Maria, I agree Dr. Hey has a pragmatic approach which probably springs from seeing all the "bracing success stories" walk into his office in surgical territory.
I fear that the BrAIST study will ratchet the browbeating to wear braces up several notches which will set up some very bad family crises if/when it goes south later in life. As things stand now, it hasn't been ruled out that bracing only delays surgery for most if not all patients that is does anything at all (leaving aside the masses of kids unnecessarily braced).
I have been thinking about something... considering just the kids who wore the brace more than 13 hours (or whatever it was) and achieved a ~90% "success" rate of not reaching 50* by maturity. Leaving aside the issue of exactly how large their curves were (specifically how many were >40*), we know that at least half those kids who happened to wear the brace that long each day on average were unnecessarily braced. So leaving aside the small sample size, while it might be true to suggest to a child that ~90% of kids who wore a brace 13 hours a day did not reach 50* at maturity, there is still half a chance they wouldn't have reached that if they didn't wear a brace.
This is no easy decision even after BrAIST as Dr. Hey makes clear.
I fear that the BrAIST study will ratchet the browbeating to wear braces up several notches which will set up some very bad family crises if/when it goes south later in life. As things stand now, it hasn't been ruled out that bracing only delays surgery for most if not all patients that is does anything at all (leaving aside the masses of kids unnecessarily braced).
I have been thinking about something... considering just the kids who wore the brace more than 13 hours (or whatever it was) and achieved a ~90% "success" rate of not reaching 50* by maturity. Leaving aside the issue of exactly how large their curves were (specifically how many were >40*), we know that at least half those kids who happened to wear the brace that long each day on average were unnecessarily braced. So leaving aside the small sample size, while it might be true to suggest to a child that ~90% of kids who wore a brace 13 hours a day did not reach 50* at maturity, there is still half a chance they wouldn't have reached that if they didn't wear a brace.
This is no easy decision even after BrAIST as Dr. Hey makes clear.
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