-appearing area of vertebral bodies T1-T4, R and L narrow-waisted-appearing area of the articular pillars of C3-C7, inferolateral aspect of both superior articular facets of C2, most superior portion of spinous process of C2-T4 | Intra-rater reliability: ICC (95% CI), SEM Tx Rater 1: 0.99 (0.98–0.99), 1.53 Rater 2: 0.99 (0.99–1.00), 1.03 Rater 3: 1.00 (0.99–1.00), 0.99 Vertebraapex: Rater 1: 0.96 (0.93–0.98), 0.99 Rater 2: 0.96 (0.92–0.98), 1.10 Rater 3: 0.97 (0.94–0.98), 0.93 Rz: Rater 1: 0.97 (0.94–0.99), 1.13 Rater 2: 0.94 (0.89–0.97), 1.64 Rater 3: 0.98 (0.95–0.99), 1.06 CDA: Rater 1: 0.95 (0.91–0.97), 1.52 Rater 2: 0.92 (0.84–0.96), 2.12 Rater 3: 0.94 (0.88–0.97), 1.80 Crossed ICC (95% CI)a [54] CDA: 0.93 (0.88–0.96) RzT1-T4:0.96 (0.94–0.98) Txapex: 0.96 (0.93–0.98) TxC2-T4: 0.99 (0.99–1.00) Interrater reliability: ICC (95% CI) Tx: 0.99 (0.99–1.00), 1.12 Vertebraapex: 0.98 (0.96–0.99), 0.80 Rz: 0.98 (0.97–0.99), 0.85 CDA: 0.97 (0.95–0.98), 1.22 Crossed ICC (95% CI)a Cervical Spine CDA: 0.91 (0.85–0.94) RzT1-T4: 0.95 (0.90–0.96) Txapex: 0.93 (0.90–0.96) TxC2-T4: 0.99 (0.98–0.99) |
Troyanovich, 1998 [52] | Intra-rater and Inter-rater reliability; 3 chiropractors certified in use of Chiropractic Biophysics® measurement analysis n = 50, lateral lumbar radiographs | Lateral lumbar radiographs without artifacts or other identifying features; from patient files of a private chiropractic office | 1 rater: CBP® standard manual method line drawing of radiographs 2 raters: CBP® standard method of analysis using computerized radiographic digitizer Measurements derived from 17 selected points used to construct following: ARA, ARCU, FERG, COBB, S(z), RRAs | Intra-rater reliability Rater 1 ICC (95% CI); SEM) T12-L1: 0.54 (0.31–0.71); 2.16 L1-L2: 0.75 (0.60–0.85); 1.82 L2-L3: 0.77 (0.63–0.87); 1.44 L3-L4: 0.85 (0.75–0.91); 1.33 L4-L5: 0.93 (0.88–0.96); 1.39 L5-S1: 0.95 (0.92–0.97); 1.68 ARA: 0.97 (0.94–0.98); 1.74 ARCU: 0.99 (0.99–1.00); 0.74 FERG: 0.94 (0.89–0.96); 1.83 COBB: 0.89 (0.81–0.94); 3.07 Sx: 1.00 (1.00–1.00); 1.07 Rater 2 ICC (95% CI); SEM) T12-L1: 0.70 (0.53–0.82); 1.46 L1-L2: 0.78 (0.64–0.87); 1.43 L2-L3: 0.61 (0.40–0.76); 2.30 L3-L4: 0.66 (0.47–0.79); 2.20 L4-L5: 0.92 (0.87–0.95); 1.44 L5-S1: 0.96 (0.94–0.98); 1.49 ARA: 0.98 (0.96–0.99); 1.47 ARCU: 0.93 (0.87–0.96); 2.40 FERG: 0.84 (0.73–0.90); 2.85 COBB: 0.88 (0.79–0.93); 3.32 Sx: 0.98 (0.97–0.99); 2.89 Rater 3 ICC (95% CI); SEM) T12-L1: 0.76 (0.61–0.86); 1.36 L1-L2: 0.77 (0.63–0.86); 1.48 L2-L3: 0.71 (0.54–0.82); 1.73 L3-L4: 0.70 (0.52–0.82); 1.77 L4-L5: 0.91 (0.85–0.95); 1.40 L5-S1: 0.97 (0.95–0.98); 1.40 ARA: 0.96 (0.93–0.98); 1.88 ARCU: 0.87 (0.78–0.92); 3.40 FERG: 0.83 (0.73–0.90); 2.77 COBB: 0.95 (0.92–0.97); 1.99 Sx: 0.99 (0.98–0.99); 2.14 Inter-rater reliability Rater 1–2 (manual-computer) ICC (95% CI); SEM ARA L1–5: 0.98 (0.96,0.99); 1.40 ARCU: 0.97 (0.95–0.98); 1.48 FERG: 0.88 (0.80–0.93); 2.42 COBB: 0.88 (0.79–0.93); 3.22 S(z): 0.99 (0.99–1.00); 1.70 RRAs: T12-L1: 0.68 (0.50–0.81); 1.49 L1-L2: 0.79 (0.65–0.87); 1.45 L2-L3: 0.77 (0.63–0.86); 1.49 L3-L4: 0.83 (0.71–0.90); 1.40 L4-L5: 0.90 (0.84–0.94); 1.56 L5-S1: 0.97 (0.94–9.98); 1.42 Rater 1–3 (manual-computer) ICC (95% CI); SEM ARA L1–5: 0.96 (0.93,0.98); 1.94 ARCU: 0.85 (0.76,0.91); 3.32 FERG: 0.79 (0.65,0.87); 3.25 COBB: 0.83 (0.72,0.90); 3.78 S(z): 1.00 (0.99,1.00); 1.36 RRAs: T12-L1: 0.66 (0.47,0.79); 1.59 L1-L2: 0.74 (0.58,0.84); 1.62 L2-L3: 0.76 (0.61,0.85); 1.43 L3-L4: 0.78 (0.65,0.87); 1.46 L4-L5: 0.88 (0.81,0.93); 1.64 L5-S1: 0.80 (0.67,0.88); 3.61 Rater 2–3 (computer-computer) ICC (95% CI); SEM ARA L1–5: 0.96 (0.94,0.98); 1.76 ARCU: 0.83 (0.73,0.90); 3.60 FERG: 0.84 (0.74,0.91); 2.63 COBB: 0.92 (0.86,0.95); 2.67 S(z): 0.99 (0.98,0.99); 2.16 RRAs: T12-L1: 0.63 (0.43,0.77); 1.57 L1-L2: 0.72 (0.55,0.83); 1.53 L2-L3: 0.72 (0.55,0.83); 1.67 L3-L4: 0.72 (0.55,0.83); 1.70 L4-L5: 0.90 (0.84,0.94); 3.50 L5-S1: 0.81 (0.70,0.89); 3.50 |
Troyanovich, 1995 [53] | Intra-rater and inter-rater reliability; 3 chiropractors certified in Chiropractic BioPhysics® method of measurement n = 35 lateral lumbar radiographs | Lateral lumbar radiographs without artifacts or other obvious identifying features selected from patient files of a private, primary-care chiropractic clinic | Arcuate line, Ferguson’s sacral-base line, vertical axis line, L1 and L5 stress lines and L1 and L5 posterior body lines, arcuate angle, relative rotation angle, absolute rotation angle, linear anterior or posterior displacement of the lower thoracic spine | Intra-rater reliability: ICC (95% CI), SEM L1-L5 Rater 1: 0.98 (0.92–0.99), 1.48 Rater 2: 0.98 (0.95–0.99), 1.53 Rater 3: 0.98 (0.96–0.99), 1.58 Sz Rater 1: 0.99 (0.99–1.00), 1.86 Rater 2: 0.97 (0.94–0.98), 4.26 Rater 3: 0.99 (0.98–1.00), 1.97 AA Rater 1: 0.40 (0.02–0.65), 5.03 Rater 2: 0.81 (0.65–0.90), 2.93 Rater 3: 0.71 (0.49–0.85), 3.53 FERG Rater 1: 0.97 (0.94–0.98), 1.41 Rater 2: 0.97 (0.94–0.98), 1.45 Rater 3: 0.91 (0.82, 0.95), 2.12 L1-L2 Rater 1: 0.87 (0.76, 0.93), 1.77 Rater 2: 0.84 (0.71–0.92), 1.84 Rater 3: 0.94 (0.88–0.97), 1.3 L2-L3 Rater 1: 0.85 (0.72–0.92), 1.54 Rater 2: 0.81 (0.66–0.90), 1.31 Rater 3: 0.80 (0.64–0.89), 1.79 L3-L4 Rater 1: 0.89 (0.79–0.94), 1.09 Rater 2: 0.81 (0.66–0.90), 1.52 Rater 3: 0.78 (0.60–0.88), 1.67 L4-L5 Rater 1: 0.89 (0.80–0.94), 1.49 Rater 2: 0.92 (0.85–0.96), 1.17 Rater 3: 0.87 (0.76–0.93), 1.69 Inter-rater reliability: ICC (95%), SEM L1-L5: 0.98 (0.96–0.99), 1.66 Sz: 0.98 (0.97–0.99), 3.20 AA: 0.66 (0.48, 0.79), 3.51 FERG: 0.95 (0.91–0.97), 1.73 L1-L2: 0.88 (0.81–0.94), 1.63 L2-L3: 0.84 (0.74–0.91), 1.43 L3-L4: 0.91 (0.85, 0.95), 0.97 L4-L5: 0.93 (0.89–0.96), 1.14 |
Haas, 1990 [50] | Inter-rater reliability; 2 radiology residents n = 58 | PA, PA right and left lateral bending lumbar radiographs of volunteer students in a chiropractic institution | Vertebral body rotation and vertebral body tilting (intersegmental tilt measured as neutral, L or R lateral bending), radiographs categorized into: I. Ipsilateral tilt with contralateral rotation II. Ipsilateral tilt with ipsilateral rotation III. Contralateral tilt with contralateral rotation IV. Contralateral tilt with ipsilateral rotation | L Lateral Bending Radiograph Global Motion: K (SE) V = overall agreement Rater 1 and 2 I. 0.63 (0.17) II. 0.60 (0.17) III. 0.54 (0.17) IV. 0.71 (0.17) V. 0.60 (0.10) R Lateral Bending Radiograph Global Motion: K (SE) V = overall agreement Rater 1 and 2 I. 0.64 (0.17) II. 0.61 (0.16) III. 0.09 (0.17) IV. 0.72 (0.16) V. 0.58 (0.10) |
McGregor, 1995 [46] | Intrarater and interrater reliability; 2 chiropractic radiology residents n = 506 | Neutral lateral, flexion lateral and extension lateral radiographs | Measure intersegmental motion excursion of each vertebra (% of sagittal body diameter) | Intrarater reliability: Generalizability coefficients C2 Flexion: 0.47 C2 Extension: 0.53 C3 Flexion: 0.66 C3 Extension: 0.68 C4 Flexion: 0.67 C4 Extension: 0.74 C5 Flexion: 0.56 C5 Extension: 0.74 C6 Flexion: 0.65 C6 Extension: 0.59 C7 Flexion: 0.49 C7 Extension 0.07 Interrater reliability: Generalizability coefficients C2 Flexion: 0.36–0.43 C2 Extension: 0.35–0.43 C3 Flexion: 0.60 C3 Extension: 0.67 C4 Flexion: 0.63 C4 Extension: 0.70–0.77 C5 Flexion: 0.55–0.56 C5 Extension: 0.70–0.71 C6 Flexion: 0.53–0.58 C6 Extension: 0.50–0.53 C7 Flexion: 0.02 C7 Extension 0.00 |
Troyanovich, 1999 [55] | Intra-rater and inter-rater reliability; 3 chiropractors familiar with Chiropractic BioPhysics® technique method of measurement n = 37 anterioposterior lumbopelvic radiographs | Digitized AP lumbopelvic radiographs without artifacts or other obvious identifying features | 2-dimensional coordinates of 33 points selected by each examiner: R and L superior and inferior corners of each vertebral body from T12 through L5, the most superior portion of the spinous processes of T12 through L5 and S2, and the R and L superolateral aspects of the sacral base Computer calculated lines of lateral displacement from true vertical, magnitude of angle of intersection of two lines (LDA), angle of intersection of inferior line with sacral base line (LS angle), horizontal line across sacral base (HB line), true vertical axis line from the spinous process of S2 cephalically and parallel to the lateral edge of the x-ray film (VAL) | Intra-rater reliability ICC (95% CI), SEM HB angle Rater 1: 0.72 (0.52–0.84), 1.62 Rater 2: 0.75 (0.57–0.87), 1.78 Rater 3: 0.94 (0.89–0.97), 0.67 LD angle Rater 1: 0.91 (0.83–0.95), 1.22 Rater 2: 0.90 (0.82–0.95), 1.33 Rater 3: 0.96 (0.92–0.98), 0.87 LS angle Rater 1: 0.84 (0.72–0.92), 2.04 Rater 2: 0.88 (0.77–0.93), 2.07 Rater 3: 0.96 (0.93–0.98), 0.93 TxT12 Rater 1: 0.97 (0.94–0.98), 1.53 Rater 2: 0.95 (0.91–0.97), 1.95 Rater 3: 0.97 (0.95–0.99), 1.40 Crossed ICC (95% CI)a HB angle: 0.78 (0.67–0.86) LD angle: 0.92 (0.87–0.95) LS angle: 0.88 (0.81–0.93) TxT12-S1: 0.96 (0.94–0.98) Inter-rater reliability ICC (95% CI), SEM HB angle: 0.71 (0.56–0.82), 1.62 LD angle: 0.97 (0.94–0.98), 0.75 LS angle: 0.83 (0.73–0.90), 2.13 TxT12: 0.95 (0.91–0.97), 2.01 Crossed ICC (95% CI)a [54] HB angle: 0.61 (0.49–0.73) LD angle: 0.89 (0.83–0.94) LS angle: 0.76 (0.66–0.85) TxT12-S1: 0.92 (0.88–0.95) |
Jackson, 1993 [56] | Intrarater and interrater reliability; 3 chiropractors certified in use of Chiropractic BioPhysics® n = 65 | Lateral cervical films from patient files of a primary care private chiropractic clinic | Standard CBP® measurement protocols: Atlas plane line, Ruth Jackson’s stress lines, vertical axis line and C2 through C7 posterior body lines; relative rotation angle measurements, ARA | Intra-rater reliability Not reported due to inadequate statistics used to compute reliability. Inter-rater reliability Bartko’s ICC; SEM Atlas plane line: 0.93; 1° ARA: 0.96; 1.20° Anterior head translation: 0.80; 1.23 mm Intersegmental angle C2–3: 0.72; 0.57° Intersegmental angle C3–4: 0.79; 0.54° Intersegmental angle C4–5: 0.86; 1.04° Intersegmental angle C5–6: 0.79; 0.66° Intersegmental angle C6–7: 0.74; 0.65° |