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Diagnostic Performance Analysis of a Three-Dimensional Depth Sensor Imaging in Identifying Idiopathic Scoliosis in Children and Adolescents: A Prospective Multicenter Cohort Study
25 Pages Posted: 12 Mar 2019
More...Abstract
Background: Adolescent idiopathic scoliosis is the most common pediatric spinal disorder that causes a three-dimensional deformity of the spine. Early detection of this often-progressive aliment is considered essential. The aim of this study was to determine the potential for accurately diagnosing adolescent idiopathic scoliosis using a newly developed, automated, noninvasive asymmetry-evaluation system for the surface of the human back using a three-dimensional depth sensor.
Methods: One hundred and seventy human subjects suspected to have adolescent idiopathic scoliosis were included in this study. Outcomes measured included patient demographics, radiographic measurements, and asymmetry indexes defined in the automated asymmetry-recognition system.
Findings: The coefficient of correlation between the asymmetry index and the Cobb angle was 0.85. For the prediction of idiopathic scoliosis of greater than 10°, the area under the curve was 0.98, sensitivity was 0.97, specificity was 0.93, positive predictive value was 0.99, negative predictive value was 0.72, accuracy was 0.97, positive likelihood ratio was 13.55, and negative likelihood ratio was 0.04. The posterior test probability for the positive screen greater than 10° was 98.9 % if the asymmetry index was greater than 1.268, three times in a row.
Interpretation: This novel system three-dimensionally scans multiple points on the back, enabling an automated evaluation of the back's asymmetry. This study demonstrates the outstanding discriminative ability of this newly developed system in determining whether an examinee requires an additional radiography to confirm diagnosis. The results suggest that this system can be used instead of the forward-bend test and scoliometer measurement in clinics. Furthermore, these findings should be confirmed in a larger group targeting mass school scoliosis screening program in a multicenter trial.
Funding: This study was supported by the Japan Agency for Medical Research and Development, AMED under Grant Number 18he1302026h0003.
Declaration of Interest: Patents pertaining to this work have been filed and pending (inventors: HS and YA). The other authors declare that they have no competing interests.
Ethical Approval: Institutional reviews board approval was obtained from all participating centers.
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