Common School Scoliosis Screening Test Lacks Precision

Forward bending test used in most programs may be insufficient for detecting spine curvature
By Jeff Muise
HealthDay Reporter

TUESDAY, May 25 (HealthDay News) -- The simple and common forward bending test (FBT) used in school scoliosis screening programs lacks precision for detecting spinal curvature and by itself is insufficient, according to a meta-analysis published in the May 1 issue of Spine.

Daniel Yee Tak Fong, Ph.D., of the University of Hong Kong, and colleagues conducted a meta-analysis of 36 studies of school scoliosis screening programs for adolescents that used either the FBT, angle of trunk rotation, or Moiré topography.

Using pooled data, the researchers calculated that the radiography referral rate was 5 percent. The positive predictive value for detecting curves of 10 degrees or more was 28 percent, for detecting curves of 20 degrees or more was 5.6 percent, and for treatment was 2.6 percent. The programs that used the FBT only (64 percent) had a higher referral rate but a lower positive predictive value for curvature than programs using the other tests. Only 13 studies reported treatment information, and only one study followed the subjects until skeletal maturity.

"In conclusion, there was substantial heterogeneity across studies due to the use of different screening tests and different study sizes. The use of the FBT alone in school scoliosis screening is insufficient. To properly assess the clinical effectiveness of school scoliosis screening, we need large retrospective cohort studies with students followed by skeletal maturity," the authors write.

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