[Idiopathic scoliosis in adolescents; an inventory into the possibilities of studying the efficacy of screening and treatment]. / Idiopathische scoliose bij adolescenten; inventarisatie van mogelijkheden van onderzoek naar de effectiviteit van screening en behandeling.

OBJECTIVE: To collect information for the purpose of establishing starting points and possibilities for a cost-effectiveness analysis of screening for adolescent idiopathic scoliosis (AIS). DESIGN: Interviews, literature review, questionnaires, an estimation of costs and discussions with experts and involved parties. METHOD: Following an initial interview with 16 orthopaedic surgeons and school doctors a literature study into the efficacy of treatment was carried out regarding the years 1989-1999. The variation in current practice was delineated by means of a questionnaire sent to all 51 municipal health services in the Netherlands. The costs of screening and treatment were estimated on the basis of health insurance premiums and a municipal health service cost model. All of the results were presented to five methodological experts and finally the study results and the recommendations of the five methodological experts were evaluated during a meeting of persons especially invited for this purpose. RESULTS: Screening for AIS was established to realise early diagnosis and treatment with a brace, so as to reduce unsatisfactory cosmetic outcomes and the need for surgery. Screening was performed using the bending test and was performed in 40/48 (83%) of the participating municipal health services. The overall costs of screening and treatment amount to 6 million euros per year. There was no convincing evidence that the screening programme was sufficiently sensitive and bracing sufficiently effective. Neither was there proof of the opposite. The following was recommended: obtain reliable data by carrying out a randomised controlled trial on the effectiveness of treating AIS with bracing in an early stage; carry out a case-control study combined with a retrospective patient follow-up study to evaluate the current screening practice; draw up a national standard for the screening of postural disorders in youth healthcare to ensure effective practice.

Shortening a quality of life questionnaire for adolescents with chronic pain and its psychometric qualities.

Chronic pain is a common experience in adolescence. To measure its influence on quality of life in adolescents with chronic headache, Langeveld developed the 71-item scale, Quality of Life Headache-Youth. On the basis of this questionnaire we develop a shortened list, also suitable for other pain locations to enhance compliance. For this, we tested a sample of 98 adolescents from an open population with chronic benign pain. This article presents the psychometric qualities of the shortened version, named the Quality of Life Questionnaire for Adolescents with Chronic Pain. The original version could be reduced to 44 items which showed suitable internal consistency and construct validity against COOP/WONCA charts.