Patient follow up screening evaluations. Examples with regard to congenital hip dislocation and congenital heart disease

Juttmann, Rikard E.

doi:10.1136/jech.55.2.126

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…In cohort studies such as ours and that of Montgomery et al, the four types of bias, which can overestimate the effectiveness of screening, are lead-time bias, selection bias, length bias and over-treatment bias. 22 Lead-time bias occurs when patients do not reach the definite outcome during the study period. The screening population may contain a large proportion of patients with disorders in a very early stage who will not have reached the (adverse) outcome during the study period; this will lead to an overestimation of the positive effect of screening.…”

Section: Discussionmentioning

confidence: 99%

“…22 Lead-time bias occurs when patients do not reach the definite outcome during the study period. The screening population may contain a large proportion of patients with disorders in a very early stage who will not have reached the (adverse) outcome during the study period; this will lead to an overestimation of the positive effect of screening.…”

Section: Discussionmentioning

confidence: 99%

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Screening for scoliosis: do we have indications for effectiveness?

2006

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Objective: The effectiveness of screening for scoliosis has not been established. This study investigated whether patients with adolescent idiopathic scoliosis detected by screening are detected in an earlier stage of the clinical course, and whether these patients have better outcome than otherwise detected patients. Setting: The study is a retrospective follow-up study of patients with adolescent idiopathic scoliosis who had completed treatment with a brace, by surgery, or with a brace followed by surgery. Of the 143 patients (born on or after 1 January 1984) consecutively recruited from 12 hospitals in the Netherlands, 125 (87%) agreed to participate. Of these, 51 patients were treated with a brace only and 74 patients were operated on. Screening for scoliosis is carried out in 80% of Dutch children. Methods: Data on being screen detected or otherwise detected and Cobb angle at diagnosis were collected using youth health-care files, medical files and interviews by telephone with the patients. Results: About 55% of the patients were detected by screening (programme sensitivity). Screen-detected patients had a significantly smaller Cobb angle at diagnosis (28° versus 40°; P<0.01) and had a 73% lower chance of having had surgery (45% versus 75%; P<0.01) than otherwise-detected patients. Conclusion: In the present study, two essential prerequisites necessary for a screening programme for scoliosis to be effective have been met. However, definite proof of the effectiveness of screening still needs to be established because length bias and over-treatment bias cannot be ruled out using this design.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Screening for scoliosis: do we have indications for effectiveness?

2006

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“…Actuarial survival is not an ideal measure for outcomes after screening, but lead time bias may be less likely to occur with studies of congenital anomalies as the condition is present from birth and the interval between birth and confirmed diagnosis may be short. 68 In addition, studies of survival after cardiac surgery varied in their reporting of actuarial survival, with some excluding early surgical mortality. We have selected figures only from reports which include early surgical mortality for this review.…”

Section: Methodological Considerations In Reporting Mortalitymentioning

confidence: 99%

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Knowles¹,

Griebsch²,

Dezateux

et al. 2005

Health Technol Assess

215

143

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“…12 However, overtreatment bias and length-biased sampling, leading to overestimation of the effect of screening, could be serious problems in such a study. 12,13 The present study investigated the effect of screening for scoliosis on reduction of the need for surgery. From a methodologic viewpoint, a RCT is the best design to establish the effectiveness of screening for scoliosis.…”

mentioning

confidence: 99%

Estimating the Effectiveness of Screening for Scoliosis: A Case-Control Study

et al. 2008

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OBJECTIVE. The aim of this study was to test the hypothesis that screening for scoliosis is effective in reducing the need for surgical treatment. METHODS. The study was a case-control study. A total of 125 consecutive patients who were treated surgically for idiopathic scoliosis between January 2001 and October 2004 and who were born on or after January 1, 1984, were invited; 108 agreed to participate. A total of 216 control subjects were selected randomly and anonymously, matched with respect to age and gender. For 279 adolescents, exact screening exposure and outcomes could be analyzed. Case subjects were recruited from 4 university and 6 nonuniversity Dutch hospitals; control subjects were recruited from all 37 municipal health services in the Netherlands. RESULTS. Screen-detected patients received diagnoses at a significantly younger age than did otherwise-detected patients (10.8 ± 2.6 vs 13.4 ± 1.7 years). In total, 32.8% of the surgically treated patients had been screened between 11 and 14 years of age, compared with 43.4% of the control subjects. The odds ratio for being exposed to screening was 0.64. In total, 28% of the patients were diagnosed as having scoliosis before 11 years of age. CONCLUSIONS. Our results showed no evidence that screening for scoliosis reduced the need for surgery. Abolishing screening seems justified, especially because the effectiveness of early treatment with bracing is still strongly debated. A randomized, controlled trial on the effectiveness of treating patients with idiopathic scoliosis with bracing is urgently needed.

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Patient follow up screening evaluations. Examples with regard to congenital hip dislocation and congenital heart disease

Cited by 5 publications

References 7 publications

Screening for scoliosis: do we have indications for effectiveness?

Screening for scoliosis: do we have indications for effectiveness?

Newborn screening for congenital heart defects: a systematic review and cost-effectiveness analysis

Estimating the Effectiveness of Screening for Scoliosis: A Case-Control Study

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