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Four-points and line-fitting methods were used to calculate the sagittal Cobb angle automatically. The average value of the sagittal Cobb angle was manually measured by two doctors as the reference standard. The percentage of correct key points (PCK), matched samples t test, intraclass correlation coefficient (ICC), Pearson correlation coefficient, mean absolute error (MAE), and Bland\u2012Altman plots were used to evaluate the performance of the DL model and the robustness and generalization of the model on the external test set.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 991 patients were included in the internal data set, and 112 patients were included in the external data set. The PCK of the DL model ranged from 78 to 100% in the test set. The four-points method, line-fitting method, and reference standard measured sagittal Cobb angles were \u2212\u20091.10\u2009\u00b1\u200918.29\u00b0, 0.30\u2009\u00b1\u200913.36\u00b0, and 0.50\u2009\u00b1\u200912.83\u00b0 in the internal test set and 4.55\u2009\u00b1\u200920.01\u00b0, 3.66\u2009\u00b1\u200918.55\u00b0, and 1.83\u2009\u00b1\u200912.02\u00b0 in the external test set, respectively. The sagittal Cobb angle calculated by the four-points method and the line-fitting method maintained high consistency with the reference standard (internal test set: ICC\u2009=\u20090.75 and 0.97; r\u2009=\u20090.64 and 0.94; MAE\u2009=\u20095.42\u00b0 and 3.23\u00b0, respectively; external test set: ICC\u2009=\u20090.74 and 0.80, r\u2009=\u20090.66 and 0.974, MAE\u2009=\u20095.25\u00b0 and 4.68\u00b0, respectively).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The DL model can accurately measure the sagittal Cobb angle of the cervical spine on CT. The line-fitting method shows a higher consistency with the doctors and a minor average absolute error.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12880-023-01156-6","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T14:02:26Z","timestamp":1701180146000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Deep learning model for measuring the sagittal Cobb angle on cervical spine computed tomography"],"prefix":"10.1186","volume":"23","author":[{"given":"Chunjie","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Ni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanqiang","family":"Ouyang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoming","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianxi","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ning","family":"Lang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huishu","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,11,28]]},"reference":[{"issue":"2","key":"1156_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.3171\/2013.4.SPINE12838","volume":"19","author":"JK Scheer","year":"2013","unstructured":"Scheer JK, Tang JA, Smith JS, et al. 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This retrospective study was approved by the Medical Science Research Ethics Committee of Peking University Third Hospital, and the requirement of informed consent was waived.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"196"}}