Does School Screening Affect Scoliosis Curve Magnitude at Presentation to a Pediatric Orthopedic Clinic?

Thomas, J. Joshua; Stans, Anthony A.; Milbrandt, Todd A.; Treder, Vickie M.; Kremers, Hilal Maradit; Shaughnessy, William J.; Larson, A. Noelle

doi:10.1016/j.jspd.2017.12.007

Cited by 10 publications

(9 citation statements)

References 22 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 14 No publications included in the task force evaluated the benefits of screening for AIS on severity of curvature compared with no screening. Thomas et al 15 compared the curve magnitude at initial presentation for evaluation of scoliosis for new patients between 1994-2004 (during school screening) and 2004-2014 (after school screening) and found that after school screening was discontinued, mean curve magnitude at presentation statistically increased. Consistent with their results, our study and that by Goldstein et al 7 collectively imply the importance of scoliosis screening for early curves detection.…”

Section: Discussionmentioning

confidence: 99%

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

Lin

Meng

Yin

et al. 2019

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Retrospective cohort study. Objectives: To determine whether there is an association between insurance status and curve magnitude in idiopathic scoliosis pediatric patients in mainland China. Methods: Medical records of patients with adolescent idiopathic scoliosis in 4 tertiary spine centers across China from January 2013 to December 2017 were analyzed. Data was extracted on insurance status, curve magnitude, recommended treatment at presentation, source of referral, and treatment initiated. Additional information was collected for patients requiring corrective surgery, including time from recommendation for surgery to surgery and clinically relevant parameters such as, postoperative complications, and pre-/postoperative Scoliosis Research Society–22 scores were also collected for patients requiring corrective surgery. Results: Of the 1785 patients included, 1032 were Urban Resident Basic Medical Insurance Scheme (URBMS) insured and 753 were New Rural Cooperative Medical Scheme (NRCMS) insured. NRCMS patients presented with a larger major curve than URBMS patients (32.9° ± 15.1° vs 29.3° ± 12.6°, P = .028). For patients having surgery recommended, NRCMS patients presented with a larger mean Cobb angle at the first presentation (57.7° vs 50.9°, P < .0001) and at time of surgery (61.3° vs 52.2°, P < .0001), and experienced a significantly longer time from surgery recommendation to decision for surgery. Complication rates were comparable between the 2 groups, except for pulmonary complications (NRCMS 7.3% vs URBMS 2.8%, P = .04). Postoperatively, patients covered by NRCMS insurance experienced greater overall improvement in health-related quality of life and were less satisfied with the treatments. Conclusions: This study shows that health insurance may influence the severity of scoliosis on presentation, with implications on early diagnosis and surgery time.

show abstract

Section: Discussionmentioning

confidence: 99%

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

Lin

Meng

Yin

et al. 2019

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…“Distribution of curves was similar for children detected through school-based screening compared to those who were detected clinically”[ 26 ]. And the effectiveness of school screening on curve magnitude at clinical presentation, in comparison to clinically detected cases, is reported as doubtful[ 39 ].…”

Section: Updated Recommendations Outdated Standards?mentioning

confidence: 99%

“…In the last decade, in the new era of guideline development[ 10 - 12 , 27 , 28 ], and after screening principles have evolved significantly[ 1 , 8 , 9 , 29 , 30 ], a number of updated and new recommendations and statements on screening for scoliosis[ 31 - 35 ], as well as on periodic examination of the spine[ 36 ], have been released. Nonetheless, the dilemmas prevail[ 37 - 39 ] and consensus does not seem to be reached[ 40 , 41 ]. Internationally, recommendations differ substantially, not only in terms of their content, but also standards of development and screening principles.…”

Section: Introductionmentioning

confidence: 99%

Screening for scoliosis - New recommendations, old dilemmas, no straight solutions

Płaszewski

Grantham

Jespersen

2020

WJO

View full text Add to dashboard Cite

This opinion review considers the prevailing question of whether to screen or not to screen for adolescent idiopathic scoliosis. New and improved standards of people-oriented care and person-centredness, as well as improved principles of preventive screening and guideline development, have been postulated and implemented in health care systems and cultures. Recommendations addressing screening for scoliosis differ substantially, in terms of their content, standards of development and screening principles. Some countries have discontinued issuing recommendations. In the last decade, a number of updated and new recommendations and statements have been released. Systematically developed guidelines and recommendations are confronted by consensus and opinion-based statements. The dilemmas and discrepancies prevail. The arguments concentrate on the issues of the need for early detection through screening in terms of the effectiveness of early treatment, on costs and cost-effectiveness issues, scientific and epidemiologic value of screenings, and the credibility of the sources of evidence. The problem matter is of global scale and applies to millions of people. It regards clinical and methodological dilemmas, but also the matter of vulnerable and fragile time of adolescence and, more generally, children’s rights. The decisions need to integrate people’s values and preferences – screening tests need to be acceptable to the population, and treatments need to be acceptable for patients. Therefore we present one more crucial, but underrepresented in the discussion, issue of understanding and implementation of the contemporary principles of person-centred care, standards of preventive screening, and guideline development, in the context of screening for scoliosis.

show abstract

“…Retrospectively studying the referral patterns of suspected cases of AIS in orthopaedic clinics, our team [5,9,10] demonstrated that after discontinuation of school screening programs, 20% of patients were referred "late" to a scoliosis clinic to benefit from appropriate and timely conservative management with a spinal brace. Thomas et al reported that in a US county, the number of referrals to orthopaedic clinics for scoliosis in areas without school screening decreased, as well as the number of spinal brace prescriptions [11].…”

Section: Introductionmentioning

confidence: 99%

Parents can reliably and accurately detect trunk asymmetry using an inclinometer smartphone app

Beauséjour

Aubin

Fortin

et al. 2022

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Purpose An inclinometer smartphone application has been developed to enable the measurement of the angle of trunk inclination (ATI) to detect trunk surface asymmetry. The objective was to determine the reliability and validity of the smartphone app in the hands of non-professionals. Methods Three non-professional observers and one expert surgeon measured maximum ATI twice in a study involving 69 patients seen in the spine clinics to rule out scoliosis or for regular follow-up (10-18 y.o., Cobb [0°-58°]). Observers were parents not familiar with scoliosis screening nor use of an inclinometer. They received training from a 4-minute video. Intra and inter-observer reliability was determined using the generalizability theory and validity was assessed from intraclass correlation coefficients (ICC), agreement with the expert on ATI measurements using Bland-Altman analysis, and correct identification of the threshold for consultation (set to ≥6° ATI). Results Intra-observer and inter-observer reliability coefficients were excellent ϕ = 0.92. The standard error of measurement was 1.5° (intra-observer, 2 measurements) meaning that a parent may detect a change of 4° between examinations 95% of the time. Comparison of measurements between non-professionals and the expert resulted in ICC varying from 0.82 [0.71-0.88] to 0.84 [0.74-0.90] and agreement on the decision to consult occurred in 83 to 90% of cases. Conclusion The use of a smartphone app resulted in excellent reliability, sufficiently low standard error of measurement (SEM) and good validity in the hands of non-professionals. The device and the instructional video are adequate means to allow detection and regular examination of trunk asymmetries by non-professionals.

show abstract

Does School Screening Affect Scoliosis Curve Magnitude at Presentation to a Pediatric Orthopedic Clinic?

Abstract: Level 3.

Cited by 10 publications

References 22 publications

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

Influence of Insurance Status on Curve Magnitude in Adolescent Idiopathic Scoliosis in Mainland China

Screening for scoliosis - New recommendations, old dilemmas, no straight solutions

Parents can reliably and accurately detect trunk asymmetry using an inclinometer smartphone app

Contact Info

Product

Resources

About