Diagnosis of shoulder pain by history and selective tissue tension: agreement between assessors.
J Orthop Sports Phys Ther
; 35(3): 147-53, 2005 Mar.
Article
em En
| MEDLINE
| ID: mdl-15839308
ABSTRACT
STUDY DESIGN:
Evaluation of agreement between assessors.OBJECTIVE:
To evaluate agreement between an expert in selective tissue tension (STT) and 3 other trained assessors, all using STT in conjunction with a preliminary clinical history, on their diagnostic labelling of painful shoulders.BACKGROUND:
Consensus on diagnostic labelling for shoulder pain is poor, hampering interpretation of the evidence for interventions. STT, a systematic approach to physical examination and diagnosis, offers potential for standardization, but its reliability is contentious. METHODS ANDMEASURES:
Four trained assessors, 1 of whom was considered an expert, separately assessed 56 painful shoulders in 53 subjects (32 male [mean+/-SD age, 51+/-13 years], 21 female [mean+/-SD age, 57+/-12 years]), using STT in conjunction with a preliminary clinical history. Assessors labelled each painful shoulder as "rotator cuff lesion," "bursitis," "capsulitis," "other diagnosis," or "no diagnosis." Combinations of diagnoses were allowed.RESULTS:
A diagnosis was made in every case, with less than 7% of the diagnoses being combined. With the diagnostic categories pooled, agreement (kappa and 95% confidence interval [CI]) between the expert assessor and each of the other assessors was good, ranging from 0.61 (0.44-0.78) to 0.75 (0.60-0.90). For single diagnostic categories, agreement between the expert and each of the others (dichotomized data) ranged from 0.35 (-0.03-0.73) to 0.58 (0.29-0.87) for bursitis; 0.63 (0.40-0.86) to 0.82 (0.65-0.99) for capsulitis; 0.71 (0.49-0.93) to 0.79 (0.61-0.96) for rotator cuff lesions; and from 0.69 (0.35-1.00) to 0.78 (0.48-1.00) for other diagnoses.CONCLUSIONS:
Overall, STT in conjunction with a preliminary clinical history enables good agreement between trained assessors. Future work is required to evaluate its criterion validity.
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Base de dados:
MEDLINE
Assunto principal:
Ortopedia
/
Dor
/
Medição da Dor
/
Lesões do Ombro
Tipo de estudo:
Diagnostic_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article