Can a Simple Smartphone Be a Cornerstone in School Health Screening Program for Detecting Scoliosis in Resource-Poor Developing Countries? Revisiting the "Scoliometer".

STUDY

DESIGN

Cross-sectional observational analytical study.

OBJECTIVE

A scoliometer is an inclinometer that quantifies rib hump. It is now possible to use various apps which can methodically function same as a scoliometer. In our study, we revisit the reliability, validity of scoliometer; its correlation with various app-based digital inclinometers and try to extrapolate the role of digital inclinometers in the overall diagnostic accuracy of scoliosis.

SUMMARY OF BACKGROUND DATA: Scoliometer is a well-tested instrument for screening of scoliosis for decades. But whether various digital applications can be used for the same is not very clear.

METHODS

An observational study was conducted on patients with Juvenile and Adolescent Idiopathic Scoliosis. Two independent observers noted 3 scoliometer values separately. Cobbs angle, apical vertebral rotation (Nash-Moe grading and CT), and SRS-22r questionnaire were also noted. The accuracy and reliability of app-based digital inclinometers were also analysed. All the values were compared statistically.

RESULTS

The interobserver agreement for scoliometer instrument and app-based digital inclinometers were found strong to substantial, respectively. A strong positive correlation exists between the scoliometer and digital inclinometers from the same patients. Except for the SRS-22r score, which has a substantial negative correlation, all radiologic parameters have a substantial to strong positive correlation. A mathematical formula was also derived between scoliometer values and Cobb angle. On the basis of that a suitable referral criterion of 7-degree of digital/manual scoliometer value to a higher center was suggested.

CONCLUSION

Scoliometer and app-based digital inclinometers have a strong predictive power to measure the degree of deformity in scoliosis. If incorporated into the latest School Health Screening Programs, these instruments have the potential to decrease the overall burden of scoliosis in society.