THE INVESTIGATION OF THE EFFICIENCY OF THE DECISION SUPPORT SYSTEM FOR DETERMINING THE SEVERITY OF SCOLIOTIC SPINAL DEFORMITY BY THE ANALYSIS OF RADIOGRAPHS.

Backgraund. First domestic computer program "Decision support system for determining  severity of scoliotic spinal deformity in  analysis of radiographs" was developed in 2020 and integrated into  medical base of  prosthetic and orthopedic center "Sсoliologic.ru".

Aims. To evaluate  performance of  computer program for determining  Cobb angle by comparing  obtained automated data with manual measurement data by various specialists.

Materials and methods. From  medical base of  prosthetic and orthopedic center "Sсoliologic.ru" selected 411 radiographs of  spine, which were drawn by  radiologist (BP-etalon),  orthopedic traumatologist with 5 years of experience and experience in vertebrology (OO),  orthopedic traumatologist with less than 1 year of experience and no experience in vertebrology (OB) and computer program (KP). Number and proportion of exact matches, as well as the average deviation of  results of measuring  Cobb angle of  reference data, were compared with  indicators obtained by OO, OB and KP in general, for various types of scoliosis according to  classification of M. Rigо, as well as in determining the main arc. Bland–Altman graphs were used.

Results. Exact matches of  KP with  standard were 21%, so every fifth measurement of  Cobb angle on  X-ray, calculated automatically, is identical to  standard. The highest proportion of matches with  standard is in  OO (33%), the lowest in  OB (16%). The highest accuracy of  KP was found at type E1,2  arc of 3 is 30% and 24%, respectively. Proportion of KP matches with  standard increases to 61% with an error of 3 °, 75% with an error of 5 °, and with an error of 7 °, the proportion of matches reaches 84%. At the same time,  proportion of coincidences of a non-experienced researcher increases only from 34 to 58%. When determining  magnitude of  main arc of scoliosis,  OO researcher increases its accuracy by almost 2,6 times,  KP by 2,1 times, and  OB researcher by 1,5 times.

 Conclusions. It can be concluded about  operability of  computer program,   use of which can be recommended for automated determination of Cobb angle, since it has been proven that  current algorithm of  computer program gives accuracy compared to  reference measurement, it is significantly higher than   novice orthopedic traumatologists with no experience in vertebrology.