Parents’ and Patients’ Perceptions of Postoperative Appearance in Adolescent Idiopathic Scoliosis
Bibliographic record
Abstract
STUDY DESIGN: A cross-sectional evaluation of patients after surgery for adolescent idiopathic scoliosis (AIS). OBJECTIVES: To determine the agreement between patients' and parents' perceptions of the patient's postoperative appearance and to compare those perceptions with physical and radiographic measures of deformity. SUMMARY OF BACKGROUND DATA: Improving cosmesis is an important aim of surgery. Patients' appearances may influence their evaluation of its outcome. METHODS: Physical and radiographic data were collected 2 years after surgery for 128 patients with AIS. Patients and parents independently rated shoulder blades, shoulders, waist, and overall appearance. Additionally, patients completed the Quality of Life Profile for Spinal Disorders (QLPSD). Agreement was evaluated with the weighted kappa statistic ranging between 0 and 1 where higher values indicate better agreement. RESULTS: Fair to moderate agreement was found between patient and parent ratings of the patient's shoulder blades (kappa = 0.39; 95% confidence interval [CI], 0.29-0.48), shoulders (kappa = 0.38; 95% CI, 0.26-0.50), waist (kappa = 0.45; 95% CI, 0.25-0.55), and overall appearance (kappa = 0.22; 95% CI, 0.04-0.40). Patients rated the appearance of their waist (P = 0.013) and overall appearance (P = 0.039) significantly worse than their parents. Patients' perceptions of their overall appearance had higher correlations with the body image subscale score (r = 0.45, P = 0.000) and the total quality of life score on the QLPSD (r = 0.37, P = 0.000) than did parents' perceptions of those same measures (r = 0.21, P = 0.025; and r = 0.08, P = 0.369, respectively). CONCLUSIONS: Radiographic and physical measures of deformity do not correlate well with patients' and parents' perceptions of appearance. Patients and parents do not strongly agree on the cosmetic outcome of AIS surgery. Therefore, given that the adolescents themselves undergo the surgery, patients' assessments of their deformity, rather than radiographic measures or parents' assessments, should play a major role in the evaluation of surgical success.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".