Screening for scoliosis-New recommendations,old dilemmas,no straight solutions

• 作者: Ejgil Jespersen Maciej Płaszewski Weronika Grantham
• 来源期刊: 世界骨科杂志:英文版
• 学科: 医学
• 关键词: SCOLIOSIS SCREENING Tests Programs RECOMMENDATIONS Guidelines Principles BENEFITS HARMS Trustworthiness
• 年，卷（期）: 2020,（9）
• 页码范围: 364-379
• 页数: 16页
• 分类号: R73

摘要

This opinion review considers the prevailing question of whether to screen or notto screen for adolescent idiopathic scoliosis. New and improved standards ofpeople-oriented care and person-centredness, as well as improved principles ofpreventive screening and guideline development, have been postulated andimplemented in health care systems and cultures. Recommendations addressingscreening for scoliosis differ substantially, in terms of their content, standards ofdevelopment and screening principles. Some countries have discontinued issuingrecommendations. In the last decade, a number of updated and newrecommendations and statements have been released. Systematically developedguidelines and recommendations are confronted by consensus and opinion-basedstatements. The dilemmas and discrepancies prevail. The arguments concentrateon the issues of the need for early detection through screening in terms of theeffectiveness of early treatment, on costs and cost-effectiveness issues, scientificand epidemiologic value of screenings, and the credibility of the sources ofevidence. The problem matter is of global scale and applies to millions of people.It regards clinical and methodological dilemmas, but also the matter of vulnerableand fragile time of adolescence and, more generally, children’s rights. Thedecisions need to integrate people’s values and preferences – screening tests needto be acceptable to the population, and treatments need to be acceptable forpatients. Therefore we present one more crucial, but underrepresented in thediscussion, issue of understanding and implementation of the contemporaryprinciples of person-centred care, standards of preventive screening, andguideline development, in the context of screening for scoliosis.