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Abstract
Recommendations addressing school screening for adolescents with idiopathic scoliosis are contradictory. Consequently a critical evaluation of the methodological quality of available systematic reviews, including those upon which these recommendations are based, was conducted. Articles meeting the minimal criteria to be considered a systematic review were included for a best evidence synthesis, umbrella review of secondary studies. The primary outcome measure was "any recommendation addressing the continuation, or not, of school screening programs". Multiple general bibliographic databases, guideline registries, as well as websites of institutions were searched. The AMSTAR tool was used to critically appraise the methodology of included reviews. Venn diagrams were created to examine potential overlaps across included papers within different reviews. Six reviews undertaken between 2002 and 2011, scored as moderate to low quality, were included. The 2012 US Preventive Services Task Force recommendation against screening was found to be based on an outdated (2004) low-quality review, whilst two higher quality and more recent (2009 and 2010) reviews support the continuation of school screening programs. As the existing recommendations supporting screening are based on moderate quality evidence whilst the recommendations against screening are based on low-quality evidence, the latter recommendations appear to be both unconvincing and methodologically invalid.
Highlights
The 2012 US Preventive Services Task Force recommendation against screening was found to be based on an outdated (2004) low-quality review, whilst two higher quality and more recent (2009 and 2010) reviews support the continuation of school screening programs
As the existing recommendations supporting screening are based on moderate quality evidence whilst the recommendations against screening are based on lowquality evidence, the latter recommendations appear to be both unconvincing and methodologically invalid
Adolescent idiopathic scoliosis (AIS) is considered by some authors to be a condition fulfilling the criterion of being an ‘‘important healthcare problem meeting the requirements for a screening program’’ [1, 2]: the prevalence is estimated to be at 2–3 % of adolescents aged 10–16 years, the condition, depending on the severity of the deformity and with individual variations, affecting both physical and psychological functioning and with pain and decreased quality of life in the long term [1]
Summary
Adolescent idiopathic scoliosis (AIS) is considered by some authors to be a condition fulfilling the criterion of being an ‘‘important healthcare problem meeting the requirements for a screening program’’ [1, 2]: the prevalence is estimated to be at 2–3 % of adolescents aged 10–16 years, the condition, depending on the severity of the deformity and with individual variations, affecting both physical and psychological functioning and with pain and decreased quality of life in the long term [1]. National institutions and professional organizations in different countries and/or states currently either opt for mandatory screening [15], recommendation [2, 16–20] or discourage screening [1, 3, 6, 21–23].
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Schedule a callMore From: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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