USPSTF Public Comment Deadline is October 28, 2015

October 14, 2015 National Scoliosis Foundation NSF News ,

The US Preventive Services Task Force has published it’s draft research plan on Screening for Adolescent Idiopathic #Scoliosis (AIS). To comment on the USPSTF draft plan please click here.

Draft: Proposed Key Questions to Be Systematically Reviewed

  1. Does screening for adolescent idiopathic scoliosis improve: a) health outcomes and b) the degree of abnormal #spinal curve in childhood or adulthood?
  2. What is the accuracy of screening for adolescent idiopathic scoliosis?
  3. Does treatment of adolescent idiopathic scoliosis with a Cobb angle of less than 50° at diagnosis improve: a) health outcomes and b) the degree of spinal curve in childhood or adulthood?
  4. What is the association between Cobb angle measurement in adolescence and health outcomes in adulthood?
  5. What are the harms of screening for adolescent idiopathic scoliosis?
  6. What are the harms of treatment of adolescent idiopathic scoliosis with a Cobb angle of less than 50° at diagnosis?

Draft: Proposed Research Approach

The proposed Research Approach identifies the study characteristics and criteria that the Evidence-based Practice Center will use to search for publications and to determine whether identified studies should be included or excluded from the Evidence Review. Criteria are overarching as well as specific to each of the key questions (KQs).

Include Exclude
Populations KQs 1, 2, 5: Asymptomatic children and adolescents ages 10 to 18 years

KQs 3, 6: Persons with adolescent idiopathic scoliosis diagnosed at ages 10 to 18 years with a Cobb angle of 10° to 50° detected through screening

KQ 4: Persons with adolescent idiopathic scoliosis diagnosed at ages 10 to 18 years with a Cobb angle of 10° to 50°

 Persons with scoliosis of:

  • Neuromuscular etiology (e.g., cerebral palsy, myelomeningocele, muscular dystrophy, spinal muscular atrophy, spina bifida, spinal cord injuries)
  • Congenital etiology (e.g., hemivertebrae, failure of segmentation)
  • Mesenchymal/syndromic etiology (e.g., Marfan syndrome, mucopolysaccharidosis, osteogenesis imperfecta, inflammatory diseases, postoperative)
  • Early-onset idiopathic etiology (infantile [ages 0 to 3 years] or juvenile [ages 4 to 9 years])
Settings
  • Primary care or generalizable to primary care
  • School-based screening programs
  • Countries categorized as “High” on the Human Development Index (as defined by the United Nations Development Programme)
 Specialty care (e.g., surgical clinics and clinics for conditions known to be associated with scoliosis) and other settings with a symptomatic population
Screening tests KQs 1, 2, 5: Forward bend test (with or without scoliometer/inclinometer), surface topography, or other methods (e.g., back-contour device), followed by x-ray for confirmation

KQ 2: Studies with a reference standard

 KQs 1, 2, 5:

  • X-ray alone
  • Selective screening
Treatments KQs 3, 6:

  • Surgery
  • Nonoperative treatment, including but not limited to: bracing, physical therapy/exercise therapy, and electrical muscle stimulation
Comparison KQs 1, 2, 5: Usual care

KQs 3, 6: Observation, usual care

 KQs 1, 2, 5: Studies with no comparator

KQs 3, 6: Comparative effectiveness studies
Harms KQ 5: Any screening harms, including but not limited to: labeling, radiation exposure

KQ 6: Any treatment harms, including but not limited to: psychosocial harms, physiological harms, functioning, or pain

 KQs 5, 6: Studies with no comparator
Outcomes Intermediate outcomes: Cobb angle measurement

Health outcomes:

  • Morbidity (e.g., pulmonary symptoms, hypertension, lumbar radiculopathy)
  • Quality of life
  • Functional outcomes (e.g., pain, musculoskeletal function, activity restriction)
  • Mortality
Study design KQs 1–4: Randomized, controlled trials; controlled trials; cohort studies

KQs 5, 6: Randomized, controlled trials; controlled trials; cohort studies; case series

 All KQs: Studies rated as poor quality

KQs 1–4: Case series, cost-effectiveness studies, qualitative study designs
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U.S. Preventive Services Task Force to Review Scoliosis Screening

September 30, 2015 National Scoliosis Foundation Scoliosis in the Media ,

The #National Scoliosis Foundation is pleased to report that the U.S. Preventive Services Task Force will be reviewing screening for #scoliosis. We encourage everyone to sign up per the notification below to follow this very important effort, which we hope will lead to an evidence based decision to replace their 2004 statement with a posiitve recommendation for early detection of AIS.

“Soon, the U.S. Preventive Services Task Force (USPSTF, Task Force) will be posting for public comment our draft research plan on screening for adolescent idiopathic scoliosis on our Web site. We thought that you and members of your organization might be interested in providing feedback on this draft research plan and receiving periodic updates on this topic. As such, I invite you to sign up for the USPSTF email list to receive announcements and updates on this and other Task Force recommendations about clinical preventive services. The USPSTF email list is open to anyone with interest in our work, so please let members of your organization know about this opportunity to offer comments on our research plan and the ability to sign up to receive updates from the Task Force.

As you may know, the Task Force is an independent, volunteer panel of national experts in prevention and evidence-based medicine. Our mission is to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, and preventive medications. The Task Force believes that the recommendation development process should be clear and transparent and, in an effort to ensure this, has implemented public comment periods throughout the recommendation process. The purpose of the public comment process is to seek feedback from organizations like yours, along with the general public, at each stage of development. The Task Force believes that our recommendations are ultimately improved when groups who care about and are knowledgeable about particular topics share their expertise. We solicit outside input to ensure that final recommendations are valid, reliable, and useful to health professionals, patients, and family members.

Individuals who sign up for the USPSTF email list will be alerted about opportunities to provide public comment on draft materials for screening for adolescent idiopathic scoliosis and other Task Force topics. Email alerts will also be sent when final materials are posted or published, including the release of final recommendation statements. For each topic, an email announcement will be sent at the following stages of the recommendation development process:

  • Posting of the draft research plan for public comment
  • Posting of the final research plan
  • Posting of the draft recommendation statement and draft evidence review for public comment
  • Publication and posting of the final recommendation statement and the evidence summary

We hope that you will widely disseminate the final recommendation statement, following the rigorous, evidence-based recommendation development process and public comment periods, among your membership and encourage your members to implement it once it becomes available.

As I noted earlier, the USPSTF email list is open to all interested organizations and individuals. If you know of any other national or local organizations, subject matter experts, or individuals who are interested in learning about Task Force recommendations, like screening for adolescent idiopathic scoliosis, public comment opportunities, and other Task Force activities, please encourage them to sign up as well.

To learn more about the Task Force, you can view a Task Force 101 slideshow or visit our Web site.

Together, we can work to improve the health of all Americans.

Sincerely,

Albert L. Siu, M.D., M.S.P.H.

Chair, U.S. Preventive Services Task Force”

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You can make a difference! Your input is welcomed!

July 24, 2015 National Scoliosis Foundation NSF News ,,

You can make a difference! Your input is welcomed!

The #National Scoliosis Foundation is building a new website to mark our 40th year of service to the #scoliosis community. And, we’d love to have your input!

For four decades we have generated scoliosis awareness, provided patient education/support/communication, trained screeners, facilitated/funded research (cause, prevention & cure), and advocated for early detection and treatment to minimize the physical, emotional and financial burdens affecting patients, and families, living with abnormal curvatures of the #spine.

Your input to our site design effort is important and appreciated. What do you suggest we include on our new website? What information or resources would you like to see to better help you, your family, the greater scoliosis community and/or our mission? What should we add to ease the scoliosis patient journey and improve the quality of life for all?

We are planning some exciting new features, but we value your thoughts and are eager to listen to your needs. No idea is too big or too small. Please email your input to nsf@scoliosis.org.

Thank you in advance for your help!

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