青少年のイディオパシー脊椎病のスクリーニング:米国予防サービスタスクフォースのためのエビデンスレポートとシステマティックレビュー
John Dunn1, Nora B Henrikson1, Caitlin C Morrison1
1Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Research Affiliates Evidence-based Practice Center, Seattle, Washington.
JAMA
|January 11, 2018
まとめ
スクリーニングにより,青少年のイディオパシー脊椎病 (AIS) が検出され,ブレスティング/運動により,曲線の進行が遅くなります. しかし,AISのスクリーニングと治療の長期的な結果と害に関する証拠は限られている.
科学分野:
- 整形外科
- 公衆衛生
- 証拠 に 基づく 医学
背景:
- Adolescent idiopathic scoliosis (AIS) は,青少年の1〜3%に罹患し,曲線が進行し,健康に悪影響を与える可能性があります.
- スクリーニングによる早期発見は,骨格の成熟前にAISの進行を管理するために不可欠です.
研究 の 目的:
- 青少年におけるAISのスクリーニングの利益と害に関する証拠を体系的に検討する.
- AISのスクリーニングと治療戦略のガイドラインを提示する.
主な方法:
- 1966年1月から2017年7月まで,複数のデータベース (Cochrane,MEDLINE,PubMedなど) で包括的な文献検索が行われました.
- スクリーニングの精度,治療の効果 (ブレーシング,運動),有害性,長期的な結果を評価した研究が含まれていた.
- データは2人の独立した審査員によって抽出され,質的に合成されました.
主要な成果:
- AISスクリーニングは,いくつかの臨床ベースのプログラムで高い精度 (感度93. 8%,特異性99. 2%) を示した.
- ブレーシングは曲線の進行を遅くし 運動はコブの角度を わずかに減少させました
- 長期的アウトカムデータは限られており,ブレスティングは治療のネガティブな経験と身体イメージの懸念と関連していました. 皮膚問題や痛みなど
結論:
- AISスクリーニングは 状態を効果的に検出できます
- ブレスティングと運動は青年の曲線の進行を緩和するかもしれないが,長期の健康結果とスクリーニング/治療の害に関する確固たる証拠は不足している.
- AISとその管理の長期的な影響を理解するには,さらなる研究が必要です.
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