title: Early detection of idiopathic scoliosis - analysis of three screening models.
abstract: BACKGROUND
  The prevalence of lateral curvatures of the spine ranges from 0.3% to 15.3% in the general population. The aim of the study was to develop and compare three different screening tests for idiopathic scoliosis (IS) with respect to their effectiveness and costs.
  
  
  METHODS
  The Delphi method was used to assess the efficacy of each screening algorithm in detecting IS in the population. An economic analysis was also performed.
  
  
  RESULTS
  Diagnostic Algorithm 1 for IS comprised a screening examination performed by nurses and a general practitioner (GP) with verification by specialists. The unit cost of carrying out diagnostic work-up for IS in Algorithm 1 was €94 per child. The second algorithm involved the use of the moiré computer method, followed by verification by a specialist. The lower unit cost of €86 per child of diagnostic work-up according to Algorithm 2 was due to fewer stages compared to Algorithm 1. The highest effectiveness with the highest costs were found for the third algorithm, with only one stage, a specialist's consultation (cost €153 per child).
  
  
  CONCLUSIONS
  The number of stages in an algorithm does not correlate positively with its efficacy or cost. The recommended scheme is Algorithm 3, where children are examined by rehabilitation specialists or a physiotherapist using a scoliometer and an inclinometer. The use of the apparently most expensive scheme (Algorithm 3) should result in lowering the costs of treatment of established idiopathic scoliosis and, in the long term, prove to be the most cost-effective solution for the health care system.
authors.affiliation: Department of Rehabilitation, Faculty of Medical Sciences, University of Warmia and Mazury, Olsztyn, Poland.
authors.forename: Ireneusz M
authors.initials: IM
authors.lastname: Kowalski
authors.affiliation: Department of Osteopathic Medicine, Medical College of Podkowa Lesna, Podkowa Lesna, Poland ; Department of Physiotherapy, Medical College of Podkowa Lesna, Podkowa Lesna, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Dwornik
authors.affiliation: Regional Children's Rehabilitation Hospital in Ameryka, Olsztynek, Poland.
authors.forename: Roman
authors.initials: R
authors.lastname: Lewandowski
authors.affiliation: Department of Chemistry, Faculty of Environmental Management and Agriculture, University of Warmia and Mazury, Olsztyn, Poland.
authors.forename: Bogusław
authors.initials: B
authors.lastname: Pierożyński
authors.affiliation: Department of Rehabilitation, Physical and Sports Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Juozas
authors.initials: J
authors.lastname: Raistenskis
authors.affiliation: Faculty of Medical Sciences, Silesian College of Computer and Biological Sciences, Chorzow, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: J Krzych
authors.affiliation: Institute of Physiotherapy, Faculty of Health Science, Jan Kochanowski University, Kielce, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Kiebzak
keywords: idiopathic scoliosis; scoliosis prevention; screening; spinal deformity