The reliability of multitest regimens with sacroiliac pain provocation tests.
BACKGROUND
Studies concerning the reliability of individual sacroiliac tests have inconsistent results. It has been suggested that the use of a test regimen is a more reliable form of diagnosis than individually performed tests.


OBJECTIVE
To assess the interrater reliability of multitest scores by using a regimen of 5 commonly used sacroiliac pain provocation tests.


METHODS
Two examiners examined 78 subjects. The threshold for a positive selection was set at 3 positive tests out of 5 tests performed. The test order and the order in which the subjects were examined were randomized per patient, and the examiners were blinded from all information regarding the subjects tested. Fifty-nine of the subjects were symptomatic for low back pain, and 19 of the subjects were asymptomatic. Weighted kappa statistic, bias-adjusted kappa, prevalence-adjusted kappa, and 95% CI intervals were used to evaluate the interrater reliability of the test regimen.


RESULTS
Weighted kappa was found to be 0.70 (95% CI = 0.45-0.95).


CONCLUSIONS
A multitest regimen of 5 sacroiliac joint pain provocation tests is a reliable method to evaluate sacroiliac joint dysfunction, although further study is needed to assess the validity of this test method.
Kokmeyer
Dirk J
DJ
Private practice of physical therapy, Vail, Colo., USA. dkoke@earthlink.net
Van der Wurff
Peter
P
Aufdemkampe
Geert
G
Fickenscher
Theresa C M
TC
D000328:Adult; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010147:Pain Measurement / Q000592:standards*; D010808:Physical Examination / Q000592:standards*; D011237:Predictive Value of Tests; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012107:Research Design / Q000592:standards; D012446:Sacroiliac Joint / Q000503:physiopathology*; D012680:Sensitivity and Specificity