Association between lay perception of morbidity and appropriateness of specialized health care use in adolescent idiopathic scoliosis

Abstract

In absence of school scoliosis screening programs (SSSP) in Canada, this study examined the relationships between the lay person's perception of morbidity and the appropriateness of referral in orthopedics. A cross‐sectional study was conducted with all children consecutively referred in orthopedics for suspected scoliosis. The 831 participants were classified as Appropriate, Late, or Inappropriate referrals for the orthopedic setting. Perceived morbidity was operationalized by: the scoliosis detection originator, the perceptions of the seriousness of the condition and urgency to consult a physician, the perception of the general health, as well as Visible Back Deformity, Self‐image, and Pain. Direct associations between the perceived morbidity and the appropriateness of referral were found in all scoliosis‐specific measures; the most discriminant variable was Visible Back Deformity. Lay perceived morbidity is a good indicator of the objective morbidity, and thus reflects in the appropriateness of referral status. The important role of the lay persons in symptoms appraisal does not however insure appropriate referral. Searching for alternatives to SSSP would wisely include a health promotion and medical management program. Statement of Clinical Significance: Perceived morbidity by the lay persons is strongly associated with the objectively evaluated severity of scoliosis deformity. Therefore, in absence of SSSP, lay person awareness plays an important role in symptom recognition and search for care. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

Inter-Establishment Complex Musculoskeletal Care Pathways in Montreal: Timeline of a Collaboration Involving a Research Team Within a Continuous Quality Improvement Initiative

“…She was known to the 4 establishments, as she worked for 20 years with some of their teams, and especially as the leader of a large survey in southwestern Québec on the pathways of care for scoliosis patients. 4 - 6 …”

Parents can reliably and accurately detect trunk asymmetry using an inclinometer smartphone app

“…These policy decisions presumably had an impact on the management of patients with progressive scoliosis. Retrospectively studying the referral patterns of suspected cases of AIS in orthopaedic clinics, our team [5,9,10] demonstrated that after discontinuation of school screening programs, 20% of patients were referred "late" to a scoliosis clinic to benefit from appropriate and timely conservative management with a spinal brace. Thomas et al reported that in a US county, the number of referrals to orthopaedic clinics for scoliosis in areas without school screening decreased, as well as the number of spinal brace prescriptions [11].…”