- Oral presentation
- Open Access
Are brace prescribers following standards?
https://doi.org/10.1186/1748-7161-5-S1-O40
© Fall et al; licensee BioMed Central Ltd. 2010
- Published: 10 September 2010
Keywords
- Logistic Regression
- Regression Model
- Multivariate Analysis
- Logistic Regression Model
- Medical Practice
Introduction
Even if braces for scoliosis are broadly used in Canada, there is no data on the orthopaedic medical practice to evaluate the circumstances of brace prescription. This study aims at comparing scoliosis brace prescription patterns with generally recognized standards.
Materials and methods
A cross-sectional study was carried out between March 2006 and March 2007, on all confirmed AIS patients aged 10 to 18, who were referred to a pediatric scoliosis clinic in a major referral center for a first visit. Agreement between the actual brace prescription patterns and the criteria for immediate prescription was analyzed using a kappa coefficient. Standard recommendations supported by the Quebec Scoliosis Network (QSN) were used, as well as the Scoliosis Research Society (SRS) therapeutic inclusion criteria. In addition, logistic regression models were used to identify variables related to brace prescription.
Results and discussion
Agreement between actual brace prescription and defined criteria (QSN and SRS).
QSN immediate prescription criteria | SRS therapeutic inclusion criteria | |||||
---|---|---|---|---|---|---|
Risser [0-3] Cobb [30° - 45° ] | Risser [0-2] Cobb [25° - 40° ] | |||||
yes | no | yes | no | Total | ||
Actual brace prescription | ||||||
yes | 36 | 34b | 37 | 33b | 70 | |
no | 24a | 227 | 17a | 234 | 251 | |
Total | 60 | 261 | 54 | 267 | 321 | |
Kappa | k=0.441; p<0.001 | k=0.502; p<0.001 |
Conclusion
Despite the professional consensus on immediate bracing, under and over prescription of brace were documented in this study. Better understanding of these patterns would require documentation of motives associated with prescription at the individual level. An investigation of the physicians’ beliefs, attitudes and intentions appears essential to achieve better ways of following therapeutic norms for brace prescription.
Authors’ Affiliations
Copyright
This article is published under license to BioMed Central Ltd.