Googling back, I'm finding snippets from the editorial, but not any definite ratios. What I see is this:
"Thus, "the bracing indications described are probably too broad, resulting in what may be unnecessary treatment for many patients," Dr. Carragee and Dr. Lehman said. Although there do not appear to be physiological side effects to bracing in adolescent idiopathic scoliosis, "it carries financial, emotional, and social burdens that need to be considered."
"The challenge in the field going forward is to identify children who are most likely to benefit from bracing and those who are unlikely to benefit," they concluded."
which I think is absolutely true and the other main conclusion of the study. You'd like to see (well, not *like* to see) 100% progression in those offered but refused a brace an 0% progression in those braced. I'm hoping that, now that they're past wondering whether bracing works at all they can focus on who actually benefits and who doesn't. They've wasted a lot of years dithering around with this.
The thing that really surprised me about this study is just how effective braces were in the kids that wore them for a long time. I'd seen something from Dolan earlier talking about a review of the braces they did early in the study and how ill-fitting, etc some of them were. Can it really be true that you can wear even an ill-fitting brace for 12 hours a day and have it keep you from progressing to surgery? That just doesn't make any sense at all. Maybe as part of the study they made sure that the braces actually fit right? Or, maybe, knowing that they were being watched over, everyone really made sure that the braces were fitted right? I don't know, but 90-93% is *really* effective - much more than I expected.
And, how does this tie back to the whole Scoliscore thing? If bracing just does not work at all for a defined group of genetic patients, why is there a dose-response? Presumably, those kids are scattered throughout the different hours-of-wear groups and they'd fail bracing at a steady rate no matter how many hours a day they wore the brace. Or, maybe, they have to wear for 12 hours a day for it to work? Don't know. But this study is throwing a lot of what I thought I understood into question.
"Thus, "the bracing indications described are probably too broad, resulting in what may be unnecessary treatment for many patients," Dr. Carragee and Dr. Lehman said. Although there do not appear to be physiological side effects to bracing in adolescent idiopathic scoliosis, "it carries financial, emotional, and social burdens that need to be considered."
"The challenge in the field going forward is to identify children who are most likely to benefit from bracing and those who are unlikely to benefit," they concluded."
which I think is absolutely true and the other main conclusion of the study. You'd like to see (well, not *like* to see) 100% progression in those offered but refused a brace an 0% progression in those braced. I'm hoping that, now that they're past wondering whether bracing works at all they can focus on who actually benefits and who doesn't. They've wasted a lot of years dithering around with this.
The thing that really surprised me about this study is just how effective braces were in the kids that wore them for a long time. I'd seen something from Dolan earlier talking about a review of the braces they did early in the study and how ill-fitting, etc some of them were. Can it really be true that you can wear even an ill-fitting brace for 12 hours a day and have it keep you from progressing to surgery? That just doesn't make any sense at all. Maybe as part of the study they made sure that the braces actually fit right? Or, maybe, knowing that they were being watched over, everyone really made sure that the braces were fitted right? I don't know, but 90-93% is *really* effective - much more than I expected.
And, how does this tie back to the whole Scoliscore thing? If bracing just does not work at all for a defined group of genetic patients, why is there a dose-response? Presumably, those kids are scattered throughout the different hours-of-wear groups and they'd fail bracing at a steady rate no matter how many hours a day they wore the brace. Or, maybe, they have to wear for 12 hours a day for it to work? Don't know. But this study is throwing a lot of what I thought I understood into question.
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