The reliability of the augmented Lehnert-Schroth and Rigo classification in scoliosis management.
Burçin Akçay, Tuğba Kuru Çolak, Adnan Apti and 2 others
PMID 34859160WHAT IT FOUND
Clinicians disagree moderately when using the ALS and Rigo classifications to identify scoliosis curve patterns, even when looking at the same X-rays or photos twice.
This means pattern-specific treatment plans based on these systems may vary significantly between therapists.
Key findings
01Inter-observer reliability (agreement between different clinicians) was moderate for ALS X-ray images (ICC 0.552) and Rigo clinical photographs (ICC 0.518), but poor for ALS clinical photographs (ICC 0.494) and Rigo X-ray images (ICC 0.452).
02Intra-observer reliability (agreement of the same clinician over time) was moderate to good for ALS classifications (averages 0.720 for X-rays and 0.726 for photos), but poor to moderate for Rigo classifications (averages 0.581 for X-rays and 0.467 for photos).
03The study found that radiological estimation (X-rays) was more reliable than clinical estimation (photos) for the ALS classification, whereas the opposite was true for the Rigo classification.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The sample size was small (45 patients) due to pandemic restrictions. All raters were experienced and familiar with the classification systems, so results may not apply to novice clinicians. The study did not assess the clinical validity of the classifications, only their reliability (consistency).
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a high intra-observer reliability (consistency of one therapist) means the classification is accurate. The study shows that while a single therapist might be consistent, different therapists often disagree on the same patient's curve pattern.