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Article: Clinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort study

TitleClinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort study
Authors
Keywordsadolescent idiopathic scoliosis
clinical effectiveness
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. 17, p. 1607-1614 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/128052
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
Hong Kong Special Administrative Region, ChinaHKU 7006-PPR-20051
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

 

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.authorLuk, KDKen_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.authorFong, DYTen_HK
dc.date.accessioned2010-10-31T14:02:14Z-
dc.date.available2010-10-31T14:02:14Z-
dc.date.issued2010en_HK
dc.identifier.citationSpine, 2010, v. 35 n. 17, p. 1607-1614en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/128052-
dc.description.abstractStudy 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.en_HK
dc.languageengen_HK
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. 17, p. 1607-1614-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectadolescent idiopathic scoliosisen_HK
dc.subjectclinical effectivenessen_HK
dc.subjectschool screening programen_HK
dc.subject.meshHong Kong-
dc.subject.meshHumans-
dc.subject.meshMass Screening - methods-
dc.subject.meshRetrospective Studies-
dc.subject.meshScoliosis - diagnosis-
dc.titleClinical effectiveness of school screening for adolescent idiopathic scoliosis: A large population-based retrospective cohort studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=35&issue=17&spage=1607&epage=1614&date=2010&atitle=Clinical+effectiveness+of+school+screening+for+adolescent+idiopathic+scoliosis:+A+large+population-based+retrospective+cohort+study-
dc.identifier.emailLuk, KDK: hcm21000@hku.hken_HK
dc.identifier.emailCheung, KMC: cheungmc@hku.hken_HK
dc.identifier.emailYip, PSF: sfpyip@hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.identifier.authorityCheung, KMC=rp00387en_HK
dc.identifier.authorityYip, PSF=rp00596en_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.description.naturepostprint-
dc.identifier.doi10.1097/BRS.0b013e3181c7cb8cen_HK
dc.identifier.pmid20453727en_HK
dc.identifier.scopuseid_2-s2.0-77955468376en_HK
dc.identifier.hkuros196983en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77955468376&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue17en_HK
dc.identifier.spage1607en_HK
dc.identifier.epage1614en_HK
dc.identifier.isiWOS:000280465200005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_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.scopusauthoridFong, DYT=35261710300en_HK

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