title: To screen or not to screen for adolescent idiopathic scoliosis? A review of the literature.
abstract: OBJECTIVE
  Over the years, there has been much debate about the desirability and efficacy of screening for adolescent idiopathic scoliosis. To analyse the current evidence from a public health point of view a renewed evaluation of the literature was performed.
  
  
  METHODS
  Literature review.
  
  
  METHODS
  We performed two literature searches: from January 2000 to April 2015 for systematic reviews or guidelines on screening for adolescent idiopathic scoliosis and from January 2009 to April 2015 for all studies on adolescent idiopathic scoliosis and screening methods. We evaluated if screening for adolescent idiopathic scoliosis fulfils the criteria of the UK National Screenings Committee for appraising a screening programme.
  
  
  RESULTS
  Adolescent idiopathic scoliosis is a condition with an unpredictable natural history. The optimal age and frequency of screening are unknown; it is not possible to predict which patients will need (conservative or surgical) treatment. The Forward Bending Test has a positive predictive value of 2.6% and a sensitivity of 56% (95% CI 23-88%) for (conservative or surgical) treatment, and is therefore not valid enough for use in a screening programme. There seems to be sufficient evidence that brace treatment is effective for preventing progression of adolescent idiopathic scoliosis. It is not clear if screening is cost effective.
  
  
  CONCLUSIONS
  Despite evidence that brace treatment is effective for preventing progression of adolescent idiopathic scoliosis, the benefits from the screening programme do not outweigh the harms. From a Public Health point of view, there is not enough evidence to support a screening programme for adolescent idiopathic scoliosis.
authors: TNO Child Health, Leiden, The Netherlands; GGD Hollands Noorden, Alkmaar, The Netherlands.
authors: J A
authors: JA
authors: Deurloo
authors: TNO Child Health, Leiden, The Netherlands. Electronic address: paul.verkerk@tno.nl.
authors: P H
authors: PH
authors: Verkerk
mesh_terms: D000293:Adolescent; D006801:Humans; D008403:Mass Screening / Q000592:standards*; D017410:Practice Guidelines as Topic; D012600:Scoliosis / Q000175:diagnosis*; D006113:United Kingdom
keywords: Forward bending test; Scoliosis; Screening