The influence of the confirmation bias on static palpation of the lumbar spine using the Mitchell method
Item
- Title
- The influence of the confirmation bias on static palpation of the lumbar spine using the Mitchell method
- Author(s)
- Altmann, N
- Abstract
- Background: The use of palpation as a diagnostic tool is a highly discussed topic among manual therapists. Chiropractors, Physiotherapists, Osteopaths and other manual therapists use palpation to support their clinical judgement about a patient. While national guidelines regard these forms of therapy as clinical effective for treating musculoskeletal conditions, the interrater reliability of palpation has shown mixed results in the literature. This study aims to explore one underlying factor, which has not been considered yet in the field of manual therapy: the confirmation bias. Objective: The aim of this study is to examine the influence of the confirmation bias on the interrater reliability of a static palpation assessment of the lower back using the Mitchell method. Design: This study was designed as an interrater reliability experiment with two groups. Methods: Four students from the final 4th year of the European School of Osteopathy were recruited as examiners and received four training sessions before the experiment. 21 students from the same class volunteered as models for the experiment. The inclusion criteria were informed consent and not fulfilling the exclusion criteria, which involved systemic of musculoskeletal conditions of the lower back. The examiners learnt a standardised palpation protocol according to Mitchell for the lower back during the training sessions. For the experiment, they were split into two groups. One group was blinded to the results of the other group member, while in the other group the second examiner was informed about the findings of the first. The findings were analysed for their interrater reliability using Cohen’s kappa, weighted kappa, PABAK and Gwet’s AC1. A comparison of these parameters between the two examiner groups was the main outcome. Results: The non-blinded group achieved better overall reliability in “rotation” and “asymmetry”. The outcomes were also highly dependent on the position of the patient. The depth of the palpation did not influence the difference between the two groups. Discussion: The study could be seen as a pilot due to the lack of comparable research in the field of manual therapy. Therefore, the design and methodology are discussable and any interpretations of the findings should be done with caution. Conclusion: The confirmation bias seems to influence the interrater reliability of lumbar spine palpation using the Mitchell method, while the position of the patient also changed the outcomes. These results should be treated with caution due to the lack of comparable studies.
- presented at
- European School of Osteopathy
- Date Accepted
- 2020
- Date Submitted
- 28.10.2020 18:08:17
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 16647
- Inst-Identifier
- 1229
- Recommended
- 0
- Item sets
- Thesis
Altmann, N, “The influence of the confirmation bias on static palpation of the lumbar spine using the Mitchell method”, Osteopathic Research Web, accessed May 5, 2025, https://www.osteopathicresearch.org/s/orw/item/208