Why we need the final Cobbs in BrAIST

[Pooka1]

2016 SRS meeting

http://srs.gmetonline.com/ViewPresen...onpackageid=12

1. post brace progression rate higher than natural history

2. Curve magnitude at completion ALONE is predictive of post-brace surgical progression. (This is what the BrAIST authors need to address in their results. Because they didn't publish the post-bracing curve magnitudes, and because curves up to 49* with up to 25% growth remaining were bracing "successes", it is IMPOSSIBLE to use their results to determine how much bracing avoids surgery.)

3. >80% of patients who completed bracing at > or = 45* reached post-brace surgical progression.

4. no patient who completed bracing with < 40* failed.

5. no patient with brace initiation at Risser II had post-brace surgical progression.

[nmhtx]

So true, a lot of material info was missing from the report. Not to mention stopping the study early distorts the results. Ended up being a small number of people in the not very randomized trial.

[Pooka1]

The main problem continues to be that researchers have to measure something objective (like whether a Cobb is >49* with less than 25% growth remaining) versus what patients and parents really need to know (will bracing avoid surgery for life?).

There is a reason the final Cobb angles were not published for the BrAIST study. It is because their conclusions would have to change in terms of some of these bracing "successes" would be seen as OBVIOUS failures in terms of needing surgery.