AI-assisted scoliosis screening in 18,631 students in Xinjiang yields 2.62% final positivity after specialist review

In a school screening of 18,631 students in Xinjiang, AI-assisted screen-positive rate was 5.36%, falling to 2.62% after specialist review. Only 24.59% of screen-positive students had radiography, but 62.50% of those had Cobb ≥10°. Age trend significant (P<0.001).

• Age was the most consistent signal: screen-positive rate was highest in junior and senior high school students (P for trend <0.001).
• Low radiography follow-up: only 24.59% of final screen-positive students completed radiography, highlighting a critical gap in the screening pathway.
• Among those who did undergo radiography, 62.50% had a Cobb angle ≥10°, confirming the value of screening for true positives among those imaged.

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