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Diagnostic reliability of osteopathic tests: A systematic review

Journal: International Journal of Osteopathic Medicine Date: 2017/08, 25Pages: 21-29. doi: Subito , type of study: systematic review

Full text    (https://www.journalofosteopathicmedicine.com/article/S1746-0689(17)30052-4/references)

Keywords:

osteopathic tests [8]
osteopathic manipulative treatment [2973]
OMT [2951]
reliability [114]
diagnostic [45]
systematic review [297]
somatic dysfunction [147]

Abstract:

Objective: The objective of this systematic review is to identify, evaluate, and synthesize the available evidence concerning studies on diagnostic reliability of osteopathic tests. Data sources: A structured literature search was conducted of medical databases Cochrane library, MedLine, EMBASE, CINAHL from 1982 to December 2014. Study selection: Inclusion criteria were journal articles on reliability of osteopathic diagnostic palpatory tests. Studies were excluded if the examiners were not osteopaths or if the studies did not examine the reliability of diagnostic methods. Data extraction: The included studies were appraised by the three authors using an 11-items scale instrument (QAREL) developed to assess the quality of studies of diagnostic reliability. The search strategy identified 159 studies. However, only 17 met the inclusion criteria. Data synthesis: The included studies involved a total of 406 patients (64 symptomatic) and 2 studies used anatomical models. 278 examiners were involved, which included 73 osteopaths and 205 osteopathic students. The body sites studied were divided between those of the pelvis, the lower limbs, the spine, and the cranium. Results of the QAREL checklists indicated that most domains met the criteria for being of high quality. Conclusions: The quality of the reviewed studies was good, while the levels of diagnostic reliability were heterogeneous. Intra-examiner reliability was higher than inter-examiner reliability. There were no significant differences in respect to evaluated osteopathic clinical diagnostic tests and body sites, either in degrees of palpatory pressure, nor in examiners’ experience. However, proper study designs, consensus training and standardizing procedures, such as the developing of models, could be effective in improving the reliability of palpatory tests.


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