Article: Clinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort study
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- Publisher Website: 10.1097/BRS.0b013e3181c7cb8c
- Scopus: eid_2-s2.0-77955468376
- PMID: 20453727
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| Title | Clinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort study | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Luk, KDK Lee, CF1 Cheung, KMC Cheng, JCY3 Ng, BKW2 Lam, TP3 Mak, KH Yip, PSF1 Fong, DYT1 | ||||||
| Keywords | adolescent idiopathic scoliosis clinical effectiveness 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. 17, p. 1607-1614 [How to Cite?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181c7cb8c | ||||||
| Abstract | Study Design.: Retrospective cohort study. Objective.: To evaluate the clinical effectiveness of school scoliosis screening using a large and long-term-followed cohort of students in Hong Kong. Sumary of Background Data.: School screening for adolescent idiopathic scoliosis has been criticized as resulting in over-referrals for radiography and having low predictive values. Indeed, all but one previous retrospective cohort studies had no follow-up assessments of students until their skeletal maturity, leaving any late-developed curves undetected. The one study that completed this follow-up was well conducted but had low precisions due to its small sample size. METHODS.: A total of 157,444 students were eligible for a biennial scoliosis screening, and their screening results and medical records up to 19 years of age were available. Students first had forward bending test and angle of trunk rotation (ATR) performed. Those with ATR between 5° and 14° or signs of adolescent idiopathic scoliosis were assessed by moiré topography regularly. Students with an ATR 15°, 2 moiré lines, or significant clinical signs were referred for radiography and had their Cobb angle measured. RESULTS.: Of the 115,190 screened students in the cohort, 3228 (2.8%, 95% confidence interval [CI] = 2.7%-2.9%) were referred for radiography. At the final follow-up, the positive predictive values were 43.6% (41.8%-45.3%) for a Cobb angle 20° and 9.4% (8.4%-10.5%) for needing treatment, while the sensitivities were 88.1% (86.4%-89.6%) and 80.0% (75.6%-83.9%), respectively. Conclusion.: This is the largest study that has demonstrated that school scoliosis screening in Hong Kong is predictive and sensitive with a low referral rate. Screening should thus be continued in order to facilitate early administration of conservative treatments. © 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.0b013e3181c7cb8c | ||||||
| ISI Accession Number ID | WOS:000280465200005
Funding Information: Supported by 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 | Luk, KDK | ||||||
|---|---|---|---|---|---|---|---|
| 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 | Fong, DYT | ||||||
| dc.date.accessioned | 2010-10-31T14:02:14Z | ||||||
| dc.date.available | 2010-10-31T14:02:14Z | ||||||
| dc.date.issued | 2010 | ||||||
| dc.description.abstract | Study Design.: Retrospective cohort study. Objective.: To evaluate the clinical effectiveness of school scoliosis screening using a large and long-term-followed cohort of students in Hong Kong. Sumary of Background Data.: School screening for adolescent idiopathic scoliosis has been criticized as resulting in over-referrals for radiography and having low predictive values. Indeed, all but one previous retrospective cohort studies had no follow-up assessments of students until their skeletal maturity, leaving any late-developed curves undetected. The one study that completed this follow-up was well conducted but had low precisions due to its small sample size. METHODS.: A total of 157,444 students were eligible for a biennial scoliosis screening, and their screening results and medical records up to 19 years of age were available. Students first had forward bending test and angle of trunk rotation (ATR) performed. Those with ATR between 5° and 14° or signs of adolescent idiopathic scoliosis were assessed by moiré topography regularly. Students with an ATR 15°, 2 moiré lines, or significant clinical signs were referred for radiography and had their Cobb angle measured. RESULTS.: Of the 115,190 screened students in the cohort, 3228 (2.8%, 95% confidence interval [CI] = 2.7%-2.9%) were referred for radiography. At the final follow-up, the positive predictive values were 43.6% (41.8%-45.3%) for a Cobb angle 20° and 9.4% (8.4%-10.5%) for needing treatment, while the sensitivities were 88.1% (86.4%-89.6%) and 80.0% (75.6%-83.9%), respectively. Conclusion.: This is the largest study that has demonstrated that school scoliosis screening in Hong Kong is predictive and sensitive with a low referral rate. Screening should thus be continued in order to facilitate early administration of conservative treatments. © 2010, Lippincott Williams & Wilkins. | ||||||
| dc.description.nature | postprint | ||||||
| dc.identifier.citation | Spine, 2010, v. 35 n. 17, p. 1607-1614 [How to Cite?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181c7cb8c | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1097/BRS.0b013e3181c7cb8c | ||||||
| dc.identifier.epage | 1614 | ||||||
| dc.identifier.hkuros | 196983 | ||||||
| dc.identifier.isi | WOS:000280465200005
Funding Information: Supported by 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 | 17 | ||||||
| dc.identifier.openurl | | ||||||
| dc.identifier.pmid | 20453727 | ||||||
| dc.identifier.scopus | eid_2-s2.0-77955468376 | ||||||
| dc.identifier.spage | 1607 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/128052 | ||||||
| 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. 17, p. 1607-1614 | ||||||
| dc.rights | Creative Commons: Attribution 3.0 Hong Kong License | ||||||
| dc.subject.mesh | Hong Kong | ||||||
| dc.subject.mesh | Humans | ||||||
| dc.subject.mesh | Mass Screening - methods | ||||||
| dc.subject.mesh | Retrospective Studies | ||||||
| dc.subject.mesh | Scoliosis - diagnosis | ||||||
| dc.subject | adolescent idiopathic scoliosis | ||||||
| dc.subject | clinical effectiveness | ||||||
| dc.subject | school screening program | ||||||
| dc.title | Clinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort study | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong
- Prince of Wales Hospital Hong Kong
- Chinese University of Hong Kong