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ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

The "Idiopathic Scoliosis Graphical Representation of Worsening Trend of Natural History" (IS-GROWTH) communication tool provides a reliable prediction useful to manage long-term treatment during growth. 2025 SOSORT award winner.

Stefano Negrini, Francesco Negrini, Francesca Febbo, Greta Jurenaite, Carmelo Pulici, Fabio Zaina, Alberto Negrini

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Stefano NegriniDepartment of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.
Francesco NegriniDepartment of Biotechnology and Life Sciences, University of Insubria, Varese, Italy. francesco.negrini@uninsubria.it.
Francesca FebboISICO (Italian Scientific Spine Institute), Milan, Italy.
Greta JurenaiteISICO (Italian Scientific Spine Institute), Milan, Italy.
Carmelo PuliciISICO (Italian Scientific Spine Institute), Milan, Italy.
Fabio ZainaISICO (Italian Scientific Spine Institute), Milan, Italy.
Alberto NegriniISICO (Italian Scientific Spine Institute), Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEffective communication with patients regarding long-term conservative treatment for idiopathic scoliosis necessitates an understanding of its natural history. Existing predictive models have limitations in this regard. Our study aimed to develop and evaluate the reliability and utility of the Idiopathic Scoliosis Graphical Representation Of Worsening Trend of Natural History (IS-GROWTH) communication tool.

methodsIS-GROWTH development and validation involved consecutive untreated patients with radiographs taken at and prior to the first consultation. To construct the model, we calculated the minimum and maximum progression of patients grouped by 10° Cobb angle range and growth phases. IS-GROWTH is developed for each patient, incorporating the expected progression of each growth phase into the preceding one. For temporal validation, we included patients whose data were obtained after the development of IS-GROWTH, comparing IS-GROWTH predictions with natural history. We calculated the percentage of correct predictions and applied the chi-square test. We also examined the distribution of natural history within IS-GROWTH. Finally, we piloted the tool's usefulness for communication with patients among a group of physicians using it for several years.

resultsTo develop IS-GROWTH, we analysed 3,184 radiographs from 1,818 participants, spanning from infancy to adolescence. For validation, we included 552 patients and found an accuracy of 95% (95% Confidence Interval, 93-97%) after adjusting for the 5° radiographic measurement error. Nineteen physicians (7.3±5.8 years' experience) reported using IS-GROWTH in 30% of their patients (range 5-95%) and found it most useful during follow-up (84%) to motivate patients (79%).

conclusionIS-GROWTH is reliable and useful. We now regularly use it to deepen our understanding of individual natural history and enhance communication with patients.

Indexed as

ScoliosisAdolescentAwards and PrizesChildCommunicationDisease ProgressionFemaleHumansMaleRadiographyReproducibility of ResultsIdiopathic scoliosisNatural historyPatient-physician communicationShared decision-making

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.