A New Clinical Tool for Scoliosis Risk Analysis: Scoliosis Tele-Screening Test

Postural evaluation of patients with idiopathic scoliosis through telehealth: A systematic review

BACKGROUND

The increasing use of remote patient care for individuals with scoliosis has created opportunities for the development and utilization of different tools and methods of evaluation. The aim of this study was to determine the clinical postural variables evaluated in patients with scoliosis through telehealth.

METHODS

Systematic searches were conducted by two independent reviewers in the PubMed, Scopus, EMBASE, and IEEE databases using the MeSH terms "scoliosis" and "telemedicine" and their synonyms. This study followed the MOOSE guideline (Meta-analysis of Observational Studies in Epidemiology). The methodological quality assessment was performed using the Critical Appraisal Skills Program (CASP).

FINDINGS

136 studies were found in the databases, and 20 were found through manual search of references. After removing duplicates (n = 41), 81 studies were excluded, leaving 14 for full-text reading. Of these, six studies were included for qualitative synthesis, with a total of 1002 subjects. Were identified: angle of trunk rotation (ATR), angle between body segments (in development), movement - oscillations per second (Hz/s), impedance (Ohms/mm), synchronous postural observation, and aesthetic deformity. Only two studies provided validity and reproducibility coefficients, however, it was not possible to conduct a meta-analysis because the presented coefficients were different.

INTERPRETATION

The angle of trunk rotation, angle between body segments, movement - oscillations per second (Hz/s), impedance (Ohms/mm), synchronous postural observation, and aesthetic deformity were the clinical postural variables evaluated through telehealth. Further research is needed to focus on the development, validation, and reproducibility of assessment instruments for patients with scoliosis through telehealth.

Satisfaction Survey of Medical Staff for Telemedicine after the COVID-19 Pandemic: A Comparison Between the COVID-Pandemic and Post-COVID Pandemic Periods

Introduction: The role of telemedicine should be reassessed in the post-COVID-19 pandemic era. This study aimed to evaluate the perception and satisfaction of medical staff with telemedicine after the COVID-19 pandemic and compare these findings with those during the COVID-19 pandemic. Methods: Between January and February 2023, a questionnaire regarding the utilization, safety, and satisfaction with telemedicine was administered to 200 medical staff members (100 doctors and 100 nurses). Additionally, open-ended questions were included to gather insights on the strengths, weaknesses, and prerequisites of telemedicine. The satisfaction levels of the medical staff were compared with those from a previous study conducted during the COVID-19 pandemic. Results: The response rate among medical staff was 60.0% (50 doctors and 70 nurses). Concerning patient safety, 83.3% of respondents indicated a risk of worsening symptoms in chronic patients, and 68.3% expressed concerns about emergencies related to patient safety. Eighty-two percent of doctors preferred in-person visits over telemedicine, while 48.6% of nurses reported equal or greater satisfaction with telemedicine (p = 0.003). The reported strengths of telemedicine included the convenience of outpatient clinics (67%), while its primary weakness was the incomplete assessment of patient conditions (73%). The likelihood of partial substitution of telemedicine for in-person visits was significantly higher in the post-COVID-19 pandemic period compared to during the pandemic (71.7% vs. 49.0%, p < 0.001). Conclusion: In the post-COVID-19 pandemic era, telemedicine continues to offer significant benefits in enhancing patient access to medical care. However, medical staff remain concerned about its safety and show lower satisfaction compared to in-person visits. In response to these concerns, an effective telemedicine platform and legal standards, including practical guidelines, should be developed.

Validation of the visual body image classification in adolescent idiopathic scoliosis: a retrospective study

STUDY DESIGN

A prospective study.

PURPOSE

To diagnose scoliosis, a visit to the hospital for radiography is typically necessary. In such cases, children with scoliosis are exposed to radiation, which may place their health at risk. Therefore, we sought to determine whether a classification method based on visual body images obtained through photography can be used to diagnose scoliosis.

OVERVIEW OF LITERATURE

Scoliosis can be diagnosed and classified into various types using radiographs. However, no studies have attempted to classify scoliosis based on visual body images.

METHODS

From January 1, 2019 to December 31, 2022, 136 patients newly diagnosed with Adolescent idiopathic scoliosis and 124 healthy candidates from our institution were enrolled. This study classified body images into five types based on visual confirmation of the positional relationship of the body. The accuracy of this classification method was identified by calculating its sensitivity, specificity, and reproducibility of this classification method within and between observers according to kappa value.

RESULTS

Overall, 136 patients and 124 control subjects who visited the Pusan National University Hospital, Busan, Korea were photographed and compared by obtaining back images and X-ray radiographs. The sensitivity and specificity of the classification method showed a satisfactory-to-good degree of accuracy, although the degree varies depending on the visual body image type. The classification methods exhibited good intraobserver reliability (κ=0.855) and moderate interobserver reliability (κ=0.751).

CONCLUSIONS

Our classification method showed a high degree of sensitivity and specificity (98.1% sensitivity, 98.9% specificity, and 98.4% accuracy) while exhibiting high reproducibility and ease of access. Based on our findings, we believe that our classification method can be used for scoliosis screening.

Repeatability and intra and interrater reproducibility of the DIPA-S eHealth© capture and analysis system for clinical assessment of scoliosis

PURPOSE

To assess the repeatability, intra and interrater reproducibility of the DIPA-S eHealth© system for capturing and measuring clinical variables of scoliosis, including frontal trunk imbalance (FTI), sagittal trunk imbalance (STI), and angle of trunk rotation (ATR).

METHODS

Patients were photographed using the DIPA-S eHealth Capture© mobile application by family members, physiotherapists, or surgeons. Three photos were taken in each position: standing in the frontal and sagittal planes and in the axial plane in forward bending position of the trunk. The photos were analyzed by three independent evaluators using the DIPA-S eHealth Analysis© software. For repeatability, each photo was analyzed twice consecutively by the three evaluators. For intrarater reproducibility, only one evaluator reanalyzed the first photo from each plane with a 5-day interval. For interrater reproducibility, the three evaluators analyzed the first photo from each plane. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimal detectable change (MDC) were used (p < 0.05).

RESULTS

The sample comprised 262 images (n = 30). Repeatability was excellent for all three evaluators in all three planes (ICC 0.94 to 1.00). Intrarater reproducibility was excellent in all three planes (ICC 0.88 to 0.99). Interrater analysis was excellent for the frontal and axial planes (ICC 0.98 and 0.93), respectively. However, it was weak in the sagittal plane ICC 0.32. The SEM ranged from 0.02 to 17.6 and MDC from 0.03 to 34.6.

CONCLUSION

The DIPA-S eHealth© Capture and Analysis system demonstrates reproducibility for use in the clinical assessment of scoliosis through teleconsultations.

Association of Functional Gastrointestinal Disorders with Adolescent Idiopathic Scoliosis

Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and Assessment Service spanning from 2012 to 2016, with a median dataset size of 1,446,632 patients. The AIS group consisted of individuals aged 10 to 19 with diagnostic codes for AIS, while the control group consisted of those without AIS diagnostic codes. The median prevalence of FGIDs in adolescents with AIS from 2012 to 2016 was 24%. When accounting for confounding factors, the analysis revealed that adolescents with AIS were consistently more prone to experiencing FGIDs each year (2012: adjusted odds ratio (aOR), 1.21 [95% confidence interval (CI), 1.10-1.35], p < 0.001; 2013: aOR, 1.31 [95% CI, 1.18-1.46], p < 0.001; 2014: aOR, 1.24 [95% CI, 1.12-1.38], p < 0.001; 2015: aOR, 1.34 [95% CI, 1.21-1.49], p < 0.001; and 2016: aOR, 1.35 [95% CI, 1.21-1.50], p < 0.001). These findings suggest that AIS is correlated with an elevated likelihood of FGIDs, indicating that AIS may function as a potential risk factor for these gastrointestinal issues. Consequently, it is recommended to provide counseling to adolescents with AIS, alerting them to the heightened probability of experiencing chronic gastrointestinal symptoms.