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Ist das Global Listening reliabel? Studie zur Intrarater- und Interrater-Reliabilität des Global Listenings
(Intraobserver and Interobserver Reliability of the Global Listening)
Rittler, M. [1]

Journal: Unpublished MSc thesis Wiener Schule für Osteopathie, Date: 2010/12, Pages: 102, type of study: controlled clinical trial

Free full text   (https://www.osteopathicresearch.org/s/orw/item/2918)

Keywords:

global listening [2]
interobserver reliability [2]
intraobserver reliability [2]
global listening test [1]
controlled clinical trial [283]
WSO [433]

Abstract:

Study Design methodological study, intraobserver and interobserver reliability of an osteopathic test Outline/Problem Definition The Global Listening is an osteopathic test, which is proposed in literature to get a first impression of the patient´s restrictions. By feeling the traction of the fascia the tester gets a hint, whether the main problem is a viszeral or structural one, whether it is on the left or right side, more cranial or caudal (Barral, 2002; Croibier, 2006; Hinkelthein und Zalpour, 2005; Puylaert, 2005). The question, whether the outcome of a test can be trusted,is often posed. An attempt to answer it, is to determine the test´s reliability. Reliability can be defined as the extent to which a repeated test will produce the same result when evaluating an unchanged characteristic. Is the test repeated by one person on the same subject, the intraobserver reliability can be determined. If two or more examiners test the same subject, the interobserver reliability can be established (Krause, 2007). Up to date reliability studies have hardly found reliable tests. In reviews (Gemmel and Miller, 2005; Hartman and Norton, 2002; Hestboeuk and Leboeuf-Yde, 2000; Van Trijffel et al., 2005)the quality of most studies is strongly criticized. A Listening has up do date just one time been evaluated with a reliability study (Polesnic, 2006). An interesting detail in reliability studies is the influence of the testers´ experience. One can assume that experienced testers achieve better reliability values than juniors, but so far the opposite has been shown (Harvey and Byfield, 1991; Jensen at al., 1993;). Research Question & Objective To investigate the intra- and interobserver reliability of the Global Listening and to observe whether the experience of the tester has an influence on his intraobserver reliability. research question one: Do different testers achieve the same result when testing the same subject? (interobserver reliability) research question two: Does one tester achieve the same result when testing the same subject several times? (intraobserver reliability) research question three: Does the testers´ experience influence the interobserver reliability achieved by him. Hypothesis null hypothesis one: Do several testers perform a Global Listening on the same patient within a short period of time their agreement is in a range, that could be achieved by mere chance. null hypothesis two: Does one tester perform a Global Listening on the same subject several times within a short period of time, the agreement of his results is in a range that could be achieved by mere chance. null hypothesis three: If a tester regularly uses the Global Listening in his practise, he does not achieve a higher agreement when testing the same subject several times than a tester, who never uses the test in his practice. alternative hypothesis one: Do several testers perform a Global Listening on the same patient within a short period of time their agreement is above k = 0,4, a value proposed by Fjellner et al.(1999) for acceptable interobserver reliability. alternative hypothesis two: Does one tester perform a Global Listening on the same subject several times within a short period of time, his agreemnet is above k = 0,6, a value proposed by Halma et al.(2008) for acceptable intrarater reliability. alternative hypothesis three: If a tester regularly uses the Global Listening in his practise, he achieves a higher agreement when testing the same subject several times than a tester, who never uses the test in his practice. Methodology 18 subjects were tested by six testers. The first ten of the subjects were tested two more times. Subjects had to have symptoms, which were judged as an indication for osteopathy. The testers´ experience was assessed on the basis of the frequency of the use of the Global Listening in their practice. One week before data collection a training was held. A standardised procedure of the test was elaborated and practised. During data collection testers had their eyes blindfolded and were assisted by additional persons. Testers were blinded to each others´ results and to the patients´ symptoms. Patients were blinded to the possible outcomes of the test. Cohen´s Kappa was used for calculation purposes. Results Neither an intraobserver nor an interobserver reliability has been found. Results were in a range of random agreement. Remarkably, the tester, who never uses the Global Listening, achieved the best intraobserver reliability. Still, his mean result shows poor agreement and thus, does not differ significantly from the other tester´s results. Critical reflection/Perspectives/Conclusions As no reliability of the Global Listening could be found, the test should be used in practice with caution. However, it is doubtful, whether stable conditions during the test were reached and whether external validity of the study is given. These problems are shared by most reliability studies.

Abstract original language:
Das Global Listening ist ein Faszientest, bei dem ein erster Eindruck über im Körper vorhandene Restriktionen gewonnen wird. In dieser Studie wird seine Intrarater- und Interrater-Reliabilität untersucht. Nach Reflexion der – in der Literatur nicht einheitlich – beschriebenen Durchführung des Tests wurde ein standardisierter Ablauf für die Studie bestimmt und sieben Interpretationsmöglichkeiten für die Tester festgelegt. Weiters wurden anhand von bisherigen Studien Qualitätskriterien für die Durchführung der Datengewinnung erarbeitet. Sechs Tester testeten 18 symptomatische Probanden. Die ersten zehn Probanden wurden noch zwei weitere Male von jedem Tester getestet. Tester waren Osteopathen, die ihre Diplomprüfung im September 2009 abgelegt hatten. Ein Tester verwendet das Global Listening in der Praxis nicht, die anderen regelmäßig. Die Tester waren gegenüber den Symptomen der Probanden und den Ergebnissen der anderen Osteopathen blindiert und testeten mit verbundenen Augen. Ein Training wurde eine Woche vor der Datengewinnung durchgeführt. Die Probanden wussten über das Ziel des Tests Bescheid, nicht aber über die den Testern zur Verfügung stehenden Interpretationsmöglichkeiten. Die Auswertung erfolgte mittels Cohens Kappa. Die Ergebnisse wurden auch in Bezug auf eine Rechts-Links-Körperachse und eine anterior-posteriore Körperachse ausgewertet, was eine Reduktion auf drei Interpretationsmöglichkeiten bedeutet. Es konnte weder eine Interrater- noch eine Intrarater-Reliabilität nachgewiesen werden. Die Ergebnisse bewegen sich im Bereich zufälliger Übereinstimmung. Auffällig war, dass der einzige Tester, der das Global Listening in der Praxis nicht anwendet, das beste Ergebnis erreichte. Dieses befindet sich jedoch auch nur im Bereich schwacher Reliabilität und hebt sich somit nicht entscheidend von den Ergebnissen der anderen Tester ab.

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