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Inter-tester reliability of a new diagnostic classification system for patients with non-specific low back pain

Petersen, Tom LU ; Olsen, S; Laslett, M; Thorsen, H; Manniche, C; Ekdahl, Charlotte LU and Jacobsen, S (2004) In Australian Journal of Physiotherapy 50(2). p.85-94
Abstract
Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying patients with non-specific low back pain into 12 different syndromes and three subcategories based on history and physical examination. The purpose of this study was to estimate the inter-tester reliability of clinical tests used as criteria for classifying patients. Ninety patients with chronic low back pain were each examined by two physiotherapists. A total of four physiotherapists conducted the assessments, Examination findings were recorded... (More)
Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying patients with non-specific low back pain into 12 different syndromes and three subcategories based on history and physical examination. The purpose of this study was to estimate the inter-tester reliability of clinical tests used as criteria for classifying patients. Ninety patients with chronic low back pain were each examined by two physiotherapists. A total of four physiotherapists conducted the assessments, Examination findings were recorded independently by the two examiners. Percentage of agreement and kappa coefficients were calculated for each category. The overall rate of agreement was 72% and the kappa coefficient was 0.62 for the mutually exclusive syndromes in the classification system. Agreement rates for each of the syndromes ranged from 74% to 100% and kappa coefficients ranged from 0.44 to 1.00. The findings suggest the inter-tester reliability of the system is acceptable. The relatively modest level of total agreement (39%) for the system as a whole might indicate that the utility of the system for general screening purposes is limited, compared with the utility in identification of particular syndromes. Due to low prevalence of positive findings in some of the syndromes, future work should focus on testing reliability on a larger sample of patients, and testing of validity and feasibility of the system. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
results, reliability of, physical examination, low back pain, classification, reproducibility of results
in
Australian Journal of Physiotherapy
volume
50
issue
2
pages
85 - 94
publisher
Australian Physiotherapy Association
external identifiers
  • wos:000222129100004
  • pmid:15151492
  • scopus:3042547265
ISSN
0004-9514
language
English
LU publication?
yes
id
1e793e58-90f8-4213-a4ba-cb166b6bc57e (old id 274373)
alternative location
http://www.physiotherapy.asn.au/AJP/vol_50/2/AustJPhysiotherv50i2Petersen.pdf
date added to LUP
2007-10-26 14:57:22
date last changed
2017-06-04 04:15:40
@article{1e793e58-90f8-4213-a4ba-cb166b6bc57e,
  abstract     = {Most patients referred to physiotherapy with low back pain are without a precise medical diagnosis. Identification of subgroups of non-specific low back pain patients may improve clinical outcomes and research efficiency. A pathoanatomic classification system has been developed, classifying patients with non-specific low back pain into 12 different syndromes and three subcategories based on history and physical examination. The purpose of this study was to estimate the inter-tester reliability of clinical tests used as criteria for classifying patients. Ninety patients with chronic low back pain were each examined by two physiotherapists. A total of four physiotherapists conducted the assessments, Examination findings were recorded independently by the two examiners. Percentage of agreement and kappa coefficients were calculated for each category. The overall rate of agreement was 72% and the kappa coefficient was 0.62 for the mutually exclusive syndromes in the classification system. Agreement rates for each of the syndromes ranged from 74% to 100% and kappa coefficients ranged from 0.44 to 1.00. The findings suggest the inter-tester reliability of the system is acceptable. The relatively modest level of total agreement (39%) for the system as a whole might indicate that the utility of the system for general screening purposes is limited, compared with the utility in identification of particular syndromes. Due to low prevalence of positive findings in some of the syndromes, future work should focus on testing reliability on a larger sample of patients, and testing of validity and feasibility of the system.},
  author       = {Petersen, Tom and Olsen, S and Laslett, M and Thorsen, H and Manniche, C and Ekdahl, Charlotte and Jacobsen, S},
  issn         = {0004-9514},
  keyword      = {results,reliability of,physical examination,low back pain,classification,reproducibility of results},
  language     = {eng},
  number       = {2},
  pages        = {85--94},
  publisher    = {Australian Physiotherapy Association},
  series       = {Australian Journal of Physiotherapy},
  title        = {Inter-tester reliability of a new diagnostic classification system for patients with non-specific low back pain},
  volume       = {50},
  year         = {2004},
}