The Clinical Effectiveness of School Screening Programme for Idiopathic Scoliosis in Malaysia
Journal Title: Malaysian Orthopaedic Journal - Year 2017, Vol 11, Issue 1
Abstract
Introduction: There is no large population size study on school screening for scoliosis in Malaysia. This study is aimed to determine the prevalence rate and positive predictive value (P PV) of screening programme for adolescent idiopathic scoliosis Materials and Methods: A total of 8966 voluntary school students aged 13-15 years old were recruited for scoliosis screening. Screening was done by measuring the angle of trunk rotation (ATR) on forward bending test (FBT) using a scoliometer. ATR of 5 degrees or more was considered positive. P ositively scree n ed students had stan d ard radiographs done for measurement of the Cobb angle. Cobb angle of >10° was used to diagnose scoliosis. The percentage of radiological assessment referral, prevalence rate and PPV of scoliosis were then calculated. Results: Percentage of radiol ogical assessment ref erra l (ATR >5 ° ) was 4.2% (182/43 81) for m ale and 5.0% (228/4585) for female. Only 38.0% of those with ATR >5° presented for further radiological assessment. The adjusted prevalence rate was 2.55% for Cobb angle >10°, 0.59% for >20° and 0.12% for >40°. The PPV is 55.8% for Cobb angle >10°, 12.8% for >20° and 2.6% for > 40°. Conclusions: This is the largest study of school scoliosis screening in Malaysia. The prevalence rate of scoliosis was 2.55%. The positive predictive value was 55.8%, which is adequate to suggest that the school scoliosis screening programme did play a role in early detection of scoliosis. However, a cost effectiveness analysis will be needed to firmly determine its efficacy.
Authors and Affiliations
Deepak AS, Ong JY, Choon DSK, Lee CK, Chiu CK, Chan CYW, Kwan MK
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