Given how Dr. Lonner immediately took that girl out of her brace once the Scoliscore came back at <41, I am guessing that surgeons might think it is unethical to brace these children.
I wonder if that is actually the standard of care now or is quickly heading towards becoming the standard of care. Linda, have you heard any noises about the ethics of bracing a child with a Scoliscore of <41? It may be viewed as outright unethical by surgeons. I could easily see that given the difficulty of brace treatment and the questionable efficacy to date.
The reason I was thinking about this is Dr. McIntire suggested that avoiding surgery was not the only goal with conservative treatments which was complete news to me! Maybe he was only referring to PT and not to bracing. PT might still be ethical for these kids but it should be made absolutely clear that the risk of not doing it in terms of reaching surgical range is zero for most kids with small curves.
Assuming the above is true, I don't see how a study population could ever be assembled for bracing or PT among kids with a Scoliscore <41. I am guessing it is a game changer for conservative treatments wherein their potential study population has decreased a lot and they can only work with ~25% of kids with smaller curves.
I predict going forward that it will become increasingly harder and harder to publish a study on surgery avoidance without first showing that the subjects had a Scoliscore of >41. And when the measurement precision is considered in light of the relevant Cobb angle range in subjects with a Scoliscore <41, I don't think those studies will ever be conducted/published due to noise.
Scoliscore seems like it might be a real game changer if it stands.
I wonder if that is actually the standard of care now or is quickly heading towards becoming the standard of care. Linda, have you heard any noises about the ethics of bracing a child with a Scoliscore of <41? It may be viewed as outright unethical by surgeons. I could easily see that given the difficulty of brace treatment and the questionable efficacy to date.
The reason I was thinking about this is Dr. McIntire suggested that avoiding surgery was not the only goal with conservative treatments which was complete news to me! Maybe he was only referring to PT and not to bracing. PT might still be ethical for these kids but it should be made absolutely clear that the risk of not doing it in terms of reaching surgical range is zero for most kids with small curves.
Assuming the above is true, I don't see how a study population could ever be assembled for bracing or PT among kids with a Scoliscore <41. I am guessing it is a game changer for conservative treatments wherein their potential study population has decreased a lot and they can only work with ~25% of kids with smaller curves.
I predict going forward that it will become increasingly harder and harder to publish a study on surgery avoidance without first showing that the subjects had a Scoliscore of >41. And when the measurement precision is considered in light of the relevant Cobb angle range in subjects with a Scoliscore <41, I don't think those studies will ever be conducted/published due to noise.
Scoliscore seems like it might be a real game changer if it stands.
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