Methods: Five osteopathic predoctoral fellows and 5 osteopathic physicians assessed 13 settings of varied ASIS asymmetry of a novel pelvic model for superior/inferior positional asymmetry from both sides of the model in a random order. Assessment from the right and left sides of the model occurred on 2 separate days. Fellows were trained for a week and retested.
Results: Average interexaminer reliability was greatest from the left side of the model for physicians and from the right side for fellows (physicians: κ = 0.46, fellows: κ = 0.37), whereas intraexaminer reliability was greatest from the right in both groups (physicians: κ = 0.49, fellows: κ = 0.52). Following training of fellows, interexaminer reliability remained highest from the right side of the model (right: κ = 0.48, left: κ = 0.36), whereas intraexaminer reliability was higher from the left side (right: κ = 0.53, left: κ = 0.59). Physicians and fellows before training were more accurate from the right side of the model (κ = 0.56 and κ = 0.52, respectively). Following training of fellows, accuracy increased from both sides of the model (right: κ = 0.59, left: κ = 0.53).
Conclusions: A novel pelvic model was developed to allow assessment of accuracy and reliability of ASIS asymmetry assessment. Individually, physicians and fellows varied in accuracy and inter-/intraexaminer reliability. Further investigation is warranted to understand the clinical and educational application of these results.
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