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首页> 外文会议>Human Factors and Ergonomics Society;Human Factors and Ergonomics Society annual meeting >EFFICIENCIES IN IMAGING DIAGNOSTICS OF THE LUMBAR SPINE
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EFFICIENCIES IN IMAGING DIAGNOSTICS OF THE LUMBAR SPINE

机译：腰椎影像学诊断的效率

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While low back pain is one of the most prevalent, if not the most prevalent reasons for visits to physicians,a majority of patients with low back pain cannot be given a definitive diagnosis. The current standard ofcare for function assessment of the lumbar spine focuses on uncontrolled patient directed motion whichresults in increased inter-patient variability and diagnostic misclassifications. The purpose of the currentpaper is to compare the measurement variability of lumbar spine motion when diagnosed usingmeasurements of intervertebral motion taken from standard flexion extension bending radiographs (FE)between uncontrolled and controlled motion and to assess the rate of diagnostic misclassification errors(false positives and false negatives) in the detection of lumbar instability. 109 patients (57 asymptomatic,52 symptomatic) were consented in the prospective investigation. The research was designed to comparestudies involving FE to controlled motion bending radiographs (CCBR) using the Vertebral MotionAnalysis (VMA) within the same patient. Measurement variability was determined by the mean andstandard deviation of intervertebral rotation when evaluated by 9 independent observers evaluating each ofthe 109 patients FE and CCBR. The resulting standard deviation of the intervertebral rotationdeterminations was used as the measure of variability. Sensitivity (true positive rate) and specificity (truenegative rate), were constructed using asymptomatic individuals and symptomatic patients in order todetermine true positive (TP) and true negative (TN) appointments. The analysis was compared to knownthreshold of 25° (IVR) to determine the rates of false negatives (FN) and false positive (FP) rates.Sensitivity and specificity were calculated as TP/(TP/FN) and TN/(FP+TN), respectively. There wasstatistical greater measurement variability in intervertebral rotation in FE when compared to CCBR (bothstanding and lying). When comparing measurement variability between FE and CCBR, results indicatebetween a 26% to 46% decrease in measurement variability under CCBR compared to FE. These findingsare consistent across asymptomatic and symptomatic patients. Sensitivity measures were 6.2% (VMA12.6%, FE 6.4%) greater in the VMA test compared to the FE. Specificity measures were 8.4% (VMA99.1%, FE 90.7%) greater in the VMA test compared to the FE. The current standard of care for functionaltesting of the lumbar spine utilizes uncontrolled FE with a manual data evaluation process. Recentdevelopments in using computerized imaging processes has improved, however there remains variability inpatient bending due to the self-selected rate and position of the bending. CCBR results in a significantreduction in measurement variability of intervertebral rotation measurements. Reducing measurementvariability would be expected to improve the efficacy rates of surgeries indicated for these conditions.
机译：腰痛是看医生的最普遍的原因之一，即使不是最普遍的原因， 大多数腰痛患者无法得到明确的诊断。目前的标准 腰椎功能评估的护理重点在于不受控制的患者定向运动 导致患者间变异性增加和诊断错误分类。目前的目的 本文旨在比较使用以下方法诊断出的腰椎运动的测量变异性 从标准屈伸弯曲X线照片（FE）进行的椎间运动测量 在不受控制的运动和受控制的运动之间进行评估，以评估诊断错误分类错误的发生率 （假阳性和假阴性）检测腰椎不稳。 109名患者（57名无症状， 52个有症状的患者）在前瞻性调查中表示同意。该研究旨在比较 椎体运动涉及有限元到受控运动弯曲射线照相（CCBR）的研究 同一患者内的分析（VMA）。测量变异性由平均值和 椎间旋转的标准偏差，当由9位独立的观察者评估每个椎间盘 109例FE和CCBR。椎间旋转的标准偏差 测定用作变异性的量度。敏感性（真实阳性率）和特异性（真实 阴性率），是由无症状的个体和有症状的患者构建的 确定真正的正面（TP）和真正的负面（TN）约会。将分析与已知的进行比较 阈值25°（IVR），以确定误报率（FN）和误报率（FP）。 敏感性和特异性分别计算为TP /（TP / FN）和TN /（FP + TN）。有 与CCBR相比，FE中椎间旋转的统计测量变异性更大（两者均 站立和躺着）。比较FE和CCBR之间的测量变异性时，结果表明 与FE相比，CCBR下的测量变异性降低了26％至46％。这些发现 在无症状和有症状的患者中是一致的。敏感度指标为6.2％（VMA 与FE相比，VMA测试的结果要高出12.6％，FE 6.4％）。特异性指标为8.4％（VMA 与FE相比，VMA测试的结果高出99.1％，FE达到90.7％）。当前的功能照护标准 腰椎的测试利用不受控制的有限元分析和手动数据评估过程。最近的 使用计算机成像过程的发展已有所改善，但是仍然存在差异。 由于患者自行选择弯曲的速度和位置，因此弯曲。 CCBR的结果显着 减少椎间旋转测量的测量变异性。减少测量 可以预期，可变性将改善针对这些情况指示的手术的有效率。

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