This Random Forest model predicts curve progression and final Cobb angle in Adolescent Idiopathic Scoliosis (AIS) patients.

Preoperative radiographs from 193 AIS patients were retrospectively obtained from a single center. The average age of the patients was 12.7 ± 1.7 years (range 10-17.8 years) with an average initial major Cobb angle of 48.9 ± 13.9°. A Random Forest (RF) model was used to predict the final Cobb angle. This RF model was trained on data from 144 patients, and tested on data from 49 patients. The average expected prediction error for final Cobb angle was 4.6 ± 4.3°.

Please consider using our RF model with retrospective data from your own center to predict final Cobb angle in AIS patents with progressive curves. We hope to encourage the use of such machine learning-based prediction models in clinical practice. We appreciate any feedback!

Note: The model’s performance on clinical data from other centers, or for patients with features out of the ranges specified in the table above may be unreliable and prone to higher prediction errors.

If you use this model, please cite our paper: Alfraihat A, Samdani AF, Balasubramanian S (2022) Predicting curve progression for adolescent idiopathic scoliosis using random forest model. PLoS ONE 17(8): e0273002. https://doi.org/10.1371/journal.pone.0273002

Features Description

Feature	Description	Radiographic Measurement
Initial Cobb angle	Cobb angle is the angle measured between the lines which are above the most tilted vertebrae superior to the apex and below the most tilted vertebrae inferior to the apex	Sud et al. (2013), DOI: 10.4103/0019-5413.108875
Flexibility	The flexibility is calculated as the percent change in Cobb angle between the standing radiograph and the side bending radiograph
Lumbar lordosis and thoracic kyphosis angles	Lordosis and Kyphosis angles are measured from lateral radiographs Lordosis angle is the angle between the superior endplate of L1 and the inferior endplate of L5 Kyphosis angle is the angle between the superior endplate of T2 and the inferior endplate of T12
Age at prediction (years)	Age of the patient at which the prediction is made	NA
Number of levels involved	The number of vertebral levels involved in the major curve. In the figure on the right, seven levels are involved in the curve	Sud et al. (2013), DOI: 10.4103/0019-5413.108875
Risser"+" stage at initial diagnosis	Risser + staging system is an eight-point system, describes the pattern of ossification of the iliac apophysis and subsequent fusion of the apophysis to the ilium. It combines the conventional Risser staging system with triradiate cartilage maturity assessment. The Risser+ system consists of grade: 0-: Open TRC (For this model input indicated as -2) 0+: Closed TRC (For this model input indicated as -1) Risser 1 :25% coverage Risser 2: 50% coverage Risser 3: 75% coverage Risser ¾: 100% coverage Risser 4: Start of fusion Risser 5: complete fusion For further details, please refer to: Troy et al. (2019), DOI: 10.1007/s00586-018-5821-8	Troy et al. (2019), DOI: 10.1007/s00586-018-5821-8