Cost effectiveness of school screening for scoliosis: A systematic review
Pourquoi ce travail est dans la base
Une base qui oublie comment elle a trouvé un travail ne peut pas être vérifiée. Voici les voies qui ont admis celui-ci.
Notice bibliographique
Résumé
IntroductionAdolescent idiopathic scoliosis, a deformity that consists of a lateral deviation and axial rotation of the spine, has a prevalence of 1-3% among children aged 10-16 years (1,2). Progression of the scoliosis curve particularly during the adolescent growth spurt can lead to severe deformity affecting both physical and psychosocial aspects of health. The use of braces to prevent curve progression during adolescence may avert the need for surgery (3). Thus, screening for scoliosis may be useful in order to detect those who may benefit from early treatment and prevent progression and the need for surgery.School screening programs for scoliosis vary with respect to the personnel involved (doctors, nurses, lay-persons), ages of children screened (ranges between 6-13 years), and screening tests used (one- tiered or two-tiered programs). The standard screening test used is the Adams Forward Bending Test; some programs use a scoliometer in conjunction with this test to quantify the degree of axial trunk rotation instead of relying on purely subjective observation (4-7). Moire topography has also been used as a second tier screen (5).School screening for scoliosis remains controversial with both Canadian and American Task Forces recommending against wide-based school screening programs (8,9) while professional organizations support school screening (American Academy of Orthopedic Surgeons, Scoliosis Research Society, American Academy of Pediatrics, Pediatric Orthopedic Society of North America) (10). Two main reasons contributing to this controversy are the lack of firm evidence supporting the efficacy of bracing as well as the low positive predictive values of the scoliosis school screening programs and by implication, questionable cost-effectiveness (11).When analyzing cost-effectiveness, one typically uses a cost-effectiveness ratio to compare costs (net expenditure of health care resources) and net improvement in health (a non-monetary measure) (12). Diamond and Kaul (13) contend that consumer protection principles are more relevant: i.e. determining the total magnitude of the expected benefit in the target population (e.g. in life-years, or quality-adjusted life years); the total cost (in per capita dollars); and a plan on how the program will be paid for. One can argue that in the case of scoliosis screening, the expected benefit in the target population would be prevention of surgical intervention. The underlying assumption is that appropriate conservative treatment at the right time can prevent progression of scoliosis and thereby avert the need for surgery.The objective of this paper was to examine the literature in terms of cost and cost-effectiveness for school screening for scoliosis and to synthesize the current evidence on this subject.MethodsThe systematic review of cost-effectiveness was part of a larger project that covered four main topics: technical efficacy of screening, clinical effectiveness, program effectiveness and costs and cost- effectiveness. An extensive literature search independently done by two research assistants and validated by a librarian included examination of four databases: Medline (1950-July 2010), Embase (1980- July 2010), CINAHL (1980-July 2010), EBM Reviews, including Cochrane Central Registry of Controlled Trials (until 2nd quarter 2010). Keywords included costs, cost-effectiveness linked with scoliosis, spinal deformities, back asymmetry, child, adolescent, screening, bending test, Moire topography. We identified 13 articles which were each reviewed by two persons (one orthopedist and one epidemiologist) using a standardized data extraction form. This form included a description of the population, the intervention, measures of effect/outcomes, key messages, the authors' conclusions, critical appraisal of the paper (strengths, weaknesses, validity of methodology and conclusions). The articles were then scored according to the Downs and Black method (14), which consists of a checklist assessing methodological quality of randomized and non-randomized health care interventions. …
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,009 | 0,002 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle