de Groot Charlotte, Heemskerk Johan L, Willigenburg Nienke W, Altena Mark C, Kempen Diederik H R
Department of Orthopedic and Trauma Surgery, OLVG, P.O. Box 95500, 1090 HM Amsterdam, The Netherlands.
Department of Orthopedic Surgery, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands.
Children (Basel). 2022 Apr 15;9(4):563. doi: 10.3390/children9040563.
(1) In countries where scoliosis screening programs ended, the responsibility for detection shifted from healthcare professionals to parents. Since recognizing scoliosis is difficult for parents, more patients are presenting late. Increased awareness of scoliosis may favor earlier detection. This study examines the effect of educating parents to recognize scoliosis. (2) In this cross-sectional study a consecutive group of parents completed a digital assessment. They had to complete two identical series of fourteen cases (eight with scoliosis and six without). Each case displayed two photographs of the child's back; one in standing position and one during forward-bending. Based on visual inspection, parents had to indicate if the child had to be referred to a physician. After assessing the first series, information was given on how to detect scoliosis. Subsequently, parents assessed the second series of cases. Sensitivity and specificity were calculated before and after education. (3) A total of 100 parents completed the assessment. The sensitivity to detect scoliosis was slightly but significantly higher after education (68.8% versus 74.0%; = 0.002), while specificity was not (74.0% versus 74.8%; = 0.457). (4) This study showed that educating parents improved their ability to recognize scoliosis without increasing the false positive referral rate. Although written instructions can bridge the gap with professional screening programs, the overall sensitivity in this study remained low. Therefore, education can improve the awareness and ability to detect scoliosis, but will not replace screening by professionals.
(1) 在那些终止了脊柱侧弯筛查项目的国家，疾病检测的责任从医护人员转移到了家长身上。由于家长很难识别脊柱侧弯，更多的患者就诊时病情已发展到较晚阶段。提高对脊柱侧弯的认识可能有助于更早发现病情。本研究旨在探讨对家长进行脊柱侧弯识别教育的效果。(2) 在这项横断面研究中，一组连续的家长完成了一项数字评估。他们需要完成两组相同的共14个病例（其中8例为脊柱侧弯，6例无脊柱侧弯）。每个病例展示了孩子背部的两张照片，一张是站立位，一张是前屈位。家长需通过目视检查指出该儿童是否需要转诊给医生。在评估第一组病例后，向家长提供了关于如何检测脊柱侧弯的信息。随后，家长对第二组病例进行评估。计算教育前后的灵敏度和特异度。(3) 共有100名家长完成了评估。教育后检测脊柱侧弯的灵敏度略有提高但具有显著差异（68.8% 对 74.0%；P = 0.002），而特异度没有变化（74.0% 对 74.8%；P = 0.457）。(4) 本研究表明，对家长进行教育可提高他们识别脊柱侧弯的能力，且不会增加假阳性转诊率。尽管书面指导可以弥补与专业筛查项目之间的差距，但本研究中的总体灵敏度仍然较低。因此，教育可以提高对脊柱侧弯的认识和检测能力，但无法取代专业人员的筛查。
