| A meta-analysis of the clinical effectiveness of school scoliosis screening. | |
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MedLine Citation:
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PMID: 20393399 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: A meta-analysis that systematically reviewed the evaluation studies of a scoliosis screening program reported in the literature. OBJECTIVE: To evaluate the best current evidence on the clinical effectiveness of school screening for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The use of school scoliosis screening is controversial, and its clinical effectiveness has been diversely reported. METHODS: Data sources included 3 databases, namely, PubMed, Google scholar, CINAHL database, and the references from identified reviews and studies. Studies were included if: (1) they adopted a retrospective cohort design; (2) were screened using either the forward bending test (FBT), angle of trunk rotation, or Moiré topography; (3) reported results of screening tests and radiographic assessments; (4) screened adolescents only; (5) reported the incidence of curves with a minimum Cobb angle of 10 degrees or greater; and (6) reported the number of referrals for radiography. Reviews, comments, case studies, and editorials were excluded. RESULTS: Thirty-six studies, including 34 from the 775 initially identified studies and 2 from the references, met the selection criteria. The pooled referral rate for radiography was 5.0%, and the pooled positive predictive values for detecting curves > or =10 degrees , curves > or =20 degrees , and treatment were 28.0%, 5.6%, and 2.6%, respectively. There was substantial heterogeneity across studies. Meta-regression showed that programs using the FBT alone reported a higher referral rate (odds ratio [OR] = 2.91) and lower positive predictive values for curves > or =10 degrees (OR = 0.49) and curves > or =20 degrees (OR = 0.34) than programs using other tests. Only one small study followed students until skeletal maturity and reported the sensitivity of screening; however, the specificity was not reported. No severe publication bias was noted. CONCLUSION: The use of the FBT alone in school scoliosis screening is insufficient. We need large, retrospective cohort studies with sufficient follow-up to properly assess the clinical effectiveness of school scoliosis screening. |
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Authors:
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Daniel Yee Tak Fong; Chun Fan Lee; Kenneth Man Chee Cheung; Jack Chun Yiu Cheng; Bobby Kin Wah Ng; Tsz Ping Lam; Kwok Hang Mak; Paul Siu Fai Yip; Keith Dip Kei Luk |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-30 Completed Date: 2010-08-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 1061-71 Citation Subset: IM |
Affiliation:
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Department of Nursing Studies, The University of Hong Kong, Pokfulam, Hong Kong SAR, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Early Diagnosis Female Humans Male Mass Screening / methods, statistics & numerical data* Physical Examination / methods, statistics & numerical data* Predictive Value of Tests Radiology / methods, statistics & numerical data* Referral and Consultation / statistics & numerical data Reproducibility of Results Schools / statistics & numerical data* Scoliosis / diagnosis*, therapy Spine / radiography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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