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勧告声明
, David C Grossman1, Susan J Curry2
1Kaiser Permanente Washington Health Research Institute, Seattle.
JAMA
|January 11, 2018
まとめ
10歳から18歳の青少年におけるイディオパシー脊椎病のスクリーニングは,利益と害に関する証拠が不足しています. 米国予防サービスタスクフォースは,スクリーニングが長期的な健康状態を改善するかどうかを判断するのに十分なデータがないことを発見しました.
科学分野:
- 小児整形医療
- 予防 医療
- 証拠 に 基づく 医学
背景:
- Adolescent idiopathic scoliosis (AIS) は10歳から18歳の若者に影響する脊椎の曲折であり,長期的な健康問題を引き起こす可能性があります.
- AISの早期発見と治療は,骨格の成熟前に進行を緩和することができます.
- AISスクリーニングに関する現在の勧告は,証拠の更新を必要とする.
研究 の 目的:
- 無症状の青少年におけるイディオパシー脊椎病のスクリーニングに関する2004年の米国予防サービスタスクフォース (USPSTF) の勧告を更新する.
- AIS のスクリーニングと治療の利害を評価する.
主な方法:
- AISのスクリーニングと治療に関する証拠の体系的なレビュー
- 無症状の青少年におけるスクリーニングの利益と害に焦点を当てた.
- 運動,矯正,外科手術の証拠を評価した.
主要な成果:
- AISスクリーニングと健康改善の直接的な関連はなく,スクリーニングの害も特定されていません.
- ブレスリングは軽度/中等度のAISでは曲線の進行を遅らせますが,成人における長期的な健康結果の証拠は不十分です.
- 運動や外科治療,そして治療の害に関する証拠は不十分です.
結論:
- USPSTFは,青少年におけるAISのスクリーニングの利益と害のバランスを決定するのに十分な証拠が見つかりませんでした.
- USPSTFは,10歳から18歳の子供と青少年におけるAISのスクリーニングは"I"の声明 (不十分な証拠) であると結論付けています.
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