Reliability and validity of adolescent idiopathic scoliosis diagnosis based on mobile phone AI scoliosis screening algorithm and infrared 3D spine assessment system.

BACKGROUND: Scoliosis affects 2–3% of the population, with adolescent idiopathic scoliosis (AIS) being the most common form. Early detection is crucial, but traditional Cobb angle measurement using X-rays has limitations, including radiation risks. A non-invasive, low-cost Infrared 3D spine system with AI was developed for radiation-free scoliosis screening and follow-up. METHODS: From August 2023 to February 2024, 69 AIS-suspected patients (ages 6–18) were enrolled at West China Hospital. The diagnostic validity of a mobile AI screening algorithm and infrared 3D spine system was evaluated against X-ray and Electronic Scoliosis Scale, measuring Cobb and Angle of Trunk Rotation (ATR). Statistical analyses used SPSS, including paired t-tests, Wilcoxon Signed-Rank, Bland-Altman, and Pearson’s correlation to assess accuracy and reliability, with ICC > 0.80 indicating high reliability. RESULTS: The study included 69 AIS cases (mean age 14.66). The diagnostic tool I3SAS showed 98.53% sensitivity, 100% specificity, and an AUC of 0.98. Intraobserver and interrater reliability for Cobb and ATR measurements were excellent, with ICC values of 0.997 to 0.998 for X-rays and 0.992 to 0.998 for the infrared system. Accuracy analysis showed minimal differences in Cobb angle (0.43) and ATR angle (-0.21), with strong Pearson’s correlations (0.964 to 0.989). CONCLUSIONS: The mobile AI scoliosis screening algorithm and infrared 3D spine system are reliable, valid, and feasible tools for AIS diagnosis, with strong potential for clinical screening use.