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Article: A meta-analysis of the clinical effectiveness of school scoliosis screening

TitleA meta-analysis of the clinical effectiveness of school scoliosis screening
Authors
KeywordsAdolescent idiopathic scoliosis
Meta-analysis
Retrospective cohort studies
School screening program
Issue Date2010
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2010, v. 35 n. 10, p. 1061-1071 How to Cite?
Abstract
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° 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 ≥10°, curves ≥20°, 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 ≥10° (OR = 0.49) and curves ≥20° (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. © 2010, Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/123808
ISSN
2013 Impact Factor: 2.447
ISI Accession Number ID
Funding AgencyGrant Number
Central Policy Unit of the Government of the Hong Kong Special Administrative Region
Council of the Hong Kong Special Administrative Region, ChinaHKU 7006-PPR-20051
Funding Information:

Supported by funds from the Central Policy Unit of the Government of the Hong Kong Special Administrative Region and the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No.: HKU 7006-PPR-20051).

References

 

Author Affiliations
  1. The University of Hong Kong
  2. Prince of Wales Hospital Hong Kong
  3. Chinese University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorLee, CFen_HK
dc.contributor.authorCheung, KMCen_HK
dc.contributor.authorCheng, JCYen_HK
dc.contributor.authorNg, BKWen_HK
dc.contributor.authorLam, TPen_HK
dc.contributor.authorMak, KHen_HK
dc.contributor.authorYip, PSFen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2010-09-27T08:08:45Z-
dc.date.available2010-09-27T08:08:45Z-
dc.date.issued2010en_HK
dc.identifier.citationSpine, 2010, v. 35 n. 10, p. 1061-1071en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/123808-
dc.description.abstractStudy 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° 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 ≥10°, curves ≥20°, 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 ≥10° (OR = 0.49) and curves ≥20° (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. © 2010, Lippincott Williams & Wilkins.en_HK
dc.languageeng-
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.rightsThis is a non-final version of an article published in final form in Spine, 2010, v. 35 n. 10, p. 1061-1071-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectAdolescent idiopathic scoliosisen_HK
dc.subjectMeta-analysisen_HK
dc.subjectRetrospective cohort studiesen_HK
dc.subjectSchool screening programen_HK
dc.subject.meshMass Screening - methods - statistics and numerical data-
dc.subject.meshPhysical Examination - methods - statistics and numerical data-
dc.subject.meshRadiology - methods - statistics and numerical data-
dc.subject.meshSchools - statistics and numerical data-
dc.subject.meshScoliosis - diagnosis - therapy-
dc.titleA meta-analysis of the clinical effectiveness of school scoliosis screeningen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=35&issue=10&spage=1061&epage=1071&date=2010&atitle=A+meta-analysis+of+the+clinical+effectiveness+of+school+scoliosis+screening-
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_HK
dc.identifier.emailYip, PSF: sfpyip@hku.hken_HK
dc.identifier.emailLuk, KDK: hcm21000@hku.hken_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authorityYip, PSF=rp00596en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1097/BRS.0b013e3181bcc835en_HK
dc.identifier.pmid20393399en_HK
dc.identifier.scopuseid_2-s2.0-77952011412en_HK
dc.identifier.hkuros173403-
dc.identifier.hkuros178288-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77952011412&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1061en_HK
dc.identifier.epage1071en_HK
dc.identifier.eissn1528-1159-
dc.identifier.isiWOS:000277224800009-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridLee, CF=36015342400en_HK
dc.identifier.scopusauthoridCheung, KMC=7402406754en_HK
dc.identifier.scopusauthoridCheng, JCY=9942890200en_HK
dc.identifier.scopusauthoridNg, BKW=7101727344en_HK
dc.identifier.scopusauthoridLam, TP=7202523234en_HK
dc.identifier.scopusauthoridMak, KH=8623141300en_HK
dc.identifier.scopusauthoridYip, PSF=7102503720en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK

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