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BackgroundAlthough scoliosis is characterized by lateral deviation of the spine, a 3D deformation actually is responsible for geometric and morphologic changes in the trunk and rib cage. In a vast related medical literature, one can find quite a few scoliosis evaluation indices, which are based on back surface data and are generally measured along three planes. Regardless the large number of such indices, the literature is lacking a coherent presentation of the underlying metrics, the involved anatomic surface landmarks, the definition of planes and the definition of the related body axes. In addition, the long list of proposed scoliotic indices is rarely presented in cross-reference to each other. This creates a possibility of misunderstandings and sometimes irrational or even wrong use of these indices by the medical society.Materials and methodsIt is hoped that the current work contributes in clearing up the issue and gives rise to innovative ideas on how to assess the surface metrics in scoliosis. In particular, this paper presents a thorough study on the scoliosis evaluation indices, proposed by the medical society.ResultsMore specifically, the referred indices are classified, according to the type of asymmetry they measure, according to the plane they refer to, according to the importance, and relevance or the level of scientific consensus they enjoy.ConclusionsSurface metrics have very little correlation to Cobb angle measurements. Indices measured on different planes do not correlate to each other. Different indices exhibit quite diverging characteristics in terms of observer-induced errors, accuracy, sensitivity and specificity. Complicated positioning of the patient and ambiguous anatomical landmarks are the major error sources, which cause observer variations. Principles that should be followed when an index is proposed are presented.

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When defining indicators on the environment, the use of existing initiatives should be a priority rather than redefining indicators each time. From an Information, Communication and Technology perspective, data interoperability and standardization are critical to improve data access and exchange as promoted by the Group on Earth Observations. GEOEssential is following an end-user driven approach by defining Essential Variables (EVs), as an intermediate value between environmental policy indicators and their appropriate data sources. From international to local scales, environmental policies and indicators are increasingly percolating down from the global to the local agendas. The scientific business processes for the generation of EVs and related indicators can be formalized in workflows specifying the necessary logical steps. To this aim, GEOEssential is developing a Virtual Laboratory the main objective of which is to instantiate conceptual workflows, which are stored in a dedicated knowledge base, generating executable workflows. To interpret and present the relevant outputs/results carried out by the different thematic workflows considered in GEOEssential (i.e. biodiversity, ecosystems, extractives, night light, and food-water-energy nexus), a Dashboard is built as a visual front-end. This is a valuable instrument to track progresses towards environmental policies.