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Journal of Upper Cervical Chiropractic Research

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Inter-examiner Agreement for C1 and C2 Static Alignment Analysis Using Analog and Digital Radiographic Technologies:  A Pilot Study


William E. Fehl, BS, DC Bio, Patricia Kuhta, BS, DC Bio, and John Hart, MHSc, DC Bio 


Journal of Upper Cervical Chiropractic Research ~ June 30, 2011 ~ Pages 45-49



Objective: This pilot study reports inter-examiner agreement during analysis of the static alignment of the upper cervical spine seen on radiographic images.


Methods: Three interns with advanced radiographic training were asked to analyze the same digital images and the same conventional analog radiographs utilizing the HIO film marking process. Four categories were predetermined for analysis comparisons.


Results: Higher inter examiner agreements were observed in two of the four categories when the digital images were utilized.  Conventional analog films showed a higher inter examiner agreement in one category.


Conclusion: This feasibility study showed how these two radiographic technologies can be compared, how students can be involved in research as examiners, and that digital technology showed a slightly greater inter-examiner agreement.


Keywords: Digital radiography, radiography, chiropractic, inter-examiner reliability