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Thread: The Braist Study

  1. #61
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    Quote Originally Posted by Pooka1 View Post
    Nobody prefers surgery. You seem to think that choosing not to brace is choosing surgery. Most cases do NOT progress to surgery so that makes no sense. Most braced kids are braced needlessly. BrAIST showed this yet again. This is not new.
    BrAIST showed much more

    'In the analysis that included both groups, the rate of treatment success was 72 percent among children with bracing, compared with 48 percent among those under observation. The benefit increased the longer bracing was worn. More than 90 percent of the children who were successfully treated wore their braces more than 13 hours a day.'

    Why do you are so sure that all parents of the brace group took a wrong decision? Do you believe the cases with significative lower chances to have surgery because the use of brace are not significant?
    Or do you believe the chances to avoid surgery in those cases, have not decreased in a significative way? Do you believe the same outcomes would have been obteined if instead of using braces, they would have only had a bath every day?

    Quote Originally Posted by Pooka1 View Post
    I think kids should know that even if they wear their brace as prescribed, if they are >30* at maturity, there is no guarantee they can avoid reaching surgical range. The brace is NO GUARANTEE to avoid surgery and I wonder how many kids are clear on this point.
    Probably it should to be as you as you say, but also they should know that without the use of brace, probably they will need surgery and nobody may assure them to be free of complications/limitations and back problems for ever as surely everone wants.

  2. #62
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    We need to know the final curve magnitudes to respond to your post. Ask yourself why they might not have been published with the original article.

    If many of the "successes" ended up >40* and even >45*, would you consider those successes?

    And when we do see the final curve magnitudes, I want to see the medians. There is much that isn't apparent if only publishing averages. Actually I want so see all the data if possible after the authors finish publishing all the articles they plan.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

  3. #63
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    "The benefit increased the longer bracing was worn. More than 90 percent of the children who were successfully treated wore their braces more than 13 hours a day."

    Here's another slant...

    What percentage of kids who wore the brace more than 13 hours a day were "successful"?
    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."

  4. #64
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    Quote Originally Posted by Pooka1 View Post
    We need to know the final curve magnitudes to respond to your post. Ask yourself why they might not have been published with the original article.
    I asked myself and I don't believe what it seems you are believing

    Quote Originally Posted by Pooka1 View Post
    If many of the "successes" ended up >40* and even >45*, would you consider those successes?
    All were <=50. Thinking that the chances to ending >50 without the use of brace would have been greater, I see it as succesful cases.
    I think they are right in remarking the fact that group using brace where more succesful.
    As I don't believe what it seems you are believing, I don't believe many of succesful cases ended in 50 and many of the failure cases of the other group ended in 51.
    And also they are right in remarking that much more cases among the succesful ones wore their braces more than 13 hours a day. As I don't believe many of succesful cases ended in 50 and many of the failure cases of the observation group ended in 51 , I don't think failure cases wore their braces the same amount of hours a day.

    Quote Originally Posted by Pooka1 View Post
    And when we do see the final curve magnitudes, I want to see the medians. There is much that isn't apparent if only publishing averages. Actually I want so see all the data if possible after the authors finish publishing all the articles they plan.
    Me too, but is not the first case I see doing that.

  5. #65
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    They not said anything about reduction in brace and spine flexibility Probably were not good and seems that brace was not complemented with nothing more (as exercises) and anyway the brace group were more succesful..

  6. #66
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    Quote Originally Posted by flerc View Post
    They not said anything about reduction in brace and spine flexibility Probably were not good and seems that brace was not complemented with nothing more (as exercises) and anyway the brace group were more succesful..
    You keep mentioning this but what is the evidence for it? There was NO correlation between flexibility, percent correction in brace, and progression in everyone's favorite bracing study(TM), Katz et al. (2010).

    p. 1351, left column, middle...

    http://scanscoliosis.com/files/DOC075.pdf

    Reduction in brace, flexibility, PT as relating to decreased progression are all faith positions at the moment, not science.
    Last edited by Pooka1; 10-14-2013 at 11:35 AM.
    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."

  7. #67
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    Quote Originally Posted by Pooka1 View Post
    You keep mentioning this
    Of course, why do you believe braces may work in order to stop/reduce a curve? Just only because they are uncomfortable? It's an interesting factor, surely the main/only one behind K-Taping, but is dificult to believe to be the same in braces and I don't believe K-Tapping may have the same effectiveness by their own.

    Quote Originally Posted by Pooka1 View Post
    but what is the evidence for it?
    Which is the evidence showing that reduction in brace, spine flexibility and something else has nothing to do?

    Quote Originally Posted by Pooka1 View Post
    There was NO correlation between flexibility, percent correction in brace, and progression in everyone's favorite bracing study(TM), Katz et al. (2010).

    p. 1351, left column, middle...

    http://scanscoliosis.com/files/DOC075.pdf
    Sorry, what I'm reading in this page is not affirming that reduction in brace and flexibility has nothing to do (they saw the opposite in other studies), but may be not significant compared with hours per day use. Surely true when initial curves and Risser are lowest.. is not obvious for you why?
    Also they are not talking about the same concept of flexibility I'm talking..it seems to be true since they meassure it in a very different way.

    Quote Originally Posted by Pooka1 View Post
    Reduction in brace, flexibility, PT as relating to decreased progression are all faith positions at the moment, not science.
    You seems to have an extreme limited idea about what science is.

  8. #68
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    One of the better bracing studies shows NO correlation with things you think are important to lack of progression. That suggests the previous studies which appeared to show some correlation might be flawed. Or likely flawed. This game is tough.

    I should have said "no good evidence" which may equate with "no evidence" depending on how poorly done those other studies are that purport to show a correlation.
    Last edited by Pooka1; 10-14-2013 at 04:03 PM.
    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."

  9. #69
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    Quote Originally Posted by flerc View Post
    You seems to have an extreme limited idea about what science is.
    I have a standard idea. You, in contrast, tend towards magical thinking.
    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."

  10. #70
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    Quote Originally Posted by Pooka1 View Post
    One of the better bracing studies shows NO correlation with things you think are important to lack of progression. That suggests the previous studies which appeared to show some correlation might be flawed. Or likely flawed. This game is tough.

    I should have said "no good evidence" which may equate with "no evidence" depending on how poorly done those other studies are that purport to show a correlation.
    Sorry again, may you show me WHERE they shows no correlation? I want to know if it is not only/mainly in cases with lowest Risser and curve. Certainly if this would be the most serious study and the other showing the contrary would be so flawed as it would seems logic to think in a clear evidende about no correlation, some reason should to be, we should to analyze which could be. Science is not just only an intrincated and complex game to justify magic things.

  11. #71
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    Hey hey
    On a lighter note.. Check this out.. EOS Scoliosis Image
    REC_2_F.jpg

    - Scott

  12. #72
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    Quote Originally Posted by flerc View Post
    may you show me WHERE they shows no correlation?
    I was asking where they concluded there is no correlation. All what I read is where they says that no correlation present in that study may be because hours in brace is a much stronger factor than reduction in brace. Obviously nobody expects that just only 4 hours in brace with 90% reduction would be more effective than 24 hours in brace without reduction.
    And of course braces are not magic things, if is reasonable to be sure about their effectiveness as this study is showing, is because something.
    If some serious study shows outcomes leading to the conclusion about no correlation between flexibility and reduction in brace vs effectiveness, I want to see it.

  13. #73
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    All I said was there was no correlation (in that study). That's what they found. No correlation.

    I did not make a sweeping truth clam about whether there is in fact never a correlation. I leave the sweeping truth claims to the folk scientists who can conclude things based on one patient and no real understanding of the issues.

    This area of research is a tough game. That's the most relevant take home message for me. Almost anything that you can rigorously show is remarkable as it is damn near impossible to show anything rigorously.

    I would bet $100 if I had the raw data to BrAIST I would likely be able to write a paper with somewhat different conclusions. Same data. This is what is not obvious to folks who don't work with data. Medians versus averages, how you bin the data, what to emphasize, propagation of errors (final angle minus initial angle - the error on that is the square root of the sum of the squares as far as I know... not the error just on one of those measurements), etc. etc.

    I am coming to understand why an important criticism to Katz et al. (2010) was about the actual curve measurements. They should have standardized on time of day when they shoot the film although if it was all random the deviations should balance/cancel. That criticism applies to Weinstein et al. (2013) though this paper is better in terms of having all blind readings. Also, all measurements are either correct (maximal in terms of normal to the beam and at the end of the day) or NOT correct (less than true value - not normal to the beam, imaging in the morning, etc.). I think it is physically impossible to OVER estimate the curve measurement other than the+/- 3* (intra-) reading error. Thus nobody is ever hustled into surgery when they were not surgical as some have imagined.
    Last edited by Pooka1; 10-15-2013 at 10:38 AM.
    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."

  14. #74
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    hi Sharon
    i think a basic research course...like research 101...teaches that two
    people can take the same info and reach different conclusions..
    even the same person can take the same info and do that...

    i believe in politics that is called "spin"...??

    jess

  15. #75
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    Quote Originally Posted by jrnyc View Post
    hi Sharon
    i think a basic research course...like research 101...teaches that two
    people can take the same info and reach different conclusions..
    even the same person can take the same info and do that...

    i believe in politics that is called "spin"...??

    jess
    Yes great point! Science is more constrained than politics but there is still some "spin" in terms of how you crunch the data and how you table/graph it.
    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."

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