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RESEARCH PRODUCT

Assessment of Early Juvenil Idiopathic Scoliosis: Clinical Trial for the Evaluation of A School-Based Screening Protocol

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Abstract This study aims to evaluate the effectiveness of clinical tests currently in use for the diagnosis of JIS, through a survey, carried out in secondary schools in the province of Palermo, in order to standardize a school screening protocol that could be extended to the whole regional territory. The adolescents underwent a specialist physiatric examination in their classrooms; moreover three screening tests have been administred: Adams test, Bunnel Inclinometer and Plumb line test. In case of single positivity to one of the three tests, the adolescent underwent to radiography of the whole column. Then we examined the sensitivity and diagnostic specificity of the Adams or inclinometer test, respectively: 56.3% and 92.7%. On the other hand, the positivity to at least one between inclinometer or plumb line sensitivity was higher than the specificity: 91.3% versus 80.8%. The same happened for the positivity to at least one test between Adams index or plumb line test, which showed a sensitivity of 95.2% compared to a specificity of 81.5%. Finally, taking into consideration patients with triple test positivity, a clear increase in specificity compared to sensitivity was demonstrated, reaching 99.7% Performing a single test cannot be considered a sufficient tool aiming to detect potential scoliotic subjects. To conclude, an effective screening program can reduce health care expenditure related to specialist medical examinations as well as unnecessary instrumental exams such as X-rays.