Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2025-05-19 Cooperative journals: 《中国全科医学》
Abstract： Background Adolescent idiopathic scoliosis（AIS）has a prevalence of 1%~3%，with over one million patients in China，predominantly female. Currently，there is a lack of effective and safe diagnostic tools beyond X-ray. Objective This study aimed to evaluate the efficacy of rastertereography（RST）in diagnosing AIS in adolescents and to assess the validity and reliability of spinal sagittal and transverse parameter measurements. Methods Data from 70 adolescents with suspected AIS treated at Wangjing Hospital of China Academy of Chinese Medical Sciences in 2023 were randomly selected，including biplanar X-ray，angle of trunk rotation（ATR），and RST measurements. To evaluate the validity of spinal angles provided by RST，Cobb angle，thoracic kyphosis（TK）（T1~T12），lumbar lordosis（LL）（L1~L5），and vertebral rotation angle（ROT）measured by RST were compared with X-ray and manual measurements. Pearson correlation and intraclass correlation coefficient（ICC）consistency tests were performed to validate the diagnostic efficacy of RST. Receiver operating characteristic（ROC）curve analysis with area under the curve（AUC）was employed to describe the diagnostic capability of RST-measured spinal parameters for AIS（defined as Cobb angle ≥ 10°），and Youden's index was used to determine optimal cutoff values（sensitivity and specificity）. Results The Cobb angle measured by RST was smaller than that by X-ray（t=3.056，P=0.003），with a correlation coefficient of 0.724 and good reliability（ICC=0.710）. RST-measured TK was smaller than X-ray values（t=1.511，P=0.135），with a moderate correlation（r=0.538 8，ICC=0.520）. RST-measured LL was smaller than X-ray values（t=2.700，P=0.008），with moderate correlation（r=0.595 6，ICC=0.589）. RST-measured ROT was significantly greater than ATR（t=3.627，P<0.001），with moderate correlation（r=0.639 0，ICC=0.626）. The AUC for RST-measured Cobb angle in diagnosing AIS was 0.895（95%CI=0.815–0.975），with an optimal cutoff of 8.5 °（sensitivity=0.769，specificity=0.889）. The AUC for RST-measured ROT was 0.697（95%CI=0.550–0.844），cutoff=3.75°（sensitivity=0.692，specificity=0.667）. ATR had an AUC of 0.638（95%CI=0.486–0.790），cutoff=2.5°（sensitivity=0.673，specificity=0.566）. Conclusion Compared with X-ray，RST demonstrated moderate reliability in measuring spinal parameters. Given its operational simplicity，RST may be considered for large-scale early screening in adolescent populations，though cost-effectiveness analyses against traditional methods are warranted.
Subjects: Medicine, Pharmacy >> Traditional Chinese Medicine and Chinese Materia Medica submitted time 2024-05-17 Cooperative journals: 《中国全科医学》
Abstract： Background Establishing the advantageous diseases in the field of traditional Chinese orthopedics treated with manual therapy will promote the development of manual techniques and dominant discipline. However，the current evaluation and selection lack a quantitative evaluation process based on evidence-based medicine. Objective To systematically review systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy using evidence mapping methodology and explore the advantageous diseases in this field. Methods Computerized searches were conducted in PubMed， EMbase，The Cochrane Library，Web of Science，SinoMed，China National Knowledge Infrastructure，Wanfang Data，and VIP database to collect systematic reviews of diseases in the field of traditional Chinese orthopedics treated with manual therapy from inception to March 5，2023. The evidence distribution characteristics were presented using a combination of charts and text. Results A total of 126 systematic reviews published from 2003 to 2023 were included，showing an overall increasing trend in the quantity of relevant studies both domestically and internationally. Methodological quality assessment results indicated that 13 reviews were of moderate quality，64 were of low quality，and 49 were of very low quality. The evidence map showed that the research evidence in the field of traditional Chinese orthopedics treated with manual therapy mainly focused on 18 clinical diseases，including cervical spondylosis，low back pain，knee osteoarthritis，lumbar disc herniation，ankle sprain，adhesive capsulitis of the shoulder，cervicogenic headache，atlantoaxial subluxation，distal radius fracture，lateral epicondylitis of the humerus，carpal tunnel syndrome，lumbar sprain，scoliosis，hip osteoarthritis，fibromyalgia syndrome，myofascial pain syndrome，rotator cuff injury，and supracondylar fracture of the humerus，demonstrating beneficial or potentially beneficial effects. Conclusion Manual therapy is widely used in the clinical practice of traditional Chinese orthopedics. However，due to methodological shortcomings and a lack of research evidence on safety and cost-effectiveness，future efforts should focus on multi-level inter-agency cooperation to establish sound evaluation standards and systems，improve research quality，update research evidence，and further explore the advantages of manual therapy in the field of traditional Chinese orthopedics.
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