Screening para la escoliosis en adolescentes: Exposición de recomendaciones.(I)

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for idiopathic scoliosis in adolescents and the supporting scientific evidence and updates the 1996 recommendations contained in the Guide to Clinical Preventive Services, 2d ed.1 In 1996, the USPSTF found insufficient evidence to recommend for or against routine screening of asymptomatic adolescents for idiopathic scoliosis (I recommendation).1 Since then, the USPSTF criteria to rate the strength of the evidence have changed. Therefore, the recommendation statement that follows has been updated and revised based on the current methodology and rating of the strength of the evidence.2 Explanations of the current USPSTF ratings and of the strength of overall evidence are given in Tables 1 and 2, respectively. The complete information on which this statement is based is contained in the brief update «Screening for Idiopathic Scoliosis in Adolescents”3 at the USPSTF Web site (http://www.preventiveservices.ahrq.gov). The recommendation statement and brief update also are available from the AHRQ Publications Clearinghouse (telephone: 1-800-358-9295; e-mail: ahrqpubs@ahrq.gov). The recommendation statement also is available through the National Guideline Clearinghouse (http://www.guideline.gov).

Summary of Recommendation

The USPSTF recommends against the routine screening of asymptomatic adolescents for idiopathic scoliosis. D recommendation.

The USPSTF did not find good evidence that screening asymptomatic adolescents detects idiopathic scoliosis at an earlier stage than detection without screening. The accuracy of the most common screening test (i.e., the forward bending test with or without a scoliometer) in identifying adolescents with idiopathic scoliosis is variable, and there is evidence of poor follow-up of adolescents with idiopathic scoliosis who are identified in community screening programs.

The USPSTF found fair evidence that treatment of idiopathic scoliosis during adolescence leads to health benefits (decreased pain and disability) in only a small proportion of persons. Most cases detected through screening will not progress to a clinically significant form of scoliosis. Scoliosis needing aggressive treatment, such as surgery, is likely to be detected without screening.

The USPSTF found fair evidence that treatment of adolescents with idiopathic scoliosis detected through screening leads to moderate harms, including unnecessary brace wear and unnecessary referral for specialty care. As a result, the USPSTF concluded that the harms of screening adolescents for idiopathic scoliosis exceed the potential benefits.

American Family Physician® > Vol. 71/No. 10 (May 15, 2005).

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