Agreement on clinical examination and management between virtual videoconferencing and in-person assessment in a tertiary shoulder center
Bibliographic record
Abstract
Background: This study examined the intra and inter-examiner agreement of clinical tests and a management plan between a virtual video encounter and an in-person assessment in patients seen at a specialty shoulder program at an academic center. Methods: Participants were evaluated using a web-based video conferencing program and an in-person assessment. Guidelines on proper positioning of the camera and specific tests were outlined and sent in advance to all patients. Range of motion (ROM) was documented. Shoulder-specific clinical signs examined rotator cuff and proximal biceps tendon. Management was categorized as nonoperative or operative. Intraclass correlation coefficients and Kappa coefficients (κ) were used. Results: Thirty patients, 14 (47%) females, mean age: 57.5 (SD = 11), were examined twice. The intraclass correlation coefficients values ranged from 0.83 to 0.87 for shoulder ROM, indicating good reliability. Cervical spine Spurling test had an almost perfect agreement (κ = 0.83). The κ values were substantial for the hornblower sign (κ = 0.78), painful arc (κ = 0.65), lift-off test (κ = 0.65), and belly press test (κ = 0.61). Agreement was moderate for the cervical spine ROM (κ = 0.60), Jobe's test (κ = 0.57), Hawkins-Kennedy (κ = 0.52), and cross-body adduction (κ = 0.47). The management plan showed almost perfect agreement with respect to conservative vs. surgical management (κ = 0.83). Percentage of agreement for inter-examiner agreement ranged from 0.80 to 1.00. Conclusions: The majority of shoulder clinical tests for rotator cuff pathology conducted via a structured video encounter were shown to be reliable. The resulting proposed management plans were essentially identical.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".