STUDY DESIGN: This study was a retrospective cohort study. OBJECTIVE: To examine the criteria recommended in the literature for the school-based scoliosis screening program in Hong Kong. SUMMARY OF BACKGROUND DATA: School-based screening for scoliosis has been a controversy. Objectors to the policy were concerned about the high over-referral and false-positive rates. Recommendations were then made for improvement, but the feasibility of these recommendations has not been studied. METHODS: The cohort consisted of students in Grade 5 in 1995/1996 or 1996/1997 who underwent scoliosis screening in Hong Kong. Participants who had an angle of trunk rotation (ATR) ≥15°, 2 or more moiré lines, or presented significant clinical signs were referred for radiography. Screening histories and radiography records before the age of 19 years were extracted. The accuracy measures for different combinations of screening tests were examined. RESULTS: There were 115,178 students in the cohort, of which 3228 (2.8%) were referred for radiography. Among the 1406 students who displayed a curve ≥20° during screening, 257 (18.3%) were boys and 336 (23.9%) were identified as 16 years or older, ruling out the suggestion of screening only 10-year-old girls. The sensitivity and positive predictive value for the current referral criteria were 88.1% and 43.6%, respectively. The sensitivity would drop substantially if the use of moiré topography (39.8%) or clinical signs (55.5%) were discarded. With the inclusion of these 2 tests, the clinical effectiveness measures were robust to the cutoff for ATR, unless it was set below 10°. CONCLUSION: Selectively screening only premenarche girls was not feasible, as this screen would have missed a significant proportion of children with significant curvature. No refinement of the current protocol was necessary, although boys could be screened beginning at 12 years of age. The tandem use of ATR, moiré topography, and clinical signs was recommended for future studies.
STUDY DESIGN: This study was a retrospective cohort study. OBJECTIVE: To examine the criteria recommended in the literature for the school-based scoliosis screening program in Hong Kong. SUMMARY OF BACKGROUND DATA: School-based screening for scoliosis has been a controversy. Objectors to the policy were concerned about the high over-referral and false-positive rates. Recommendations were then made for improvement, but the feasibility of these recommendations has not been studied. METHODS: The cohort consisted of students in Grade 5 in 1995/1996 or 1996/1997 who underwent scoliosis screening in Hong Kong. Participants who had an angle of trunk rotation (ATR) ≥15°, 2 or more moiré lines, or presented significant clinical signs were referred for radiography. Screening histories and radiography records before the age of 19 years were extracted. The accuracy measures for different combinations of screening tests were examined. RESULTS: There were 115,178 students in the cohort, of which 3228 (2.8%) were referred for radiography. Among the 1406 students who displayed a curve ≥20° during screening, 257 (18.3%) were boys and 336 (23.9%) were identified as 16 years or older, ruling out the suggestion of screening only 10-year-old girls. The sensitivity and positive predictive value for the current referral criteria were 88.1% and 43.6%, respectively. The sensitivity would drop substantially if the use of moiré topography (39.8%) or clinical signs (55.5%) were discarded. With the inclusion of these 2 tests, the clinical effectiveness measures were robust to the cutoff for ATR, unless it was set below 10°. CONCLUSION: Selectively screening only premenarche girls was not feasible, as this screen would have missed a significant proportion of children with significant curvature. No refinement of the current protocol was necessary, although boys could be screened beginning at 12 years of age. The tandem use of ATR, moiré topography, and clinical signs was recommended for future studies.
Authors: Wei Wei Jiang; Connie Lok Kan Cheng; Jason Pui Yin Cheung; Dino Samartzis; Kelly Ka Lee Lai; Michael Kai Tsun To; Yong Ping Zheng Journal: Eur Spine J Date: 2018-06-25 Impact factor: 3.134
Authors: Xue Li; Zhaohua Huo; Zongshan Hu; Tsz Ping Lam; Jack Chun Yiu Cheng; Vincent Chi-Ho Chung; Benjamin Hon Kei Yip Journal: PLoS One Date: 2022-07-20 Impact factor: 3.752
Authors: Stefano Negrini; Sabrina Donzelli; Angelo Gabriele Aulisa; Dariusz Czaprowski; Sanja Schreiber; Jean Claude de Mauroy; Helmut Diers; Theodoros B Grivas; Patrick Knott; Tomasz Kotwicki; Andrea Lebel; Cindy Marti; Toru Maruyama; Joe O'Brien; Nigel Price; Eric Parent; Manuel Rigo; Michele Romano; Luke Stikeleather; James Wynne; Fabio Zaina Journal: Scoliosis Spinal Disord Date: 2018-01-10
Authors: Marina Pegoraro Baroni; Geronimo José Bouzas Sanchis; Sanderson José Costa de Assis; Rafael Gomes dos Santos; Silvana Alves Pereira; Klayton Galante Sousa; Johnnatas Mikael Lopes Journal: J Epidemiol Date: 2015-01-19 Impact factor: 3.211
Authors: Tomasz Kotwicki; Joanna Chowanska; Edyta Kinel; Dariusz Czaprowski; Marek Tomaszewski; Piotr Janusz Journal: Adolesc Health Med Ther Date: 2013-07-23
Authors: Hubert Labelle; Stephens B Richards; Marinus De Kleuver; Theodoros B Grivas; Keith D K Luk; Hee Kit Wong; John Thometz; Marie Beauséjour; Isabelle Turgeon; Daniel Y T Fong Journal: Scoliosis Date: 2013-10-31
Authors: Joshua J Thomas; Anthony A Stans; Todd A Milbrandt; Hilal M Kremers; William J Shaughnessy; A Noelle Larson Journal: J Pediatr Orthop Date: 2021-07-01 Impact factor: 2.537