Reliability of 2 Smartphone Applications for Cobb Angle Measurement in Scoliosis

As mobile technology has evolved, smartphone applications have been used for radiographic angle measurements in daily clinical practice. This study aimed to assess the reliability of 2 smartphone applications (iPinPoint and Cobbmeter) in measuring scoliosis Cobb angles compared with picture archiving and communication system (PACS) tools. Anteroposterior whole spinal digital radiographs of 50 patients were retrospectively analyzed. Four observers measured Cobb angles of predetermined major structural curves using the tools in the PACS software and 2 smartphone applications. The inter- and intraobserver reliabilty were measured using intraclass correlation coefficients (ICC). Very good interobserver agreement was seen with PACS, iPinPoint, and Cobbmeter measurements (ICC, 0.991, 0.980, and 0.991, respectively). Intraobserver reliability of the 4 observers was also very good for all techniques (ICC > 0.9 for all observers). Both smartphone applications were reliable in measuring scoliosis Cobb angles, with reference to PACS tools. They may be useful when digital or manual mesurement tools are not available.