The effectiveness of a protocol without routine radiographs for follow-up of adolescent idiopathic scoliosis patients (CURVE): a study protocol

Background and purpose - Current follow-up protocols for adolescent idiopathic scoliosis (AIS) are based on consensus and consist of regular full -spine radiographs to monitor curve progression and surgical complications. Consensus exists to avoid inappropriate use of radiographs in children. It is unknown whether a standard radiologic follow-up (S -FU) approach is necessary or if a patient -empowered follow-up (PE -FU) approach can reduce the number of radiographs without treatment consequences. low -up, radiation exposure, societal costs, positive predictive value, and interrelation of clinical assessment, quality of life, and parameters for initiation of treatment during followup. Outcomes will be analyzed using linear mixed -effects models, adjusted for relevant baseline covariates, and are based on intention -to -treat principle. Study summary: (i) a national, multicenter pragmatic randomized trial addressing the optimal frequency of radiographic follow-up in patients with AIS; (ii) first study that includes patient -empowered follow-up; (iii) an inclusive study with 3 follow-up subgroups and few exclusion criteria representative for clinical reality; (iv) preference cohorts alongside to amplify generalizability; (v) first study conducting an economic evaluation comparing both follow-up approaches.