OBJECTIVE: The purpose of this literature review was to assess the current validity of thoracolumbar paraspinal scanning EMG as practiced by the chiropractic profession within the context of adequate and acceptable epidemiological standards for validating a new diagnostic test.
DATA SOURCES, STUDY SELECTION AND DATA EXTRACTION: Sources for the primary literature citations were obtained from several indexing services (MEDLINE--April 1993 to 1989; Index to Chiropractic Literature--1991 to 1980, Chiropractic Research Archives Collection--Vol. I-IV and Chiropractic Literature Analysis and Retrieval System) and hand searched under the subject heading of electromyography. For MEDLINE this was combined with electromyography as a title/abstract word and limited to "human." Primary literature citations were included in this review if the author, institution or journal was associated with the chiropractic profession and the paper dealt with thoracolumbar scanning EMG. Thirty-seven primary publications were identified and were systematically evaluated for contribution to any of the twelve key criteria used to validate a new diagnostic test. Secondary or tertiary citations from all sources were included if referenced in the primary literature as previous investigations supporting one of the key criteria. Additional secondary sources were included providing that the author was aware of them and the subject matter was germane to the EMG subtopic.
DATA SYNTHESIS: Based upon this review, none of the 12 key criteria used to validate a new diagnostic test have been adequately satisfied.
CONCLUSIONS: It is concluded that thoracolumbar paraspinal scanning EMG is premature for clinical application as a paraclinical diagnostic test. Recommendations for evaluation directions in the immediate future are provided.
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