Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis

Introduction: A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, interexaminer reliability of this interpretation has not been reported. The purpose of this study was to report interexaminer reliability for classifying cervical paraspinal thermographic findings. Methods: Seventeen doctors of chiropractic selfreporting a minimum of 2 years of experience using thermography classified thermographic scans into categories (full pattern, partial +, partial, partial -, and adaptation). Kappa statistics (k) were calculated to determine inter-examiner reliability. Results: Overall inter-examiner reliability was fair (k=0.43). There was good agreement for identifying full pattern (k=0.73) and fair agreement for adaptation (k=0.55). Poor agreement was noted in partial categories (k=0.05-0.22). Conclusion: Inter-examiner reliability demonstrated fair to good agreement for identifying comparable (full pattern) and disparate (adaptation) thermographic findings; agreement was poor for those with moderate similarity (partial). Further research is needed to determine whether thermographic findings should be used in clinical decision-making for spinal manipulation.

Duke Scholars

Author Christine Goertz Orthopaedic Surgery