Measuring the morphological characteristics of thoracolumbar fascia in ultrasound images: an inter-rater reliability study

De Coninck, Kyra, Hambly, Karen, Dickinson, John W., Passfield, Louis (2018) Measuring the morphological characteristics of thoracolumbar fascia in ultrasound images: an inter-rater reliability study. BMC Musculoskeletal Disorders, 19 (180). ISSN 1471-2474. E-ISSN 1471-2474. (doi:10.1186/s12891-018-2088-5)

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Abstract

BACKGROUND: Chronic lower back pain is still regarded as a poorly understood multifactorial condition. Recently, the thoracolumbar fascia complex has been found to be a contributing factor. Ultrasound imaging has shown that people with chronic lower back pain demonstrate both a significant decrease in shear strain, and a 25% increase in thickness of the thoracolumbar fascia. There is sparse data on whether medical practitioners agree on the level of disorganisation in ultrasound images of thoracolumbar fascia. The purpose of this study was to establish inter-rater reliability of the ranking of architectural disorganisation of thoracolumbar fascia on a scale from ‘very disorganised’ to ‘very organised’. METHODS: An exploratory analysis was performed using a fully crossed design of inter-rater reliability. Thirty observers were recruited, consisting of 21 medical doctors, 7 physiotherapists and 2 radiologists, with an average of 13.03 ± 9.6 years of clinical experience. All 30 observers independently rated the architectural disorganisation of the thoracolumbar fascia in 30 ultrasound scans, on a Likert-type scale with rankings from 1 = very disorganised to 10 = very organised. Internal consistency was assessed using Cronbach’s alpha. Krippendorff’s alpha was used to calculate the overall inter-rater reliability. RESULTS: The Krippendorf’s alpha was .61, indicating a modest degree of agreement between observers on the different morphologies of thoracolumbar fascia.The Cronbach’s alpha (0.98), indicated that there was a high degree of consistency between observers. Experience in ultrasound image analysis did not affect constancy between observers (Cronbach’s range between experienced and inexperienced raters: 0.95 and 0.96 respectively). CONCLUSIONS: Medical practitioners agree on morphological features such as levels of organisation and disorganisation in ultrasound images of thoracolumbar fascia, regardless of experience. Further analysis by an expert panel is required to develop specific classification criteria for thoracolumbar fascia.

Item Type: Article
DOI/Identification number: 10.1186/s12891-018-2088-5
Uncontrolled keywords: inter-observer reliability; thoracolumbar fascia; ultrasound imaging
Subjects: Q Science
Q Science > QM Human anatomy
R Medicine
Divisions: Faculties > Sciences > School of Sport and Exercise Sciences
Depositing User: Kyra De Coninck
Date Deposited: 08 May 2018 11:43 UTC
Last Modified: 29 May 2019 20:31 UTC
Resource URI: https://kar.kent.ac.uk/id/eprint/66942 (The current URI for this page, for reference purposes)
De Coninck, Kyra: https://orcid.org/0000-0002-2672-6761
Hambly, Karen: https://orcid.org/0000-0002-3442-2493
Passfield, Louis: https://orcid.org/0000-0001-6223-162X
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