Maintenance and Improvement of Interobserver Reliability of Osteopathic Palpatory Tests
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Ronald V. Marino
To the Editor:
We applaud the efforts by Brian F. Degenhardt, DO, and colleagues,1 published in the October 2010 JAOA—The Journal of the American Osteopathic Association, to document maintenance and improvement in the interexaminer reliability of osteopathic physicians' palpatory skills. Because reliable palpatory diagnosis is fundamental to osteopathic diagnosis and treatment, this subject matter is an important area to explore. Furthermore, the demonstration of interexaminer reliability is a prelude to an objective basis for description of somatic dysfunction.
In diagnosis and treatment, osteopathic physicians examine tissue texture and drag, structural asymmetry, tenseness or tightness of underlying tissues, pain response to pressure, and response to introduced motion. As a profession, we must work to reconcile the diversity of these various osteopathic diagnostic and treatment approaches.
In 1982, Johnston et al2 described consistency of palpatory findings with a high degree of accuracy and interexaminer reliability within a select population. As reported in the study by Degenhardt et al,1 careful training and hand placement with periodic recalibration can result in credible diagnostic accuracy. These new findings resonate well with those published in 1982.2
In a world of increasing demands for evidence-based medicine, this type of evidence is invaluable to the osteopathic medical profession.
1 Degenhardt BF, Johnson JC, Snider KT, Snider EJ. Maintenance and improvement of interobserver reliability of osteopathic palpatory tests over a 4-month period. J Am Osteopath Assoc.2010;110(10):579-586.Search in Google Scholar
2 Johnston WL, Elkiss ML, Marino RV, Blum GA. Passive gross motion testing: part II. A study of interexaminer agreement. J Am Osteopath Assoc. 1982;81(5);304-308.Search in Google Scholar
The American Osteopathic Association
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Articles in the same Issue
- AOA COMMUNICATIONS
- OFFICIAL CALL
- LETTERS
- Maintenance and Improvement of Interobserver Reliability of Osteopathic Palpatory Tests
- Redirect Terminology Debate Toward Improved Definition of Osteopathic Medicine
- ORIGINAL CONTRIBUTIONS
- Impact of Osteopathic Manipulative Treatment on Secretory Immunoglobulin A Levels in a Stressed Population
- Association of Maternal Hypoglycemia With Low Birth Weight and Low Placental Weight: A Retrospective Investigation
- REVIEWS
- Bioidentical Hormones: An Evidence-Based Review for Primary Care Providers
- CASE REPORTS
- Cannabinoid Hyperemesis Syndrome as the Underlying Cause of Intractable Nausea and Vomiting
- High-Dose Steroid Treatment in a Patient With Balò Disease Diagnosed by Means of Magnetic Resonance Imaging
- BOOK REVIEWS
- The Sound of a Wild Snail Eating
- LETTERS
- Understanding Osteopathic Medical School Applicants and the Class of 2014
- Response
- AOA Not Enforcing OMM Educational Standards
- Letters
- Osteopathic Manipulative Treatment in Developing Countries: A Call for Education and Research
- Case Report of Mesenteric Metastases From Lobular Breast Carcinoma
Articles in the same Issue
- AOA COMMUNICATIONS
- OFFICIAL CALL
- LETTERS
- Maintenance and Improvement of Interobserver Reliability of Osteopathic Palpatory Tests
- Redirect Terminology Debate Toward Improved Definition of Osteopathic Medicine
- ORIGINAL CONTRIBUTIONS
- Impact of Osteopathic Manipulative Treatment on Secretory Immunoglobulin A Levels in a Stressed Population
- Association of Maternal Hypoglycemia With Low Birth Weight and Low Placental Weight: A Retrospective Investigation
- REVIEWS
- Bioidentical Hormones: An Evidence-Based Review for Primary Care Providers
- CASE REPORTS
- Cannabinoid Hyperemesis Syndrome as the Underlying Cause of Intractable Nausea and Vomiting
- High-Dose Steroid Treatment in a Patient With Balò Disease Diagnosed by Means of Magnetic Resonance Imaging
- BOOK REVIEWS
- The Sound of a Wild Snail Eating
- LETTERS
- Understanding Osteopathic Medical School Applicants and the Class of 2014
- Response
- AOA Not Enforcing OMM Educational Standards
- Letters
- Osteopathic Manipulative Treatment in Developing Countries: A Call for Education and Research
- Case Report of Mesenteric Metastases From Lobular Breast Carcinoma
