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Article: A meta-analysis of the clinical effectiveness of school scoliosis screening
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TitleA meta-analysis of the clinical effectiveness of school scoliosis screening
 
AuthorsFong, DYT1
Lee, CF1
Cheung, KMC1
Cheng, JCY3
Ng, BKW2
Lam, TP3
Mak, KH
Yip, PSF1
Luk, KDK1
 
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
 
CitationSpine, 2010, v. 35 n. 10, p. 1061-1071 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181bcc835
 
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.
 
ISSN0362-2436
2012 Impact Factor: 2.159
2012 SCImago Journal Rankings: 1.447
 
DOIhttp://dx.doi.org/10.1097/BRS.0b013e3181bcc835
 
ISI Accession Number IDWOS:000277224800009
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).

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorFong, DYT
 
dc.contributor.authorLee, CF
 
dc.contributor.authorCheung, KMC
 
dc.contributor.authorCheng, JCY
 
dc.contributor.authorNg, BKW
 
dc.contributor.authorLam, TP
 
dc.contributor.authorMak, KH
 
dc.contributor.authorYip, PSF
 
dc.contributor.authorLuk, KDK
 
dc.date.accessioned2010-09-27T08:08:45Z
 
dc.date.available2010-09-27T08:08:45Z
 
dc.date.issued2010
 
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.
 
dc.description.naturepostprint
 
dc.identifier.citationSpine, 2010, v. 35 n. 10, p. 1061-1071 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181bcc835
 
dc.identifier.doihttp://dx.doi.org/10.1097/BRS.0b013e3181bcc835
 
dc.identifier.eissn1528-1159
 
dc.identifier.epage1071
 
dc.identifier.hkuros173403
 
dc.identifier.hkuros178288
 
dc.identifier.isiWOS:000277224800009
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).

 
dc.identifier.issn0362-2436
2012 Impact Factor: 2.159
2012 SCImago Journal Rankings: 1.447
 
dc.identifier.issue10
 
dc.identifier.openurl
 
dc.identifier.pmid20393399
 
dc.identifier.scopuseid_2-s2.0-77952011412
 
dc.identifier.spage1061
 
dc.identifier.urihttp://hdl.handle.net/10722/123808
 
dc.identifier.volume35
 
dc.languageeng
 
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofSpine
 
dc.relation.referencesReferences in Scopus
 
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.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.subjectAdolescent idiopathic scoliosis
 
dc.subjectMeta-analysis
 
dc.subjectRetrospective cohort studies
 
dc.subjectSchool screening program
 
dc.titleA meta-analysis of the clinical effectiveness of school scoliosis screening
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong
  2. Prince of Wales Hospital Hong Kong
  3. Chinese University of Hong Kong