The diagnostic accuracy of community spine radiology for adolescent idiopathic scoliosis brace candidates.

Autor: Kim DJ; Hospital for Sick Children, 555 University Avenue, Room S229, Toronto, ON M5G 1X8, Canada. dorothy.kim@sickkids.ca., Dermott JA; Hospital for Sick Children, 555 University Avenue, Room S229, Toronto, ON M5G 1X8, Canada., Mitani AA; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada., Doria AS; Hospital for Sick Children, 555 University Avenue, Room S229, Toronto, ON M5G 1X8, Canada., Howard AW; Hospital for Sick Children, 555 University Avenue, Room S229, Toronto, ON M5G 1X8, Canada., Lebel DE; Hospital for Sick Children, 555 University Avenue, Room S229, Toronto, ON M5G 1X8, Canada.
Jazyk: angličtina
Zdroj: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2024 Oct; Vol. 33 (10), pp. 3776-3783. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1007/s00586-024-08389-1
Abstrakt: Purpose: The study aims to establish the diagnostic accuracy of community spine x-rays for brace candidates.
Methods: A review of adolescent idiopathic scoliosis patients seen for initial visit at a tertiary care pediatric hospital was conducted (n = 170). The index test was the pre-referral community spine x-ray interpreted by a community radiologist. Measures of diagnostic accuracy for the index test were determined against the reference standard if images were obtained within 90 days (n = 111). The reference standard was the 3-foot standing EOS spine x-ray evaluated by spine specialists. Diagnostic criterion for a brace candidate was dichotomized by Cobb angle range (25-40°) according to Scoliosis Research Society criteria. Risser stage was not included given significant missing data in index reports. To mitigate the uncertainty around true progression, sensitivity analyses were conducted on a sub-sample of data when index test was within 60 days of the reference standard (n = 67).
Results: Accuracy of the community spine x-ray to detect a brace candidate was 65.8% (95% CI 56.2-74.5). Sensitivity of the index test was 65.4% with a false negative rate of 34.6%. Specificity was 66.1% with a false positive rate of 33.9%. Positive and negative predictive values were 63.0% and 68.4%, respectively. Of the total number of brace candidates (n = 52), 32.7% were missed because of underestimation in Cobb angle (95% CI 21.5-46.2). The proportion of missed brace candidates because of underestimation was unchanged with 60-day data (p = 0.37).
Conclusions: Inaccuracies in community spine radiology may lead to missed opportunities for non-operative treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
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