title: Use of the smartphone for end vertebra selection in scoliosis.
abstract: OBJECTIVE
  The aim of our study was to develop a smartphone-aided end vertebra selection method and to investigate its effectiveness in Cobb angle measurement.
  
  
  METHODS
  Twenty-nine adolescent idiopathic scoliosis patients' pre-operative posteroanterior scoliosis radiographs were used for end vertebra selection and Cobb angle measurement by standard method and smartphone-aided method. Measurements were performed by 7 examiners. The intraclass correlation coefficient was used to analyze selection and measurement reliability. Summary statistics of variance calculations were used to provide 95% prediction limits for the error in Cobb angle measurements. A paired 2-tailed t test was used to analyze end vertebra selection differences.
  
  
  RESULTS
  Mean absolute Cobb angle difference was 3.6° for the manual method and 1.9° for the smartphone-aided method. Both intraobserver and interobserver reliability were found excellent in manual and smartphone set for Cobb angle measurement. Both intraobserver and interobserver reliability were found excellent in manual and smartphone set for end vertebra selection. But reliability values of manual set were lower than smartphone. Two observers selected significantly different end vertebra in their repeated selections for manual method.
  
  
  CONCLUSIONS
  Smartphone-aided method for end vertebra selection and Cobb angle measurement showed excellent reliability. We can expect a reduction in measurement error rates with the widespread use of this method in clinical practice.
  
  
  METHODS
  Level III, Diagnostic study.
authors.affiliation: Ankara Training and Research Hospital, Ankara, Turkey. Electronic address: dr_muradpepe@hotmail.com.
authors.forename: Murad
authors.initials: M
authors.lastname: Pepe
authors.affiliation: Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Kocadal
authors.affiliation: Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Iyigun
authors.affiliation: Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Gunes
authors.affiliation: Ankara Medical Park Hospital, Ankara, Turkey.
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Aksahin
authors.affiliation: Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Cem Nuri
authors.initials: CN
authors.lastname: Aktekin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results; D012600:Scoliosis / Q000175:diagnosis*; D000068997:Smartphone / Q000706:statistics & numerical data*; D013131:Spine / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Cobb angle; End vertebra; Scoliosis; Smartphone