Diagnostic Reliability of the Singh index: Femoral Neck Osteoporosis

Abstract

Background

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.

Objective

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.

Design

Cross-sectional descriptive study

Setting

Thai elderly women in Khon Kane province, Thailand.

Outcome Measurements

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

Results

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.

Conclusion

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