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Intra- and inter-observer reliability of the Cobb measurement by chiropractic interns using digital evaluation
Jesse Cracknell1, Douglas M Lawson2, John A Taylor2
1D'Youville College, Buffalo, NY ; Private practice, Etobicoke, Ontario, Canada.
The Journal of the Canadian Chiropractic Association
|October 27, 2015
Summary
Chiropractic interns showed good to excellent reliability in using the Cobb Measurement for spinal radiographs. However, agreement on selecting specific vertebrae for measurement was less than optimal.
Area of Science:
- Chiropractic Medicine
- Radiographic Analysis
- Diagnostic Accuracy
Background:
- Establishing the reliability of diagnostic criteria is crucial in healthcare.
- The Cobb Measurement's reliability is known among licensed professionals.
- This study assesses Cobb Measurement reliability specifically among chiropractic interns.
Purpose of the Study:
- To determine the inter- and intra-observer reliability of the Cobb Measurement.
- To evaluate the consistency of Cobb Measurement application by chiropractic interns.
- To identify potential areas for improvement in radiographic interpretation training.
Main Methods:
- Fourteen chiropractic interns analyzed 10 digital spinal radiographs.
- Measurements were taken twice by each intern using a Picture Archiving and Communication System (PACS).
- Inter- and intra-observer reliability were assessed using percentage agreement, Pearson r, and Inter-Class Coefficient (ICC).
Main Results:
- Vertebral level selection agreement ranged from 36% to 79%.
- Intra-observer reliability (Pearson r) was 0.79 across both rounds.
- Inter-observer reliability (ICC) was 0.79 in round 1 and 0.70 in round 2.
Conclusions:
- Agreement on vertebral level selection among interns was suboptimal.
- Intra- and inter-observer reliability for the Cobb Measurement itself was rated as 'excellent' and 'good'.
- Findings suggest a need for enhanced training in precise landmark identification for the Cobb Measurement.
