TY  - JOUR
T1  - Agreement and Diagnostic Accuracy of Clinical and Surface Topography Screening for Adolescent Idiopathic Scoliosis in Children Engaged in Organized Sports
A1  - Hiroshi Nakamura
A1  - Yuta Kato
JF  - Bulletin of Pioneering Researches of Medical and Clinical Science
JO  - Bull Pioneer Res Med Clin Sci
SN  - 3006-2659
Y1  - 2026
VL  - 6
IS  - 1
DO  - 10.51847/oMkP0RC8lf
SP  - 131
EP  - 139
N2  - Idiopathic scoliosis (IS) is a common spinal deformity affecting 0.5%-5.2% of children globally, with a broader range in Spain (0.7%–7.5%). Prompt identification through screening programs is vital for preventing mild curves from worsening into serious deformities. Although conventional clinical approaches such as the ADAM test and the trunk rotation angle (TRA) remain standard, recent advances in three-dimensional (3D) surface topography (ST) systems have introduced innovative options for radiation-free assessment. This study aimed to (1) carry out both clinical and ST-based scoliosis screening among healthy children engaged in club sports, (2) measure the level of agreement between the two screening techniques, (3) outline the occurrence of scoliosis across different sports, sexes, and age groups, and (4) assess the diagnostic effectiveness of each method by comparing them with available radiographs as the reference standard. Altogether, 343 children (58.7% males, 41.3% females; mean age 11.69 ± 2.05 years) participated in screening that combined clinical examination and ST analysis. The clinical evaluation included the ADAM test and TRA assessment, while ST screening used BackSCNR®, a markerless three-dimensional scanning application. Participants with positive results from either method were referred for radiographic imaging to verify the diagnosis. Statistical measures, including the Kappa coefficient, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy, were calculated for both approaches, with radiographic confirmation as the gold standard. Radiographic verification established an overall prevalence of scoliosis of 3.2% (n = 11). The highest sport-specific prevalence was observed in swimming (17.6%), while sex differences remained small (males: 3.6%; females: 2.5%). Clinical screening achieved a sensitivity of 73%, specificity of 97%, PPV of 47%, NPV of 99%, and accuracy of 96%. In comparison, ST screening recorded a sensitivity of 36%, specificity of 99%, PPV of 80%, NPV of 97%, and accuracy of 97%. Kappa statistics pointed to moderate agreement beyond chance for both techniques (clinical κ = 0.55; ST κ = 0.48). Balanced accuracy reached 84% for clinical screening and 68% for ST screening. Clinical screening demonstrated greater sensitivity and superior balanced accuracy compared with ST screening. In contrast, ST screening offered greater specificity and PPV, suggesting it could serve as an effective supportive tool to minimize unnecessary referrals. Overall, these outcomes emphasize the benefit of integrating multiple screening strategies to boost early detection of IS among active children, while underscoring that radiographic confirmation of all positive cases remains indispensable for reliable diagnosis.
UR  - https://bprmcs.com/article/agreement-and-diagnostic-accuracy-of-clinical-and-surface-topography-screening-for-adolescent-idiopa-koq3htlgwbck8eh
ER  -