Volume 2 Supplement 1

4th International Conference on Conservative Management of Spinal Deformities

Open Access

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

  • Stefano Negrini1Email author,
  • Fabio Zaina1,
  • Marco Monticone1 and
  • Chiara Paroli1
Scoliosis20072(Suppl 1):S47

https://doi.org/10.1186/1748-7161-2-S1-S47

Published: 12 October 2007

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.

 

Kappa statistics range

Percent of agreement

95% level of agreement (range)

 

Intra-raters

Inter-raters

Intra-raters

Inter-raters

Intra-raters

Inter-raters

TRACE1

0.16–0.24

0.09–0.14

28.8–36.3

18.8–36.1

2/11(99.4–96.9%)

3/11(95.0–100%)

Shoulders

0.29–0.43

0.16–0.25

51.3–70.6

48.8–70.6

1/3 (96.9–100%)

1/3 (92.5–100%)

Scapulae

0.43–0.58

0.41–0.50

76.9–79.4

70.6–80.0

1/2 (99.4–100%)

1/2 (100–100%)

Hemithorax

0.22–0.41

0.12–0.20

58.8–63.1

50.6–63.1

1/2 (98.1–99.4%)

1/2 (95.6–99.4%)

Flanks

0.40–0.48

0.07–0.11

55.0–68.0

24.4–68.1

1/4 (95.6–99.4%)

2/4 (98.7–100%)

Repeatability index for TRACE2: intra-rater 47–49%, inter-rater 47–50%.

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.

Authors’ Affiliations

(1)
ISICO (Italian Scientific Spine Institute)

References

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

Copyright

© Negrini et al; licensee BioMed Central Ltd. 2007

This article is published under license to BioMed Central Ltd.

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