TRACE (Trunk Aesthetic Clinical Evaluation), a new everyday clinical tool to assess adolescent idiopathic scoliosis patients aesthetics

Objective

Evaluate the repeatability of a new everyday clinical tool developed to increase Aesthetic Index results: TRACE (Trunk Aesthetic Clinical Evaluation).

Study design

TRACE is based on four sub-scales: shoulders (0–3), scapulae (0–2), hemithorax (0–2) and flanks (0–4): each point is fully described and gives an ordinal scale for increasing asymmetry; TRACE 1 was given by the sum of the sub-score, while TRACE2 by a percentage weighting each single sub-score. 160 PA photographs of the trunk of adolescent idiopathic scoliosis patients were scored two times independently by four observers. We used the Kappa statistics for Agreement [1] whose values give the following agreements: 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. We looked also at the 95% level of agreement, to identify the minimum clinically significant change to be considered between two different clinical exams. TRACE2 was evaluated for repeatability according to Bland-Altman.

Results

See Table 1.

Table 1 Results.

Conclusion

These results are provisional, because a longer practice on TRACE is needed, mainly for inter-raters data. Widening the scales of the Aesthetic Index to develop TRACE increased sensitivity, and this is better in clinical everyday practice.