Article: A meta-analysis of the clinical effectiveness of school scoliosis screening
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- Publisher Website: 10.1097/BRS.0b013e3181bcc835
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- PMID: 20393399
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| Title | A meta-analysis of the clinical effectiveness of school scoliosis screening | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Fong, DYT1 Lee, CF1 Cheung, KMC1 Cheng, JCY3 Ng, BKW2 Lam, TP3 Mak, KH Yip, PSF1 Luk, KDK1 | ||||||
| Keywords | Adolescent idiopathic scoliosis Meta-analysis Retrospective cohort studies School screening program | ||||||
| Issue Date | 2010 | ||||||
| Publisher | Lippincott, 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?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181bcc835 | ||||||
| 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. | ||||||
| ISSN | 0362-2436 2011 Impact Factor: 2.078 2011 SCImago Journal Rankings: 0.137 | ||||||
| DOI | http://dx.doi.org/10.1097/BRS.0b013e3181bcc835 | ||||||
| ISI Accession Number ID | WOS:000277224800009
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 | References in Scopus |
| dc.contributor.author | Fong, DYT | ||||||
|---|---|---|---|---|---|---|---|
| dc.contributor.author | Lee, CF | ||||||
| dc.contributor.author | Cheung, KMC | ||||||
| dc.contributor.author | Cheng, JCY | ||||||
| dc.contributor.author | Ng, BKW | ||||||
| dc.contributor.author | Lam, TP | ||||||
| dc.contributor.author | Mak, KH | ||||||
| dc.contributor.author | Yip, PSF | ||||||
| dc.contributor.author | Luk, KDK | ||||||
| dc.date.accessioned | 2010-09-27T08:08:45Z | ||||||
| dc.date.available | 2010-09-27T08:08:45Z | ||||||
| dc.date.issued | 2010 | ||||||
| dc.description.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. | ||||||
| dc.description.nature | postprint | ||||||
| dc.identifier.citation | Spine, 2010, v. 35 n. 10, p. 1061-1071 [How to Cite?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181bcc835 | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1097/BRS.0b013e3181bcc835 | ||||||
| dc.identifier.epage | 1071 | ||||||
| dc.identifier.hkuros | 173403 | ||||||
| dc.identifier.hkuros | 178288 | ||||||
| dc.identifier.isi | WOS:000277224800009
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). | ||||||
| dc.identifier.issn | 0362-2436 2011 Impact Factor: 2.078 2011 SCImago Journal Rankings: 0.137 | ||||||
| dc.identifier.issue | 10 | ||||||
| dc.identifier.openurl | | ||||||
| dc.identifier.pmid | 20393399 | ||||||
| dc.identifier.scopus | eid_2-s2.0-77952011412 | ||||||
| dc.identifier.spage | 1061 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/123808 | ||||||
| dc.identifier.volume | 35 | ||||||
| dc.language | eng | ||||||
| dc.publisher | Lippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com | ||||||
| dc.publisher.place | United States | ||||||
| dc.relation.ispartof | Spine | ||||||
| dc.relation.references | References in Scopus | ||||||
| dc.rights | This is a non-final version of an article published in final form in Spine, 2010, v. 35 n. 10, p. 1061-1071 | ||||||
| dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | ||||||
| dc.subject.mesh | Mass Screening - methods - statistics and numerical data | ||||||
| dc.subject.mesh | Physical Examination - methods - statistics and numerical data | ||||||
| dc.subject.mesh | Radiology - methods - statistics and numerical data | ||||||
| dc.subject.mesh | Schools - statistics and numerical data | ||||||
| dc.subject.mesh | Scoliosis - diagnosis - therapy | ||||||
| dc.subject | Adolescent idiopathic scoliosis | ||||||
| dc.subject | Meta-analysis | ||||||
| dc.subject | Retrospective cohort studies | ||||||
| dc.subject | School screening program | ||||||
| dc.title | A meta-analysis of the clinical effectiveness of school scoliosis screening | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong
- Prince of Wales Hospital Hong Kong
- Chinese University of Hong Kong