{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:45:45Z","timestamp":1787028345718,"version":"build-2736575974"},"reference-count":64,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Education and Science","award":["SONP\/SP\/461408\/2020"],"award-info":[{"award-number":["SONP\/SP\/461408\/2020"]}]},{"name":"J\u00f3zef Pi\u0142sudski University of Physical Education","award":["SONP\/SP\/461408\/2020"],"award-info":[{"award-number":["SONP\/SP\/461408\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Recommendations addressing screening for scoliosis differ substantially. Systematically developed guidelines are confronted by consensus and opinion-based statements. This paper elaborates on the issue of the standards of development and reporting of current guidelines and recommendation statements, as well as on the methodological quality of the corresponding evidence syntheses. The SORT classification and the AMSTAR 2 tool were used for those purposes, respectively. Publications included in the analysis differed substantially in terms of their methodological quality. Based on the SORT and AMSTAR 2 scores, the 2018 US PSTF recommendation statement and systematic review on screening for scoliosis are trustworthy and high-quality sources of evidence and aid for decision making. The recommendation statement on insufficient evidence to formulate any recommendations is, paradoxically, very informative. Significantly, updated opinion-based position statements supporting screening for scoliosis acknowledged the importance of research evidence as a basis for recommendation formulation and are more cautious and balanced than formerly. Expert opinions, not built on properly presented analyses of evidence, are at odds with evidence-based practice. Nonetheless, contemporary principles of screening programs, especially those addressing people\u2019s values and preferences, and the possible harms of screening, remain underrepresented in both research and recommendations addressing screening for scoliosis.<\/jats:p>","DOI":"10.3390\/ijerph19116659","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T10:05:14Z","timestamp":1653905114000},"page":"6659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["No Recommendation Is (at Least Presently) the Best Recommendation: An Updating Quality Appraisal of Recommendations on Screening for Scoliosis"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9874-5964","authenticated-orcid":false,"given":"Maciej","family":"P\u0142aszewski","sequence":"first","affiliation":[{"name":"Faculty of Physical Education and Health in Bia\u0142a Podlaska, J\u00f3zef Pi\u0142sudski University of Physical Education, 00-809 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11832-012-0457-4","article-title":"Epidemiology of Adolescent Idiopathic Scoliosis","volume":"7","author":"Konieczny","year":"2013","journal-title":"J. Child. Orthop."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1056\/NEJMcp1209063","article-title":"Idiopathic Scoliosis in Adolescents","volume":"368","author":"Hresko","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Dunn, J., Henrikson, N.B., Morrison, C.C., Nguyen, M., Blasi, P.R., and Lin, J.S. (2018). Screening for Adolescent Idiopathic Scoliosis: A Systematic Evidence Review for the U.S. Preventive Services Task Force, U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews.","DOI":"10.1001\/jama.2017.11669"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"606","DOI":"10.2105\/AJPH.2011.300531","article-title":"A Dangerous Curve: The Role of History in America\u2019s Scoliosis Screening Programs","volume":"102","author":"Linker","year":"2012","journal-title":"Am. J. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e032865","DOI":"10.1136\/bmjopen-2019-032865","article-title":"Mapping the Evidence of Experiences Related to Adolescent Idiopathic Scoliosis: A Scoping Review Protocol","volume":"9","author":"Grantham","year":"2019","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1016\/j.puhe.2015.07.021","article-title":"To Screen or Not to Screen for Adolescent Idiopathic Scoliosis? A Review of the Literature","volume":"129","author":"Deurloo","year":"2015","journal-title":"Public Health"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hagan, J.F., Shaw, J.S., and Duncan, P.M. (2017). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, American Academy of Pediatrics. [4th ed.]. updated March 2019.","DOI":"10.1542\/9781610020237"},{"key":"ref_8","unstructured":"Costello Medical (2022, April 16). Evidence Map: Screening for Adolescent Idiopathic Scoliosis a Literature Search to Outline the Volume and Type of Evidence Related to Screening for Adolescent Idiopathic Scoliosis for the UK National Screening Committee, Available online: https:\/\/view-health-screening-recommendations.service.gov.uk\/scoliosis\/."},{"key":"ref_9","first-page":"292","article-title":"New Concepts in Screening","volume":"54","author":"Gray","year":"2004","journal-title":"Br. J. Gen. Pract."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"E422","DOI":"10.1503\/cmaj.171154","article-title":"Consolidated Principles for Screening Based on a Systematic Review and Consensus Process","volume":"190","author":"Dobrow","year":"2018","journal-title":"Can. Med. Assoc. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/epirev\/mxr005","article-title":"Reconsidering the Criteria for Evaluating Proposed Screening Programs: Reflections From 4 Current and Former Members of the U.S. Preventive Services Task Force","volume":"33","author":"Harris","year":"2011","journal-title":"Epidemiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1001\/jama.2017.20190","article-title":"Evolving Recommendations for Scoliosis Screening: A Compelling Need for Further Research","volume":"319","author":"Sarwark","year":"2018","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"364","DOI":"10.5312\/wjo.v11.i9.364","article-title":"Screening for Scoliosis-New Recommendations, Old Dilemmas, No Straight Solutions","volume":"11","author":"Grantham","year":"2020","journal-title":"World J. Orthop."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jspd.2017.03.009","article-title":"Systematic Review of School Scoliosis Screening","volume":"5","author":"Altaf","year":"2017","journal-title":"Spine Deform."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e20193150","DOI":"10.1542\/peds.2019-3150","article-title":"Unique Needs of the Adolescent","volume":"144","author":"Alderman","year":"2019","journal-title":"Pediatrics"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/MRR.0b013e32834df622","article-title":"Screening for Scoliosis: Different Countries\u2019 Perspectives and Evidence-Based Health Care","volume":"35","author":"Plaszewski","year":"2012","journal-title":"Int. J. Rehabil. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e67","DOI":"10.2106\/JBJS.16.00224","article-title":"Early Detection of Idiopathic Scoliosis in Adolescents","volume":"98","author":"Hresko","year":"2016","journal-title":"J. Bone Jt. Surg. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13013-017-0145-8","article-title":"2016 SOSORT Guidelines: Orthopaedic and Rehabilitation Treatment of Idiopathic Scoliosis during Growth","volume":"13","author":"Negrini","year":"2018","journal-title":"Scoliosis"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"US Preventive Services Task Force, Grossman, D.C., Curry, S.J., Owens, D.K., Barry, M.J., Davidson, K.W., Doubeni, C.A., Epling, J.W., Kemper, A.R., and Krist, A.H. (2018). Screening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement. JAMA, 319, 165.","DOI":"10.1001\/jama.2017.19342"},{"key":"ref_20","unstructured":"UK National Screening Committee (UK NSC) (2022, April 16). Screening for Adolescent Idiopathic Scoliosis in Children, Available online: https:\/\/view-health-screening-recommendations.service.gov.uk\/scoliosis\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"155932581985281","DOI":"10.1177\/1559325819852810","article-title":"The Scoliosis Quandary: Are Radiation Exposures From Repeated X-Rays Harmful?","volume":"17","author":"Oakley","year":"2019","journal-title":"Dose-Response"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1007\/s13244-014-0354-0","article-title":"Idiopathic Scoliosis in Children and Adolescents: Assessment with a Biplanar X-Ray Device","volume":"5","author":"Uyttenhove","year":"2014","journal-title":"Insights Imaging"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Moynihan, R., Henry, D., and Moons, K.G.M. (2014). Using Evidence to Combat Overdiagnosis and Overtreatment: Evaluating Treatments, Tests, and Disease Definitions in the Time of Too Much. PLoS Med., 11.","DOI":"10.1371\/journal.pmed.1001655"},{"key":"ref_24","unstructured":"U.S. Preventive Services Task Force (2021, November 25). Standards for Guideline Development. June 2018. Available online: https:\/\/www.uspreventiveservicestaskforce.org\/Page\/Name\/standards-for-guidelinedevelopment."},{"key":"ref_25","unstructured":"U.S. Preventive Services Task Force (2021, November 25). Procedure Manual. December 2015. Available online: https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/procedure-manual."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1007\/s00586-014-3307-x","article-title":"Are Current Scoliosis School Screening Recommendations Evidence-Based and up to Date? A Best Evidence Synthesis Umbrella Review","volume":"23","year":"2014","journal-title":"Eur. Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"E839","DOI":"10.1503\/cmaj.090449","article-title":"AGREE II: Advancing Guideline Development, Reporting and Evaluation in Health Care","volume":"182","author":"Brouwers","year":"2010","journal-title":"Can. Med. Assoc. J."},{"key":"ref_28","unstructured":"Institute of Medicine (U.S.), and Graham, R. (2011). Clinical Practice Guidelines We Can Trust, National Academies Press."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"525","DOI":"10.7326\/0003-4819-156-7-201204030-00009","article-title":"Guidelines International Network: Toward International Standards for Clinical Practice Guidelines","volume":"156","author":"Qaseem","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"ref_30","first-page":"548","article-title":"Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading Evidence in the Medical Literature","volume":"69","author":"Ebell","year":"2004","journal-title":"Am. Fam. Physician"},{"key":"ref_31","unstructured":"Scottish Intercollegiate Guidelines Network (SIGN) (2019). A Guideline Developer\u2019s Handbook, SIGN. Available online: http:\/\/www.sign.ac.uk."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jclinepi.2010.07.015","article-title":"GRADE Guidelines: 3. Rating the Quality of Evidence","volume":"64","author":"Balshem","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_33","unstructured":"(2022, April 16). OCEBM Levels of Evidence\u2014Centre for Evidence-Based Medicine (CEBM), University of Oxford. Available online: https:\/\/www.cebm.ox.ac.uk\/resources\/levels-of-evidence\/ocebm-levels-of-evidence."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1093\/intqhc\/mzv115","article-title":"Guide to Clinical Practice Guidelines: The Current State of Play","volume":"28","author":"Kredo","year":"2016","journal-title":"Int. J. Qual. Health Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1001\/jama.2018.9660","article-title":"Clinical Practice Guidelines: What\u2019s Next?","volume":"320","author":"Shekelle","year":"2018","journal-title":"JAMA"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.jclinepi.2015.11.018","article-title":"Rating the Quality of Evidence Is by Necessity a Matter of Judgment","volume":"74","author":"Murad","year":"2016","journal-title":"J. Clin. Epidemiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1136\/ebmed-2017-110798","article-title":"What Does Expert Opinion in Guidelines Mean? A Meta-Epidemiological Study","volume":"22","author":"Ponce","year":"2017","journal-title":"BMJ Evid.-Based Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jclinepi.2019.02.009","article-title":"Structured Decision-Making Drives Guidelines Panels\u2019 Recommendations \u201cfor\u201d but Not \u201cagainst\u201d Health Interventions","volume":"110","author":"Djulbegovic","year":"2019","journal-title":"J. Clin. Epidemiol."},{"key":"ref_39","first-page":"l4606","article-title":"Distinguishing Opinion from Evidence in Guidelines","volume":"366","author":"Zhang","year":"2019","journal-title":"BMJ"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"E23","DOI":"10.1503\/cmaj.190144","article-title":"Guideline Groups Should Make Recommendations Even If the Evidence Is Considered Insufficient","volume":"192","author":"Neumann","year":"2020","journal-title":"Can. Med Assoc. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"134","author":"Page","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e12931","DOI":"10.1111\/eci.12931","article-title":"Time to Challenge the Spurious Hierarchy of Systematic over Narrative Reviews?","volume":"48","author":"Greenhalgh","year":"2018","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"j4008","DOI":"10.1136\/bmj.j4008","article-title":"AMSTAR 2: A Critical Appraisal Tool for Systematic Reviews That Include Randomised or Non-Randomised Studies of Healthcare Interventions, or Both","volume":"358","author":"Shea","year":"2017","journal-title":"BMJ"},{"key":"ref_44","unstructured":"(2022, April 16). Glossary of Terms \u00bb SUPPORT Summaries; Epistemonikos. Available online: https:\/\/supportsummaries.epistemonikos.org\/support-summaries\/glossary-of-terms\/#S."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/2046-4053-1-28","article-title":"Clarifying Differences between Review Designs and Methods","volume":"1","author":"Gough","year":"2012","journal-title":"Syst. Rev."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1186\/s13643-019-1089-2","article-title":"Clarifying Differences between Reviews within Evidence Ecosystems","volume":"8","author":"Gough","year":"2019","journal-title":"Syst. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1111\/j.1471-1842.2009.00848.x","article-title":"A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies: A Typology of Reviews","volume":"26","author":"Grant","year":"2009","journal-title":"Health Inf. Libr. J."},{"key":"ref_48","unstructured":"UK National Screening Committee (UK NSC) (2015). Screening for Adolescent Idiopathic Scoliosis: External Review against Programme Appraisal Criteria for the UK National Screening Committee (UK NSC)."},{"key":"ref_49","first-page":"7","article-title":"Cost effectiveness of school screening for scoliosis: A systematic review","volume":"7","author":"Beausejour","year":"2014","journal-title":"Int. J. Child Adolesc. Health"},{"key":"ref_50","first-page":"7","article-title":"Methodological Quality (Risk of Bias) Assessment Tools for Primary and Secondary Medical Studies: What Are They and Which Is Better?","volume":"7","author":"Ma","year":"2020","journal-title":"Mil. Med. Res."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1167","DOI":"10.1001\/jamadermatol.2019.1514","article-title":"Evaluation of the Number-Needed-to-Biopsy Metric for the Diagnosis of Cutaneous Melanoma: A Systematic Review and Meta-Analysis","volume":"155","author":"Nelson","year":"2019","journal-title":"JAMA Dermatol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1111\/apa.14988","article-title":"Updated Italian Recommendations for the Diagnosis, Treatment and Follow-up of the First Febrile Urinary Tract Infection in Young Children","volume":"109","author":"Ammenti","year":"2020","journal-title":"Acta Paediatr."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Roca-Millan, E., Jan\u00e9-Salas, E., Estrugo-Devesa, A., and L\u00f3pez-L\u00f3pez, J. (2020). Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review. Materials, 13.","DOI":"10.3390\/ma13235346"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"P\u0142aszewski, M., and Bettany-Saltikov, J. (2014). Non-Surgical Interventions for Adolescents with Idiopathic Scoliosis: An Overview of Systematic Reviews. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0110254"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"100921","DOI":"10.1016\/j.ijotn.2022.100921","article-title":"A Systematic Scoping Review and Textual Narrative Synthesis of the Qualitative Evidence Related to Adolescent Idiopathic Scoliosis","volume":"45","author":"Essex","year":"2022","journal-title":"Int. J. Orthop. Trauma Nurs."},{"key":"ref_56","unstructured":"Evans, I., Thornton, H., Chalmers, I., and Glasziou, P. (2011). Testing Treatments: Better Research for Better Healthcare, Pinter & Martin. [2nd ed.]."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Members of the Quebec Scoliosis Society and of the Canadian Paediatric Spinal Deformities Study Group, Beaus\u00e9jour, M., Goulet, L., Parent, S., Feldman, D.E., Turgeon, I., Roy-Beaudry, M., Sosa, J.F., and Labelle, H. (2013). The Effectiveness of Scoliosis Screening Programs: Methods for Systematic Review and Expert Panel Recommendations Formulation. Scoliosis, 8, 12.","DOI":"10.1186\/1748-7161-8-12"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1001\/jamapediatrics.2017.5585","article-title":"Early Detection of Scoliosis\u2014What the USPSTF \u201cI\u201d Means for Us","volume":"172","author":"Hresko","year":"2018","journal-title":"JAMA Pediatr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"g3725","DOI":"10.1136\/bmj.g3725","article-title":"Evidence Based Medicine: A Movement in Crisis?","volume":"348","author":"Greenhalgh","year":"2014","journal-title":"BMJ"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Greenhalgh, T., Snow, R., Ryan, S., Rees, S., and Salisbury, H. (2015). Six \u2018Biases\u2019 against Patients and Carers in Evidence-Based Medicine. BMC Med., 13.","DOI":"10.1186\/s12916-015-0437-x"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1093\/bjsw\/bcq149","article-title":"The Myth of Evidence-Based Practice: Towards Evidence-Informed Practice","volume":"41","author":"Nevo","year":"2011","journal-title":"Br. J. Soc. Work"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"812","DOI":"10.21037\/jss.2018.10.04","article-title":"Editorial on \u201cScreening for Adolescent Idiopathic Scoliosis: US Preventive Services Task Force Recommendation Statement\u201d","volume":"4","author":"Ha","year":"2018","journal-title":"J. Spine Surg."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/S0140-6736(18)31671-4","article-title":"When No Guideline Recommendation Is the Best Recommendation","volume":"392","author":"Bretthauer","year":"2018","journal-title":"Lancet"},{"key":"ref_64","unstructured":"U.S. Preventive Services Task Force (2021, April 22). Tenth Annual Report to Congress on High-Priority Evidence Gaps for Clinical Preventive Services. Available online: https:\/\/www.uspreventiveservicestaskforce.org\/uspstf\/sites\/default\/files\/inline-files\/10th-USPSTF-Annual-Report-to-Congress.pdf."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6659\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:21:10Z","timestamp":1760138470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/11\/6659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":64,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["ijerph19116659"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19116659","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,30]]}}}