Goldberg C J, Dowling F E, Fogarty E E, Moore D P
Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Ireland.
Spine (Phila Pa 1976). 1995 Jun 15;20(12):1368-74.
Analysis of scoliosis screening in Dublin (1979-1990) of patients who passed significant levels (25 degrees and 40 degrees) and received orthotic treatment or surgery.
To reexamine the basis of school scoliosis screening.
The United States Preventive Services Task Force questioned the validity of school screening for adolescent idiopathic scoliosis because there is insufficient scientific evidence to justify it.
New entrants (1986-87) to the screening program were used to test the validity of the screening methods. The total screened population, proportions reaching significant Cobb angles or undergoing treatment, were compared across the time period.
The sensitivity of the forward bend test in detecting or predicting 40 degrees scoliosis was 0.83, the specificity was 0.99, and the predictive value was 0.08. The proportion prescribed braces declined significantly (P < 0.01), but there was no significant change in those with scoliosis greater than 24 degrees (0.18%) or 39 degrees (.08%) nor was there a significant change in the numbers needing surgery (.045%).
The incidence of significant scoliosis and of surgery is low and independent of changes in bracing policy. The validity of screening to cause significant change in prevalence must be challenged.
对都柏林（1979 - 1990年）脊柱侧弯筛查进行分析，这些患者侧弯度数达到显著水平（25度和40度）并接受了支具治疗或手术。
重新审视学校脊柱侧弯筛查的依据。
美国预防服务工作组质疑学校对青少年特发性脊柱侧弯进行筛查的有效性，因为没有足够的科学证据证明其合理性。
使用筛查项目的新参与者（1986 - 1987年）来测试筛查方法的有效性。比较整个时间段内的总筛查人群、达到显著Cobb角或接受治疗的比例。
前屈试验检测或预测40度脊柱侧弯的敏感性为0.83，特异性为0.99，预测值为0.08。佩戴支具的比例显著下降（P < 0.01），但侧弯大于24度（0.18%）或39度（0.08%）的患者数量没有显著变化，需要手术的患者数量也没有显著变化（0.045%）。
显著脊柱侧弯和手术的发生率较低，且与支具治疗政策的变化无关。必须对筛查能否导致患病率发生显著变化的有效性提出质疑。
