Diagnostic Reliability of the Singh index: Femoral Neck Osteoporosis

Main Article Content

Suppasin Soontrapa
Prathana Chowchuen
Jiraporn Srinakarin
Sukree Soontrapa



The incidence of osteoporotic hip fracture increases annually, the key to successful treatment of osteoporosis is early diagnosis and treatment before fracture. The Singh index was a popular tool for diagnosis of osteoporosis in the past, but its reliability is debated.


To evaluate the intra- and inter-personal reliability of Singh grading among elderly Thai  women between two radiologists at Srinagarind hospital, Khon Kaen University, Thailand.


Cross-sectional descriptive study


Thai elderly women in Khon Kane province, Thailand.

Outcome Measurements

Singh grading, intra- and inter-observer reliability by kappa (k) and weighted-k


We registered  130 elderly Thai women in the study. The age of participants averaged 71.6 years (range 61-86 years). The first and second intra-observer (and their weighted) reliability k was 0.15 (95%CI: 0.04-0.26) (and 0.27), and 0.29 (95%CI: 0.15-0.42) (and 0.35), respectively. The inter-observer (and weighted) reliability k was 0.10 (95%CI: 0.00-0.20) and 0.26.


The intra- and inter-person reliability of the Singh index is poor; therefore, the index needs to be simplified to establish its reliability as a screening tool for osteoporosis.

Key word

Singh index, Kappa (k), Reliability, Osteoporosis

Article Details

How to Cite
Soontrapa S, Chowchuen P, Srinakarin J, Soontrapa S. Diagnostic Reliability of the Singh index: Femoral Neck Osteoporosis. SRIMEDJ [Internet]. 2013 Nov. 25 [cited 2024 Mar. 4];19(4):215-9. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/14555
Original Articles