Screening for Adolescent Idiopathic Scoliosis: Evidence Report and Systematic Review for the US Preventive Services Task Force
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TLDR
There is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of Ais screening on adult health outcome.Abstract:
Importance Adolescent idiopathic scoliosis (AIS), a spinal curvature of 10° or more, is the most common form of scoliosis, with a prevalence of 1% to 3%. Curves progress in approximately two-thirds of patients with AIS before skeletal maturity, and large curves (>50°) may be associated with adverse health outcomes. Objective To systematically review evidence on benefits and harms of AIS screening for the US Preventive Services Task Force (USPSTF). Data Sources Cochrane Central Register of Controlled Trials, MEDLINE, ERIC, PubMed, CINAHL, and relevant systematic reviews were searched for studies published from January 1966 to October 20, 2016; studies included in a previous USPSTF report were also reviewed. Surveillance was conducted through July 24, 2017. Study Selection Fair- and good-quality studies that evaluated the accuracy of screening children and adolescents aged 10 to 18 years for AIS, the benefits of AIS treatment, the harms of AIS screening or treatment, or long-term health outcomes. Data Extraction and Synthesis Two investigators independently reviewed abstracts and full-text articles and extracted data into evidence tables. Results were qualitatively summarized. Main Outcomes and Measures Health outcomes and spinal curvature in adolescence and adulthood, accuracy of screening for AIS, any harm of AIS screening or treatment. Results Fourteen studies (N = 448 276) in 26 articles were included. Accuracy of AIS screening was highest (93.8% sensitivity; 99.2% specificity) in a cohort study of a clinic-based program using forward bend test, scoliometer, and Moire topography screening (n = 306 082); accuracy was lower in cohort studies of 6 programs using fewer modalities (n = 141 161). Four controlled studies (n = 587) found evidence for benefit of bracing on curve progression compared with controls. A randomized clinical trial and a nonrandomized trial of exercise treatment (N = 184) found favorable reductions in Cobb angle of 0.67° to 4.9° in the intervention group compared with increases of 1.38° to 2.8° in the control group. Two cohort studies (n = 339) on long-term outcomes found that braced participants reported more negative treatment experience and body appearance compared with surgically treated or untreated participants. A study that combined a randomized clinical trial and cohort design (n = 242) reported harms of bracing, which included skin problems on the trunk and nonback body pains. There was no evidence on the effect of AIS screening on adult health outcomes. Conclusions and Relevance Screening can detect AIS. Bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of AIS screening on adult health outcomes.read more
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Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement.
US Preventive Services Task Force,David C Grossman,Susan J. Curry,Douglas K Owens,Douglas K Owens,Michael J. Barry,Karina W. Davidson,Chyke A. Doubeni,John W. Epling,Alex R. Kemper,Alex H. Krist,Ann E. Kurth,C. Seth Landefeld,Carol M. Mangione,Maureen G. Phipps,Michael Silverstein,Melissa A. Simon,Chien-Wen Tseng +17 more
TL;DR: The United States Preventive Services Task Force (USPSTF) concludes that the current evidence is insufficient and that the balance of benefits and harms of screening for adolescent idiopathic scoliosis cannot be determined.
Journal ArticleDOI
Development and validation of deep learning algorithms for scoliosis screening using back images
Junlin Yang,Kai Zhang,Kai Zhang,Hengwei Fan,Zifang Huang,Yifan Xiang,Jingfan Yang,Lin He,Zhang Lei,Yahan Yang,Ruiyang Li,Yi Zhu,Yi Zhu,Chuan Chen,Chuan Chen,Fan Liu,Haoqing Yang,Yaolong Deng,Weiqing Tan,Nali Deng,Xuexiang Yu,Xuan Xiaoling,Xiaofeng Xie,Xiyang Liu,Haotian Lin +24 more
TL;DR: Deep learning algorithms are developed that are superior to those of human specialists in detecting scoliosis, detecting cases with a curve ≥20°, and severity grading for both binary classifications and the four-class classification.
Journal ArticleDOI
Reducing the lifetime risk of cancer from spinal radiographs among people with adolescent idiopathic scoliosis
Journal ArticleDOI
Establishing consensus on the best practice guidelines for the use of bracing in adolescent idiopathic scoliosis
Benjamin D. Roye,Matthew E. Simhon,Hiroko Matsumoto,Hiroko Matsumoto,Prachi Bakarania,Hagit Berdishevsky,Lori A. Dolan,Kelly Grimes,Theodoros B Grivas,Michael T. Hresko,Lori A. Karol,Baron S. Lonner,Michael J. Mendelow,Stefano Negrini,Peter O. Newton,Eric C. Parent,Manuel Rigo,Luke Strikeleather,John Tunney,Stuart L. Weinstein,Grant Wood,Michael G. Vitale +21 more
TL;DR: Ad adherence to these best practice guidelines will lead to fewer sub-optimal outcomes in patients with AIS by reducing the variability in AIS bracing practices, and provide a framework future research.
Journal ArticleDOI
From genetics to epigenetics to unravel the etiology of adolescent idiopathic scoliosis
Gisselle Pérez-Machado,Ester Berenguer-Pascual,Miquel Bovea-Marco,Pedro Antonio Rubio-Belmar,Eva García-López,María José Garzón,Salvador Mena-Mollá,Federico V. Pallardó,Teresa Bas,Juan R. Viña,José Luis García-Giménez +10 more
TL;DR: The most relevant biomarkers are presented to help explain the etiopathogenesis of AIS and provide new potential biomarkers to be validated in large clinical trials so they can be finally implemented into clinical settings.
References
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The task force.
TL;DR: The Joint UNECE/Eurostat/OECD Working Group on Statistics for Sustainable Development (WGSSD) was commissioned by the CES in 2005 to develop a broad conceptual framework for measuring sustainable development based on the capital approach, and to identify a small set of indicators that could serve for international comparisons.
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TL;DR: The objective was to critically appraise six prominent systems for grading levels of evidence and the strength of recommendations as a basis for agreeing on characteristics of a common, sensible approach.
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Effects of bracing in adolescents with idiopathic scoliosis
TL;DR: Bracing significantly decreased the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis and the benefit increased with longer hours of brace wear.
Journal ArticleDOI
Epidemiology of adolescent idiopathic scoliosis
TL;DR: For example, this paper found that the prevalence of curves with higher Cobb angles is substantially higher in girls than in boys, and the female to male ratio rises from 1.5:1 to 3:1 and increases substantially with increasing age.
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