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 studySetting: Thai elderly women in Khon Kane province, Thailand.Outcome Measurements Singh grading, intra- and inter-observer reliability by kappa (k) and weighted-kResults: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  kwas 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