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Dorsal Shear Forces

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  • #16
    Hi Pooka1

    Do you happen to have the list of articles that you are referring to, makes it easier for me to check if I actually have the full articles? I have some of Weiss articles but not all of them. Many of his papers are published in “Stud Health Technol Inform” and I do not have any of them.

    You are correct in your thought that in retrospective studies there is a high chance of data selection, it is therefore of outmost importance that data selection process with criteria for inclusion/exclusion is highlighted in respective papers.

    As for your third question why majority of Weiss are not conducted/published as novel research papers.
    I believe that the following abstract might help to illustrate the difficulty in getting good randomized controlled trials conducted when it comes to scoliosis.

    Preference assessment of recruitment into a randomized trial for adolescent idiopathic scoliosis.

    Dolan LA, Sabesan V, Weinstein SL, Spratt KF.
    J Bone Joint Surg Am. 2008 Dec;90(12):2594-605.

    BACKGROUND: Randomized controlled trials are powerful tools to evaluate the outcomes of clinical treatments. However, these trials tend to be expensive and time-consuming, and their conclusions can be threatened by several limitations. This study estimated the strength of three common limitations (underenrollment, selective enrollment, and nonadherence to protocol) in a proposed study of adolescent idiopathic scoliosis. METHODS: Patients with scoliosis and their parents were asked to complete a web-based survey about their preferences concerning a hypothetical randomized trial. Adolescents without scoliosis and their parents also participated. Surveys included questions about treatment preference, likelihood of participation, required risk reduction, and propensity to drop out or choose a different treatment while enrolled in the study. RESULTS: Ninety adolescents and eighty-three parents participated. Observation was preferred to bracing by the majority of subjects. Overall, 33% of the parents and adolescents would both agree to participate in the hypothetical trial. Of the subjects who would not agree to participate, the majority would rather share the decision-making responsibility with the physician than have the treatment chosen in a random fashion. Many of the subjects would consider changing treatments during the course of the trial if they were not satisfied with the outcomes; the majority of parents who preferred bracing would consider crossing over to the bracing arm if their children were randomized to observation. CONCLUSIONS: Recruitment into a randomized trial of bracing compared with observation for the treatment of adolescent idiopathic scoliosis may well be problematic, considering the relatively small percentage of families who said they would consider randomization. Additionally, the threat of nonadherence to protocol may be strong and must be addressed in the protocol of the trial. Most families wanted to make the treatment decision with the physician in lieu of randomization; therefore, the role of the physician in patient recruitment and retention should not be underestimated.


    These might be reasons why Weiss is not producing that much novel research and I believe that they certainly are factors for other therapies not doing it.
    A practitioner seeking answers to enhance the treatment of Idiopathic Scoliosis

    Blog: www.fixscoliosis.com/

    Comment


    • #17
      No I don't have any of the articles.

      I think the results of that article you posted are reasonable and expected. It may be a long time before anything is known about the efficacy of bracing. Maybe never. I think the surgical routes, both fusion and non-fusion will be the obvious and more efficacious treatments in the future. I think they are now.

      Quackwatch wrote back to me about Schroth. I posted the response in the Non Surgical section of the Adult section but here it is again (written by a Quackwatch consultant)...

      "I have done several PubMed and OVID searches on Schroth and Scoliosis. All I can find is a handful of abstracts (around 30). None are of controlled studies. Several studies are prospective looks at the Schroth method, but none have large numbers of patients, none have long term follow up and none have controls. And only abstracts can be found- no actual articles. From the best I can tell, most of the "journals" in which these articles appear are not peer reviewed. A majority of the articles are written by HR Weiss, the medical director of a Schroth clinic. Many of his articles attack surgery for scoliosis with untrue "facts." He does not appear to be an unbiased researcher. Most important- there are no prospective, controlled studies which would indicate there is any basis for the use of the Schroth method."

      And by the way, it isn't clear if pubmed only carries peer-reviewed journals.
      Sharon, mother of identical twin girls with scoliosis

      No island of sanity.

      Question: What do you call alternative medicine that works?
      Answer: Medicine


      "We are all African."

      Comment


      • #18
        Hi Pooka1

        You don’t need to have any of his articles; I have a few of them in my collection of articles related to scoliosis and the spine.
        I was just wondering if you have the names of the few articles that you were interested in and I can see if I have them and see what we can learn from them.

        As for the reply to you form Quackwatch:

        I do not know what Quackwatch stance is on Weiss HR, but I am surprised and disappointed by their lack of proper research on his articles. They should have at least read them before taking a stance.
        They say that they can only find abstracts and no articles. We must understand that these journals are not charity organizations so one must purchase these articles, price ranging between $15 – 35 per article or subscribe to them.
        A quick look at the journals that Weiss HR is published in, one can see many reputable peer reviewed journals, out of 8 different journals that has published his papers 6 are peer reviewed and I do not know the status of the remaining two, but I would suspect that they are also peer reviewed.
        I do not believe that Weiss HR is not biased, but neither is any surgeon for that matter. This is why papers are subjected review of their professional peers, to weed out any unsubstantiated claims. I do believe that his papers will have substantial references to get published in respected journals and they should be published so that an academic debate can take place to ensure that the future patients will get the best treatments developed/available.


        I also found this regarding PubMed. most are peer reviewed, but not all.
        link below

        FAQ Peer-Reviewed/Refereed Journals in PubMed
        A practitioner seeking answers to enhance the treatment of Idiopathic Scoliosis

        Blog: www.fixscoliosis.com/

        Comment


        • #19
          dorsal shear forces

          Getting back to the start of this thread, Dorsal Shear Forces, I’ve made 3 posts on my blog with few illustrations, that may help to explain dorsal shear loads and how they are unique to humans and what influence they can have.

          I suggest that you read them in this order.
          1. The Human Spine and Idiopathic Scoliosis
          2. Dorsal Shear Forces and Idiopathic Scoliosis
          3. Dorsal Shear Loads affects rotational stability in the spine

          This knowledge highlights the importance of the sagittal alignment the development of thoracic idiopathic scoliosis and why it is unique to humans.

          I hope you'll like it.
          A practitioner seeking answers to enhance the treatment of Idiopathic Scoliosis

          Blog: www.fixscoliosis.com/

          Comment

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