Volume 2 Supplement 1

4th International Conference on Conservative Management of Spinal Deformities

Open Access

Repeatability of the Aesthetic Index for adolescent scoliosis idiopathic evaluation

  • Fabio Zaina1,
  • Stefano Negrini1Email author,
  • Marco Monticone1,
  • Chiara Paroli1 and
  • Angelo Aulisa1
Scoliosis20072(Suppl 1):S46

DOI: 10.1186/1748-7161-2-S1-S46

Published: 12 October 2007

Objective

To evaluate the intra- and inter-rater repeatability of the Aesthetic Index (AI) and its sub-scores.

Study design

Since many years in our Institute we have used a clinical tool to evaluate the aesthetics of the trunks posteriorly. This is based on a three point scale for asymmetry (0 absent, 1 slight, 2 important) of the shoulders, scapulae and flanks; the sum of these sub-scores gives the AI. One hundred sixty posterior anterior photographs of the trunk of adolescent idiopathic scoliosis patients were scored two times independently by three observers. We used the Kappa statistics [1]: 0–0.2 poor, 0.2–0.4 fair, 0.4–0.6 moderate, 0.6–0.8 good, 0.8–1.0 very good. The 95% level of agreement was used to identify the minimum clinically significant change to be considered between two different clinical examinations.

Results

See Table 1.
Table 1

Results.

 

Kappa statistics range

Percent of agreement

95% level of agreement (range)

 

Intra-raters

Inter-raters

Intra-raters

Inter-raters

Intra-raters

Inter-raters

Aesthetic Index

0.28–0.41

0.17–0.28

46.2–55.6

37.6–41.5

2(98.7–99.4%)

2 (92.5–99.4%)

Shoulders

0.42–0.53

0.30–0.35

64.4–73.7

58.3–61.2

1 (99.4–100%)

1 (96.9–100%)

Scapulae

0.50–0.58

0.20–0.43

69.4–76.9

53.5–61.9

1 (98.1–100%)

1 (95.6–100%)

Flanks

0.48–0.70

0.28–0.33

75.6–82.5

62.8–66.1

1 (100–100%)

1 (98.7–100%)

Conclusion

The intra-raters agreement is between moderate and good for single sub-scores, and fair for the AI, as it happens for the inter-raters agreement. The AI and its sub-scores can be used in the everyday clinical practice, but a change of 2 points for sub-scores, and 3 for AI is required to reach clinical significance, and this gives to the AI a low sensitivity.

Authors’ Affiliations

(1)
ISICO (Italian Scientific Spine Institute)

References

  1. Altman DG: Practical Statistics for Medical Research. 1991, London: Chapman and HallGoogle Scholar

Copyright

© Zaina et al; licensee BioMed Central Ltd. 2007

This article is published under license to BioMed Central Ltd.

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