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Found the paper
http://early-onset-scoliosis.com/Doc...Compliance.pdf
Apparently, the important variables (type of curve, magnitude of curve, etc.) for each group is in another paper:
Takemitsu M, Bowen RJ, Rahman T, et al. Compliance monitoring of brace treatment for patients with idiopathic scoliosis. Spine. 2004;29: 2070–2074.)
making it impossible to assess this paper on its own. It's interesting that not even one sentence about the key variables in this article. Looking at the data the way they did assumes compliance is a master variable which is something they are trying to prove. Circular.
I'll try to find the other paper online.
There is a WILD variation in prescribed wear time among these 34 patients:
Prescribed regimens for the bracewearing schedule were 8 (nighttime) or 12 hours per day in the brace for patients with curves 30 degrees or less and 16, 20, or 23 hours per day for those with curves greater than 30 degrees.
I am predicting the most compliant group were the ones wearing the brace only 8 hours at night and those wearing it only 12 hours during the day (as opposed to 16, 20, or 23 hours). And since it is highly likely that people with smaller curves were told to wear the brace less than people with larger curves, what prescribed wear time might reduce to is being a proxy for Cobb angle. I will be looking specifically for that in the other paper. And I question how they can relate any of this to outcome when the treatments are so wildly variant (among 34 patients no less).
Importantly, ~21% of the 34 subjects went on to have fusion. There is not one word about how compliant they were. It would be an important result if some or most came from the compliant group. That would make sense if they had larger curves and suspected they might be moving into surgery territory. It would also be a confounder if the people most worried were most compliant--- it would skew the results. But one wonders why not even one sentence on which group they were in.
This is a VERY short paper. Unless the journal set length constraints, I don't understand why this wasn't simply folded into the other paper with the "rubber-meets-the -road" results. If these results paint a different picture compared to the larger paper then I'm going to have some questions (as usual!).
Last, they confirm the last measurements in this study were final "brace use." That is, ALL these numbers are in brace and they admit up front in the intro that no rigorous correlation between compliance and final outcome has been shown. Also, there is a penetrating glimpse into the obvious aspect of folks who wear the brace more have less IN BRACE progression. That is another reason why this paper should have been folded into the other in my opinion.
As always, just a bunny opinion from the field as this is not my field.
http://early-onset-scoliosis.com/Doc...Compliance.pdf
Apparently, the important variables (type of curve, magnitude of curve, etc.) for each group is in another paper:
Takemitsu M, Bowen RJ, Rahman T, et al. Compliance monitoring of brace treatment for patients with idiopathic scoliosis. Spine. 2004;29: 2070–2074.)
making it impossible to assess this paper on its own. It's interesting that not even one sentence about the key variables in this article. Looking at the data the way they did assumes compliance is a master variable which is something they are trying to prove. Circular.
I'll try to find the other paper online.
There is a WILD variation in prescribed wear time among these 34 patients:
Prescribed regimens for the bracewearing schedule were 8 (nighttime) or 12 hours per day in the brace for patients with curves 30 degrees or less and 16, 20, or 23 hours per day for those with curves greater than 30 degrees.
I am predicting the most compliant group were the ones wearing the brace only 8 hours at night and those wearing it only 12 hours during the day (as opposed to 16, 20, or 23 hours). And since it is highly likely that people with smaller curves were told to wear the brace less than people with larger curves, what prescribed wear time might reduce to is being a proxy for Cobb angle. I will be looking specifically for that in the other paper. And I question how they can relate any of this to outcome when the treatments are so wildly variant (among 34 patients no less).
Importantly, ~21% of the 34 subjects went on to have fusion. There is not one word about how compliant they were. It would be an important result if some or most came from the compliant group. That would make sense if they had larger curves and suspected they might be moving into surgery territory. It would also be a confounder if the people most worried were most compliant--- it would skew the results. But one wonders why not even one sentence on which group they were in.
This is a VERY short paper. Unless the journal set length constraints, I don't understand why this wasn't simply folded into the other paper with the "rubber-meets-the -road" results. If these results paint a different picture compared to the larger paper then I'm going to have some questions (as usual!).
Last, they confirm the last measurements in this study were final "brace use." That is, ALL these numbers are in brace and they admit up front in the intro that no rigorous correlation between compliance and final outcome has been shown. Also, there is a penetrating glimpse into the obvious aspect of folks who wear the brace more have less IN BRACE progression. That is another reason why this paper should have been folded into the other in my opinion.
As always, just a bunny opinion from the field as this is not my field.
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