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October 20, 1999

Political Considerations for Changing Medical Screening Programs

Author Affiliations

Author Affiliation: Health Division, Oregon Department of Human Resources, Portland.

JAMA. 1999;282(15):1472-1474. doi:10.1001/jama.282.15.1472

An effective medical screening program provides presumptive identification of individuals with unrecognized disease by applying rapid and simple tests or examinations to differentiate asymptomatic persons who probably have a disease from those who do not. The article in this issue of THE JOURNAL by Yawn and colleagues1 questions the effectiveness of routine scoliosis screening in the school setting. Twenty-six states have laws that mandate scoliosis screening, and other states without such laws may still provide state-supported screening programs or have screening programs conducted voluntarily in communities by local agencies. States with scoliosis screening activities will need to reevaluate the effectiveness of this screening and determine whether any changes in screening activities are needed. In those states that do mandate screening, the decisions are more meaningful and any changes will require more effort. Individual physicians and the organizations that represent them can be instrumental in assisting states with this decision-making process.