The effectiveness of scoliosis screening programs: methods for systematic review and expert panel recommendations formulation
1 Sainte-Justine University Hospital Center, Unité de recherche clinique en orthopédie, 3175 Chemin Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, Canada
2 School of Public Health, Université de Montréal, 7101 Avenue du Parc, 3rd floor, Montréal, Québec H3N 1X9, Canada
3 Department of surgery, Faculty of medicine, Université de Montréal, PO Box 6128, Succ. Centre-Ville, Montréal, Québec H3C 3J7, Canada
Scoliosis 2013, 8:12 doi:10.1186/1748-7161-8-12Published: 24 July 2013
Literature on scoliosis screening is vast, however because of the observational nature of available data and methodological flaws, data interpretation is often complex, leading to incomplete and sometimes, somewhat misleading conclusions. The need to propose a set of methods for critical appraisal of the literature about scoliosis screening, a comprehensive summary and rating of the available evidence appeared essential.
To address these gaps, the study aims were: i) To propose a framework for the assessment of published studies on scoliosis screening effectiveness; ii) To suggest specific questions to be answered on screening effectiveness instead of trying to reach a global position for or against the programs; iii) To contextualize the knowledge through expert panel consultation and meaningful recommendations. The general methodological approach proceeds through the following steps: Elaboration of the conceptual framework; Formulation of the review questions; Identification of the criteria for the review; Selection of the studies; Critical assessment of the studies; Results synthesis; Formulation and grading of recommendations in response to the questions. This plan follows at best GRADE Group (Grades of Recommendation, Assessment, Development and Evaluation) requirements for systematic reviews, assessing quality of evidence and grading the strength of recommendations.
In this article, the methods developed in support of this work are presented since they may be of some interest for similar reviews in scoliosis and orthopaedic fields.