Affiliation:
1. Institute for Spinal Health and Performance, 460 Brannon Road, #101, Cumming, GA 30041, USA
Abstract
Background:
Spinal radiographic analyses are valid and reliable practices used for patient
management in healthcare. Technologies and tools used for these analyses need to be valid and reliable.
Objective:
This study investigates repeated accuracy for validity and intra- and inter-examiner reliability
of computer-aided lateral spinal radiograph measurements using PostureRay® EMR software.
Methods:
Rectangle renderings representing lateral spinal radiographic views were created to remove
examiner interpretation of anatomical landmarks as performed on actual radiographs to examine the
objective repeated accuracy of PostureRay® software. A blind, randomized, repeated measure design
was performed using four examiners trained and experienced with the Harrison Posterior Tangent
method of measurement. Each examiner analyzed the spine renderings using a hand-drawn and PostureRay
® method multiple times. A fully crossed design whereby examiners performed multiple assessments
per rendering using each analysis method was used to assess intra- and inter-examiner reliability
within each method and a formal comparison of the two methods.
Results:
Using hand-drawn and PostureRay® methods, examiners displayed very high intra-examiner
reliability with correlation values greater than 0.999 for each combination of trials. PostureRay® method
showed consistent accuracy of measurements. Further, there was no statistical difference in average
concordance between hand-drawn and PostureRay® methods for the lateral cervical, thoracic, and
thoracolumbosacral spinal regions.
Conclusion:
This study reports a very high degree of intra- and inter-examiner reliability of radiographic
line drawing methods and establishes concurrent validity of PostureRay® EMR software in
determining angles and displacements of lateral spinal alignment as an equivalent method to the handdrawn
method.
Publisher
Bentham Science Publishers Ltd.
Subject
Radiology, Nuclear Medicine and imaging
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