TY  - JOUR
T1  - A population-based study of school scoliosis screening
AU  - Yawn BP, Yawn RA, Hodge D, et al
Y1  - 1999/10/20
N1  - 10.1001/jama.282.15.1427
JO  - JAMA
SP  - 1427
EP  - 1432
VL  - 282
IS  - 15
N2  - Context 
                  Although school-based screening programs for adolescent idiopathic scoliosis
are mandated in 26 states in the United States, few program outcomes data
exist regarding the effectiveness of such programs.Objective 
                  To determine the effectiveness of a community-based school scoliosis
screening program.Design, Setting, and Participants 
                  Retrospective cohort study of children who attended kindergarten or
first grade at public or private schools in Rochester, Minn, during 1979-1982.
Children were followed up until age 19 years or until they left the school
district.Main Outcome Measures 
                  Number of children diagnosed and treated for scoliosis, based on results
from scoliosis screenings performed annually in grades 5 through 9, linked
to community medical records data; performance characteristics of the screening
program.Results 
                  Of the 2242 children screened, 92 (4.1%) were referred for further evaluation.
Of these, 68 (74%) had documented medical or chiropractic evaluation of scoliosis.
School screening identified 5 of the 9 children treated for scoliosis but
resulted in referrals for another 87 children who were not treated. The cumulative
incidence of diagnosed scoliosis in this population was 1.8% (95% confidence
interval [CI], 1.2%-2.3%) for curves of more than 10°, 1.0% (95% CI, 0.6%-1.5%)
for curves of at least 20°, and 0.4% (95% CI, 0.1%-0.6%) for curves of
40° or more; 0.4% (0.5% of girls and 0.3% of boys) were treated for scoliosis.
The positive predictive value of the school screening program for the identification
of treated scoliosis was 0.05 (95% CI, 0.048-0.052), with 448 children needed
to screen to identify 1 child who subsequently received treatment. The percent
positive agreement across consecutive years of screening varied from 7% to
30%.Conclusion 
                  In this population, school scoliosis screening identified some children
who went on to receive treatment but referred many more who did not. These
data should be considered in making decisions regarding school scoliosis screening.
SN  - 0098-7484
M3  - doi: 10.1001/jama.282.15.1427
UR  - http://dx.doi.org/10.1001/jama.282.15.1427
ER  -