Locating the Seventh Cervical Spinous Process: Development and Validation of a Multivariate Model Using Palpation and Personal Information
| Autor: | Arthur de Sá Ferreira, Ana Paula A. Ferreira, José F.C. Zanier, Luciana C. Póvoa |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Multivariate statistics medicine.medical_specialty Radiography Palpation 03 medical and health sciences 0302 clinical medicine Bayesian multivariate linear regression medicine Cutoff Humans Single-Blind Method 030212 general & internal medicine Prospective Studies Aged 030222 orthopedics Receiver operating characteristic medicine.diagnostic_test business.industry Reproducibility of Results Middle Aged Confidence interval Surgery Cross-Sectional Studies Multivariate Analysis Cervical Vertebrae Linear Models Female Chiropractics business Nuclear medicine Body mass index Neck |
| Zdroj: | Journal of manipulative and physiological therapeutics. 40(2) |
| ISSN: | 1532-6586 |
| Popis: | Objective The aim of this study was to develop and validate a multivariate prediction model, guided by palpation and personal information, for locating the seventh cervical spinous process (C7SP). Methods A single-blinded, cross-sectional study at a primary to tertiary health care center was conducted for model development and temporal validation. One-hundred sixty participants were prospectively included for model development (n = 80) and time-split validation stages (n = 80). The C7SP was located using the thorax-rib static method (TRSM). Participants underwent chest radiography for assessment of the inner body structure located with TRSM and using radio-opaque markers placed over the skin. Age, sex, height, body mass, body mass index, and vertex-marker distance (D V-M ) were used to predict the distance from the C7SP to the vertex (D V-C7 ). Multivariate linear regression modeling, limits of agreement plot, histogram of residues, receiver operating characteristic curves, and confusion tables were analyzed. Results The multivariate linear prediction model for D V-C7 (in centimeters) was D V-C7 = 0.986D V-M + 0.018(mass) + 0.014(age) – 1.008. Receiver operating characteristic curves had better discrimination of D V-C7 (area under the curve=0.661; 95% confidence interval=0.541-0.782; P = .015) than D V-M (area under the curve=0.480; 95% confidence interval=0.345-0.614; P = .761), with respective cutoff points at 23.40 cm (sensitivity = 41%, specificity=63%) and 24.75 cm (sensitivity = 69%, specificity=52%). The C7SP was correctly located more often when using predicted D V-C7 in the validation sample than when using the TRSM in the development sample: n=53 (66%) vs n=32 (40%), P Conclusions Better accuracy was obtained when locating the C7SP by use of a multivariate model that incorporates palpation and personal information. |
| Databáze: | OpenAIRE |
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