title: Evaluation of an apparatus to be combined with a smartphone for the early detection of spinal deformities.
abstract: BACKGROUND
  Mobile smartphones are equipped with inclinometers enabling them to acquire angular clinical measures. The Scolioscreen has been developed in conjunction with a smartphone APP to enable the measure of the angle of trunk inclination (ATI) thus offering a convenient and reliable means to measure and screen for spinal deformities. The objective was to compare the reliability and accuracy of a Scolioscreen-smartphone combination, a smartphone alone, and a Scoliometer, for measuring the angle of trunk inclination in spinal deformities under blinded conditions for intra- and inter-observer analyses.
  
  
  METHODS
  A cohort of 39 patients with adolescent idiopathic scoliosis were recruited. Each had maximum ATI measured by 3 observers: attending spine surgeon, nurse, and parent presenting with patient. Two series of measurements were performed by each observer using Scolioscreen-smartphone, smartphone alone and Scoliometer. Intra-class correlation coefficients (ICC) from two-way mixed model based on absolute agreement were used to assess intra- and inter-observer reliability as well as consistency between measurement techniques.
  
  
  RESULTS
  Intra- and inter-observer reliability for measuring maximum ATI was 0.94-0.89 with Scolioscreen-smartphone, decreased to 0.89-0.75 for smartphone alone, and was 0.95- 0.89 for Scoliometer. Considering Scoliometer measurement taken by surgeon the gold standard, there was excellent consistency with measurements from Scolioscreen-smartphone taken by surgeon (ICC = 0.99), nurse (ICC = 0.95), and parent (ICC = 0.91). Conversely, consistency decreased when surgeon (ICC = 0.86), nurse (ICC = 0.86) and parent (ICC = 0.85) used smartphone alone.
  
  
  CONCLUSIONS
  Study shows the Scolioscreen-smartphone to overcome limitations associated with ATI measurements using smartphones alone. The Scolioscreen-smartphone provides a reliability and consistency similar to the gold standard (use of Scoliometer by spine surgeon) and enables a parent to take reliable measurements on their own thus offering an accessible and convenient tool for all to use.
authors: Spinologics, Montreal, QC, Canada.
authors: Mark
authors: M
authors: Driscoll
authors: University of Montreal, Montreal, QC, Canada.
authors: Chanel
authors: C
authors: Fortier-Tougas
authors: Spinologics, Montreal, QC, Canada.
authors: Hubert
authors: H
authors: Labelle
authors: Spinologics, Montreal, QC, Canada.
authors: Stefan
authors: S
authors: Parent
authors: Spinologics, Montreal, QC, Canada.
authors: Jean-Marc
authors: JM
authors: Mac-Thiong
keywords: Angle of trunk inclination; Diagnosis; Early detection; Scoliosis; Screening; Smartphone