The inter- and intraexaminer reliability of a paraspinal skin temperature differential instrument

An experiment was undertaken to determine the intra- and interexaminer reliability of a paraspinal skin temperature differential instrument. Nineteen pain-free female chiropractic college students participated as subjects for the investigation. Three separate areas of the spine (C4-T2, T4-T8 and L2-L5) were examined for concordance between two examiners. Additionally, intraexaminer reliability was tested by having each examiner repeat the scanning procedure. Concordance for whether a temperature differential existed in a particular area was evaluated with the Kappa statistic. Kappas ranged from 0.034 to 0.6591 and were all statistically significant (p less than 0.05). This represented slight to moderate reliability in the area C4-T2 and substantial agreement in the region T4-T8. The lumbar region could not be evaluated with the Kappa statistic due to limited variation. Following agreement for a positive finding in a given area, the numerical ratings were evaluated for agreement with the intraclass correlation coefficient (ICC). The first observation between examiners indicated fair agreement (ICC = 0.2756, p = 0.0478). The second observation between examiners had substantial agreement (ICC = 0.6402, p = 0.042). Intraexaminer agreement was moderate for one examiner (ICC = 0.5078, p = 0.0016). The other examiner showed an excellent level of agreement (ICC = 0.8588, p less than 0.001) between observations.