Index to Chiropractic Literature
Index to Chiropractic Literature
My ICL     Sign In
Monday, April 15, 2024
Index to Chiropractic LiteratureIndex to Chiropractic LiteratureIndex to Chiropractic Literature

For best results switch to Advanced Search.
Article Detail
Return to Search Results
ID 26104
  Title Degenerative findings in lumbar spine MRI: An inter-rater reliability study involving three raters
Journal Chiropr & Manual Ther. 2020 ;28(8):Online access only 10 p
Peer Review Yes
Publication Type Article

Background: For diagnostic procedures to be clinically useful, they must be reliable. The interpretation of lumbar spine MRI scans is subject to variability and there is a lack of studies where reliability of multiple degenerative pathologies are rated simultaneously. The objective of our study was to determine the inter-rater reliability of three independent raters evaluating degenerative pathologies seen with lumbar spine MRI.

Methods: Fifty-nine people, 35 patients with low back pain (LBP) or LBP and leg pain and 24 people without LBP or leg pain, received an MRI of the lumbar spine. Three raters (one radiologist and two chiropractors) evaluated the MRIs for the presence and severity of eight degenerative spinal pathologies using a standardized format: Spondylolisthesis, scoliosis, annular fissure, disc degeneration, disc contour, nerve root compromise, spinal stenosis and facet joint degeneration. Findings were identified and classified at disc level according to type and severity. Raters were instructed to evaluate all study sample persons once to assess inter-rater reliability (fully crossed design). Reliability was calculated using Gwet’s Agreement Coefficients (AC1 and AC2) and Cohen’s Kappa (κ) and Conger’s extension of Cohen’s. Gwet’s probabilistic benchmarking method to the Landis and Koch scale was used. MRI-findings achieving substantial reliability was considered acceptable.

Results: Inter-rater reliability for all raters combined, ranged from (Gwet’s AC1 or AC2): 0.64–0.99 and according to probabilistic benchmarking to the Landis and Koch scale equivalent to moderate to almost perfect reliability. Overall reliability level for individual pathologies was almost perfect reliability for spondylolisthesis, spinal stenosis, scoliosis and annular fissure, substantial for nerve root compromise and disc degeneration, and moderate for facet joint degeneration and disc contour.

Conclusion: Inter-rater reliability for 3 raters, evaluating 177 disc levels, was found to be overall acceptable for 6 out of 8 degenerative MRI-findings in the lumbar spine. Ratings of facet joint degeneration and disc contour achieved moderate reliability and was considered unacceptable.

Author keywords: Agreement — Reliability —  Reproducibility —  Lumbar spine —  Low Back pain —  Leg pain —  Sciatica —  No-low back pain —  Recumbent MRI —  Supine MRI —  MR —   Magnetic resonance imaging

Author affiliations: KD, EB, JH: Department of Sport Sciences and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark;  KD, TSJ, HWC, JH: Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark; KD, TSJ, UF, MK: Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital, Aarhus University, Odense, Denmark; TSJ: Department of Clinical Medicine, Aarhus University, Odense, Denmark; UF: The Rheumatology Research Unit, Odense University Hospital, University of Southern Denmark, Odense, Denmark

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record


   Text (Citation) Tagged (Export) Excel
Email To
HTML Text     Excel

To use this feature you must register a personal account in My ICL. Registration is free! In My ICL you can save your ICL searches in My Searches, and you can save search results in My Collections. Be sure to use the Held Citations feature to collect citations from an entire search session. Read more search tips.

Sign Into Existing My ICL Account    |    Register A New My ICL Account
Search Tips
  • Enclose phrases in "quotation marks".  Examples: "low back pain", "evidence-based"
  • Retrieve all forms of a word with an "asterisk*", also called a wildcard or truncation.  Example: "chiropract*" retrieves chiropractic, chiropractor, chiropractors
  • Register an account in My ICL to save search histories (My Searches) and collections of records (My Collections)
Advanced Search Tips