title: Intertester reliability of a classification system for shoulder pain.
abstract: OBJECTIVE
  To describe and determine the intertester reliability of a newly developed classification system of shoulder syndrome recognition.
  
  
  METHODS
  Intertester reliability study.
  
  
  METHODS
  Fourteen primary care physiotherapy clinics.
  
  
  METHODS
  Two hundred and fifty-five patients with shoulder pain. Inclusion criterion: presence of shoulder pain aring within the glenohumeral or associated joints and structures.
  
  
  METHODS
  previous shoulder surgery, surgical candidates, recognised malignancy, systemic illness, or concurrent cervical pain and/or radiculopathy.
  
  
  METHODS
  Examiners were 55 physiotherapists who were arranged in pairs; each patient received two independent and blinded assessments, one by each of the paired physiotherapists. This shoulder classification approach contains three main clinical syndromes: Pattern 1 (impingement pain), Pattern 2 (acromioclavicular joint pain) and Pattern 3 (shoulder pain: frozen shoulder, glenohumeral arthritis, massive cuff tear, subscapularis tear, painful laxity, post-traumatic instability, internal derangement).
  
  
  METHODS
  Percentage agreement and Cohen's kappa coefficient.
  
  
  RESULTS
  The mean age of patients was 46.6 years (standard deviation 16.3, range 16 to 86), and 57% were male. Physiotherapists agreed on the pattern of shoulder pain for 205 of the 255 shoulders assessed (agreement rate 80%); the kappa coefficient was 0.664 (95% confidence interval 0.622 to 0.706; P<0.001). Of the 205 agreements, Pattern 1 was the most common condition; physiotherapists agreed on this pattern for 139 patients (68%). Both physiotherapists diagnosed Pattern 2 for 20 patients and Pattern 3 for 46 patients.
  
  
  CONCLUSIONS
  This clearly defined system uses key elements of the history and examination to classify patients with shoulder pain. The kappa coefficient denotes good reproducibility.
authors.affiliation: CBI Health Group, Toronto, Ontario, Canada.
authors.forename: Tom
authors.initials: T
authors.lastname: Carter
authors.forename: Hamilton
authors.initials: H
authors.lastname: Hall
authors.forename: Greg
authors.initials: G
authors.lastname: McIntosh
authors.forename: John
authors.initials: J
authors.lastname: Murphy
authors.forename: Janice
authors.initials: J
authors.lastname: MacDougall
authors.forename: Christina
authors.initials: C
authors.lastname: Boyle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results; D020069:Shoulder Pain / Q000145:classification* / Q000175:diagnosis; D055815:Young Adult