Screening for adolescent idiopathic scoliosis is more accurate when performed by healthcare professionals compared to untrained parents: a diagnostic accuracy study.
Eur Spine J
; 31(9): 2339-2347, 2022 09.
Article
in En
| MEDLINE
| ID: mdl-35389103
ABSTRACT
BACKGROUND:
Many countries ended their professional scoliosis screening due to ongoing controversies. Discontinuation resulted in a shift of screening responsibility from trained healthcare professionals to untrained parents.PURPOSE:
To compare the diagnostic accuracy of picture-based scoliosis screening between parents and healthcare professionals.METHODS:
In this cross-sectional diagnostic accuracy study, parents and healthcare professionals assessed pictures of 28 children (20 AIS & 8 non-scoliosis). Each child had two photographs (standing position & full-flexion during forward-bending test) that were presented simultaneously. Lumbar and thoracic curves were represented with a range in severity (10 to > 40°). The assessors had to answer whether they detected an abnormality that ought to be referred to a specialist. Measures of accuracy were calculated for both groups and various curve severities.RESULTS:
All pictures were assessed by 101 parents and 122 healthcare professionals. The sensitivity for detecting scoliosis was significantly lower in untrained parents (63.8%, [95% CI 61.7-65.9%]) compared to healthcare professionals (73.4%, [95% CI 71.6-75.2%]; p < 0.001), while the specificity was not significantly different (63.6%, [95% CI 60.2-66.9%] vs. 65.3%, [95% CI 62.2-68.3%]; p = 0.49). Healthcare professionals consistently recognized the gibbus as a warning sign when referring patients, while untrained parents highlighted various regions, including the spine, gibbus and scapula regions.CONCLUSION:
The sensitivity of screening for scoliosis was significantly lower when it was performed by parents, while the false-positive rate was similar to healthcare professionals. The window of opportunity for conservative treatment may be missed when parents rather than professionals are responsible for screening.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Scoliosis
/
Kyphosis
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adolescent
/
Child
/
Humans
Language:
En
Journal:
Eur Spine J
Journal subject:
ORTOPEDIA
Year:
2022
Document type:
Article
Affiliation country:
Netherlands