Association between lay perception of morbidity and appropriateness of specialized health care use in Adolescent Idiopathic Scoliosis.

In absence of school scoliosis screening programs (SSSP) in Canada, this study examined the relationships between the lay person's perception of morbidity and the appropriateness of referral in orthopedics. A cross-sectional study was conducted with all children consecutively referred in orthopedics for suspected scoliosis. The 831 participants were classified as Appropriate, Late, or Inappropriate referrals for the orthopedic setting. Perceived morbidity was operationalized by: the scoliosis detection originator, the perceptions of the seriousness of the condition and urgency to consult a physician, the perception of the general health, as well as Visible Back Deformity, Self-image, and Pain. Direct associations between the perceived morbidity and the appropriateness of referral were found in all scoliosis-specific measures; the most discriminant variable was Visible Back Deformity. Lay perceived morbidity is a good indicator of the objective morbidity, and thus reflects in the appropriateness of referral status. The important role of the lay persons in symptoms appraisal does not however insure appropriate referral. Searching for alternatives to SSSP would wisely include a health promotion and medical management program. Statement of Clinical Significance: Perceived morbidity by the lay persons is strongly associated with the objectively evaluated severity of scoliosis deformity. Therefore, in absence of SSSP, lay person awareness plays an important role in symptom recognition and search for care. (c) 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res