Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain

Russo, David P., Interexaminer Reliability of Somatic Palpatory Findings Associated with Chronic Low Back Pain. Master of Science, May 2002, 15 pp., 1 table, 1 figure, bibliography, 26 titles. Osteopathic physicians rely on specific clinical palpatory tests to diagnose somatic dysfunction of the neuromusculoskeletal system. The purpose of this study is to compare the interexaminer reliability of six common osteopathic clinical tests to severity ratings of somatic dysfunction in six body regions. Ten trained and clinically supervised predoctoral osteopathic manipulative medicine fellows collected palpatory data using the Standardized Outpatient Osteopathic Soap Note Form (SNF) and recorded findings for six pre-selected osteopathic clinical diagnostic tests as part of a randomized controlled trial of osteopathic manipulative treatment for chronic low back pain. Kappa coefficients were used to assess overall examiner agreement for the osteopathic clinical tests. Intraclass correlational coefficients (ICC) and Chronbach’s alpha were used to assess examiner agreement for the severity ratings. Kappa values for the six clinical tests ranged from 0 to 0.32. The single item ICC was 0.32, average item ICC was .74, and the coefficient alpha for internal consistency of the six body region scores was 0.80. These results indicate that diagnostic impressions of somatic dysfunction severity may be more reliable than outcomes from isolated osteopathic clinical tests.