Diagnostic accuracy of upper cervical spine instability tests: A systematic review
Nathan Hutting,Gwendolijne G.M. Scholten-Peeters,Veerle Vijverman,Martin D.M. Keesenberg,Arianne P. Verhagen +4 more
TLDR
The membranes tests had the best diagnostic accuracy, but their applicability as a test for diagnosing upper cervical spine instability in primary care has yet to be confirmed.Abstract:
Background Patients with neck pain, headache, torticollis, or neurological signs should be screened carefully for upper cervical spine instability, as these conditions are “red flags” for applying physical therapy interventions. However, little is known about the diagnostic accuracy of upper cervical spine instability tests.
Purpose The purpose of this study was to evaluate the diagnostic accuracy of upper cervical spine instability screening tests in patients or people who are healthy.
Data Sources PubMed, CINAHL, EMBASE, and RECAL Legacy databases were searched from their inception through October 2012.
Study Selection Studies were included that assessed the diagnostic accuracy of upper cervical instability screening tests in patients or people who are healthy and in which sensitivity and specificity were reported or could be calculated using a 2 × 2 table.
Data Extraction and Quality Assessment Two reviewers independently performed data extraction and the methodological quality assessment using the QUADAS-2.
Data Synthesis Depending on heterogeneity, statistical pooling was performed. All diagnostic parameters (sensitivity, specificity, predictive values, and likelihood ratios) were recalculated, if possible.
Results Five studies were included in this systematic review. Statistical pooling was not possible due to clinical and statistical heterogeneity. Specificity of 7 tests was sufficient, but sensitivity varied. Predictive values were variable. Likelihood ratios also were variable, and, in most cases, the confidence intervals were large.
Limitations The included studies suffered from several biases. None of the studies evaluated upper cervical spine instability tests in patients receiving primary care.
Conclusions The membranes tests had the best diagnostic accuracy, but their applicability as a test for diagnosing upper cervical spine instability in primary care has yet to be confirmed.read more
Citations
More filters
Journal ArticleDOI
Neck Pain: Revision 2017
Peter Blanpied,Anita Gross,James M. Elliott,Laurie Lee Devaney,Derek Clewley,David M. Walton,Cheryl Sparks,Eric K. Robertson +7 more
TL;DR: The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopedic physical therapy management of patients with musculoskeletal impairments described in the International Classification of Functioning, Disability, and Health (ICF) as mentioned in this paper.
Journal ArticleDOI
How to diagnose cervicogenic dizziness.
Alexander S. Reiley,Frank M. Vickory,Sarah E. Funderburg,Rachel A. Cesario,Richard A. Clendaniel +4 more
TL;DR: This narrative will outline a stepwise process for evaluating patients who may have CGD and provide steps to exclude diagnoses that can present with symptoms similar to those seen in CGD, including central and peripheral vestibular disorders, Vestibular migraine, labyrinthine concussion, cervical arterial dysfunction, and whiplash associated disorder.
Journal ArticleDOI
Adverse events associated with the use of cervical spine manipulation or mobilization and patient characteristics: A systematic review.
H.A. Kranenburg,H.A. Kranenburg,M.A. Schmitt,Emilio J. Puentedura,Gert-Jan Luijckx,C.P. van der Schans,C.P. van der Schans +6 more
TL;DR: A systematic search was performed in PubMed, Embase, CINAHL, Web-of-science, AMED, and ICL (Index Chiropractic Literature) to identify characteristics of patients, practitioners, treatment process and adverse events (AE) occurring after CSM or cervical mobilization.
Journal ArticleDOI
Effect Evaluation of a Self-Management Program for Dutch Workers with a Chronic Somatic Disease: A Randomized Controlled Trial
Sarah I. Detaille,Yvonne F. Heerkens,Josephine A. Engels,J.W.J. van der Gulden,F. J. H. van Dijk +4 more
TL;DR: The results show that low educated workers, older workers and women benefit significantly more from the training than highereducated workers, younger workers and men.
Journal ArticleDOI
Considerations to improve the safety of cervical spine manual therapy
Nathan Hutting,Roger Kerry,Michel W. Coppieters,Michel W. Coppieters,Michel W. Coppieters,Gwendolijne G.M. Scholten-Peeters +5 more
TL;DR: The aim of this article is to critically reflect on and summarize the current knowledge about cervical spine manual therapy and to provide guidance for clinical reasoning for cervical spine Manual therapy.
References
More filters
Journal ArticleDOI
The measurement of observer agreement for categorical data
J. R. Landis,Gary G. Koch +1 more
TL;DR: A general statistical methodology for the analysis of multivariate categorical data arising from observer reliability studies is presented and tests for interobserver bias are presented in terms of first-order marginal homogeneity and measures of interob server agreement are developed as generalized kappa-type statistics.
Journal ArticleDOI
QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies
Penny Whiting,Anne W S Rutjes,Marie Westwood,Susan Mallett,Jonathan J Deeks,Johannes B. Reitsma,Mariska M.G. Leeflang,Jonathan A C Sterne,Patrick M.M. Bossuyt +8 more
TL;DR: The QUADAS-2 tool will allow for more transparent rating of bias and applicability of primary diagnostic accuracy studies.
Book
Users' Guides to the Medical Literature
Gordon H. Guyatt,Drummond Rennie +1 more
TL;DR: Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information to learn and decide how to modify their practice.
Book
Statistics with Confidence : Confidence Intervals and Statistical Guidelines
TL;DR: This comprehensive collection of methods for using confidence intervals, illustrative worked examples and helpful checklists this is a truly practical guide for clinical readers to a fundamental aspect of medical statistics.
Journal ArticleDOI
The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration
Patrick M.M. Bossuyt,Johannes B. Reitsma,David E. Bruns,Constantine Gatsonis,Paul Glasziou,Les Irwig,David Moher,Drummond Rennie,Henrica C.W. de Vet,Jeroen G. Lijmer +9 more
TL;DR: The STARD (standards for reporting of diagnostic accuracy) statement as discussed by the authors was developed by a group of scientists and editors to improve the reporting quality of reporting of studies of diagnostic accuracies.