The reliability of multitest regimens with sacroiliac pain provocation tests

Abstract

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.