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首页> 外文期刊>Spine >Reliability and Validity of Lumbosacral Spine Radiograph Reading by Chiropractors, Chiropractic Radiologists, and Medical Radiologists.
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Reliability and Validity of Lumbosacral Spine Radiograph Reading by Chiropractors, Chiropractic Radiologists, and Medical Radiologists.

机译：脊医，脊骨放射科医生和医学放射科医生对腰ac骨X线片的可靠性和有效性进行了研究。

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STUDY DESIGN: A cross-sectional diagnostic study was conducted in two sessions. OBJECTIVE: To determine and compare the reliability and validity of contraindications to chiropractic treatment (infections, malignancies, inflammatory spondylitis, and spondylolysis-listhesis) detected by chiropractors, chiropractic radiologists, and medical radiologists on plain lumbosacral radiographs. SUMMARY OF BACKGROUND DATA: Plain radiography of the spine is an established part of chiropractic practice. Few studies have assessed the ability of chiropractors to read plain radiographs. METHODS: Five chiropractors, three chiropractic radiologists and five medical radiologists read a set of 300 blinded lumbosacral radiographs, 50 of which showed an abnormality (prevalence, 16.7%), in two sessions. The results were expressed in terms of reliability (percentage and kappa) and validity (sensitivity and specificity). RESULTS: The interobserver agreement in the first session showed generalized kappas of 0.44 for the chiropractors, 0.55 for the chiropractic radiologists, and 0.60 for the medical radiologists. The intraobserver agreement showed mean kappas of 0.58, 0.68, and 0.72, respectively. The difference between the chiropractic radiologists and medical radiologists was not significant. However, there was a difference between the chiropractors and the other professional groups. The mean sensitivity and specificity of the first round, respectively was 0.86 and 0.88 for the chiropractors, 0.90 and 0.84 for the chiropractic radiologists, and 0.84 and 0.92 for the medical radiologists. No differences in the sensitivities were found between the professional groups. The medical radiologists were more specific than the others. CONCLUSIONS: Small differences with little clinical relevance were found. All the professional groups could adequately detect contraindications to chiropractic treatment on radiographs. For this indication, there is no reason to restrict interpretation of radiographs to medical radiologists. Good professional relationships between the professions are recommended to facilitate interprofessional consultation in case of doubt by the chiropractors.
机译：研究设计：在两个环节中进行了横断面诊断研究。目的：确定并比较禁忌症治疗师，整脊放射科医生和医学放射科医生在普通腰s部X光片上检测到的禁忌症对整脊疗法（感染，恶性肿瘤，炎性脊柱炎和脊柱软化性滑脱）的禁忌症的可靠性和有效性。背景数据摘要：脊柱平片是脊椎治疗的公认部分。很少有研究评估脊椎治疗师阅读平片的能力。方法：五名脊医，三名脊椎放射科医生和五名医学放射科医生在两次会议中阅读了300份盲腰部X光片，其中50幅显示异常（患病率16.7％）。结果以可靠性（百分数和kappa）和有效性（敏感性和特异性）表示。结果：在第一届会议的观察员之间达成的协议显示，脊医的卡帕值分别为0.44，脊椎放射科医生为0.55，医学放射科医生为0.60。观察者内部协议显示平均卡帕分别为0.58、0.68和0.72。整脊放射科医生和医学放射科医生之间的差异不显着。然而，脊医与其他专业人士之间却有所不同。脊医的第一轮平均敏感性和特异性分别为0.86和0.88，脊骨放射科医师为0.90和0.84，医疗放射科医师为0.84和0.92。在专业组之间没有发现敏感性差异。医学放射线医师比其他放射线医师更具体。结论：发现差异很小，临床意义不大。所有专业人士都可以在X射线照片上充分发现脊骨治疗的禁忌症。对于这种指示，没有理由将射线照片的解释限于医学放射线医生。建议各专业人士之间建立良好的专业关系，以便在脊医产生疑问时促进专业间的咨询。

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