{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:01:07Z","timestamp":1790420467153,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Combining evidence-based medicine and shared decision making, current guidelines support an evidence-based personalised approach (EBPA) for idiopathic scoliosis in adolescents (AIS). EBPA is considered important for adolescents\u2019 compliance, which is particularly difficult in AIS. Benchmarking to existing Randomised Controlled Trials (RCTs) as paradigms of single treatments, we aimed to check the effectiveness and burden of care of an EBPA in high-risk AIS. This study\u2019s design features a retrospective observation of a prospective database including 25,361 spinal deformity patients &lt; 18 years of age. Participants consisted of 1938 AIS, 11\u201345\u00b0 Cobb, Risser stage 0\u20132, who were studied until the end of growth. EBPA included therapies classified for burdensomeness according to current guidelines. Using the same inclusion criteria of the RCTs on exercises, plastic, and elastic bracing, out of the 1938 included, we benchmarked 590, 687, and 884 participants, respectively. We checked clinically significant results and burden of care, calculating Relative Risk of success (RR) and Number Needed to Treat (NNT) for efficacy (EA) and intent-to-treat analyses. At the end of growth, 19% of EBPA participants progressed, while 33% improved. EBPA showed 2.0 (1.7\u20132.5) and 2.9 (1.7\u20134.9) RR of success versus Weinstein and Coillard\u2019s studies control groups, respectively. Benchmarked to plastic or elastic bracing, EBPA had 1.4 (1.2\u20131.5) and 1.7 (1.2\u20132.5) RR of success, respectively. The EBPA treatment burden was greater than RCTs in 48% of patients, and reduced for 24% and 42% versus plastic and elastic bracing, respectively. EBPA showed to be from 40% to 70% more effective than benchmarked individual treatments, with low NNT. The burden of treatment was frequently reduced, but it had to be increased even more frequently.<\/jats:p>","DOI":"10.3390\/jcm10215020","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T23:51:36Z","timestamp":1635465096000},"page":"5020","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A Pragmatic Benchmarking Study of an Evidence-Based Personalised Approach in 1938 Adolescents with High-Risk Idiopathic Scoliosis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1878-2747","authenticated-orcid":false,"given":"Stefano","family":"Negrini","sequence":"first","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University \u201cLa Statale\u201d, 20122 Milan, Italy"},{"name":"IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6637-7797","authenticated-orcid":false,"given":"Sabrina","family":"Donzelli","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7995-1700","authenticated-orcid":false,"given":"Francesco","family":"Negrini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Arienti","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Don Gnocchi, 20148 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1256-5362","authenticated-orcid":false,"given":"Fabio","family":"Zaina","sequence":"additional","affiliation":[{"name":"ISICO (Italian Scientific Spine Institute), 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen","family":"Peers","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, University Hospital Leuven, 3000 Leuven, Belgium"},{"name":"Department of Development and Regeneration, University of Leuven, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.312.7023.71","article-title":"Evidence Based Medicine: What It Is and What It Isn\u2019t","volume":"312","author":"Sackett","year":"1996","journal-title":"BMJ"},{"key":"ref_2","first-page":"349","article-title":"Providers and Patients Caught Between Standardization and Individualization: Individualized Standardization as a Solution Comment on \u201c(Re) Making the Procrustean Bed?","volume":"7","author":"Ansmann","year":"2017","journal-title":"Standardization and Customization as Competing Logics in Healthcare.\u201d Int. 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