Reliability of diagnosis of somatic dysfunction among osteopathic physicians and medical students

Several studies have assessed interexaminer correlation of diagnosis of somatic dysfunction (SD). This study looks at the simple task of palpating the anterior superior iliac spine (ASIS) of both a live and a fixed plastic model to determine whether examination results are reliable. It is expected that osteopathically trained individuals would be able to do this with reasonable accuracy. However, we tested the results of 151 examiners and found low levels of agreement on diagnosis. Furthermore, the fixed models 'ASIS' were set at equal, yet most examiners (89.2%) chose either left or right. Based on these statistically significant results, we can conclude that palpation for symmetry of two paired structures (such as ASIS') is not an accurate way to assess for SD. It is important to have a standardized approach to diagnosis, because comparing one ASIS with the other does not seem to be the best way to teach students how to diagnose.