title: Inter-examiner reliability of the interpretation of paraspinal thermographic pattern analysis.
abstract: BACKGROUND
  A few spinal manipulation techniques use paraspinal surface thermography as an examination tool that informs clinical-decision making; however, inter-examiner reliability of this interpretation has not been reported. The purpose of this study was to report inter-examiner reliability for classifying cervical paraspinal thermographic findings.
  
  
  METHODS
  Seventeen doctors of chiropractic self-reporting a minimum of 2 years of experience using thermography classified thermographic scans into categories (full pattern, partial +, partial, partial -, and adaptation). Kappa statistics (k) were calculated to determine inter-examiner reliability.
  
  
  RESULTS
  Overall inter-examiner reliability was fair (k=0.43). There was good agreement for identifying full pattern (k=0.73) and fair agreement for adaptation (k=0.55). Poor agreement was noted in partial categories (k=0.05-0.22).
  
  
  CONCLUSIONS
  Inter-examiner reliability demonstrated fair to good agreement for identifying comparable (full pattern) and disparate (adaptation) thermographic findings; agreement was poor for those with moderate similarity (partial). Further research is needed to determine whether thermographic findings should be used in clinical decision-making for spinal manipulation.
authors.affiliation: Associate Professor, Clinic, Palmer College of Chiropractic barbara.mansholt@palmer.edu.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Mansholt
authors.affiliation: Associate Professor, Senior Research Clinician, Palmer Center for Chiropractic Research, Palmer College of Chiropractic robert.vining@palmer.edu.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Vining
authors.affiliation: Professor, Director of Research, Palmer Center for Chiropractic Research, Palmer College of Chiropractic LONG_C@palmer.edu.
authors.forename: Cynthia R
authors.initials: CR
authors.lastname: Long
authors.affiliation: Vice Chancellor for Research and Health Policy, Palmer College of Chiropractic christine.goertz@palmer.edu.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Goertz
keywords: chiropractic; diagnosis; instrumentation; technique