Positive predictive values in clinical screening for developmental dysplasia of the hip.
developmental dysplasia of the hip
paediatric orthopaedics
predictive values
screening
Journal
Acta paediatrica (Oslo, Norway : 1992)
ISSN: 1651-2227
Titre abrégé: Acta Paediatr
Pays: Norway
ID NLM: 9205968
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
30
03
2021
received:
07
01
2021
accepted:
26
04
2021
pubmed:
30
4
2021
medline:
6
8
2021
entrez:
29
4
2021
Statut:
ppublish
Résumé
To establish the positive predictive value (PPV) of clinical hip examinations performed by referrers in the Danish screening programme for Developmental Dysplasia of the Hip (DDH) utilising three definitions of true positive DDH diagnosis. We retrospectively identified 290 children (169 female) referred during a 4-year period to the orthopaedic outpatient clinic at our institution with a positive clinical hip examination. Positive predictive value was calculated for clinical hip examinations across three definitions of a true positive clinical hip examination for all referrers and subgroups consisting of general practitioners, midwives and paediatricians. The PPV for clinical hip examinations was calculated for paediatric orthopaedic surgeons using one of the three definitions. Positive predictive value of clinical hip examinations for all referrers were 5.4%, 3.6% and 1.8% with the definition of a true positive DDH diagnosis defined as clinical instability found by orthopaedic surgeon, ultrasound classification ≥Graf IIc or both definitions combined, respectively. Positive predictive value of clinical hip examinations performed by orthopaedic surgeons was 33.3% with a true positive clinical examination defined as an ultrasound classification ≥Graf IIc. We conclude that the positive predictive value of clinical hip examinations made by referrers in the Danish screening programme for DDH is low.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2430-2434Informations de copyright
©2021 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Références
Sewell MD, Rosendahl K, Eastwood DM. Developmental dysplasia of the hip. BMJ. 2009;339:1242-1248. https://doi.org/10.1136/bmj.b4454
Sundhedsstyrelsen. Anbefalinger for Svangreomsorgen, 2nd edn. Copenhagen, Denmark: Sundhedsstyrelsen; 2013.
El-Shazly M, Trainor B, Kernohan WG, et al. Reliability of the barlow and ortolani tests for neonatal hip instability. J Med Screen. 1994;1:165-168. https://doi.org/10.1177/096914139400100306
Choudry QA, Paton RW. Neonatal screening and selective sonographic imaging in the diagnosis of developmental dysplasia of the hip. Bone Jt J. 2018;100B:806-810. https://doi.org/10.1302/0301-620X.100B6.BJJ-2017-1389.R1
Graf R. Hip Sonography. Diagnosis and Management of Infant Hip Dysplasia, 2nd edn. New York City, USA: Springer; 2006.
Gardiner HM, Dunn PM. Controlled trial of immediate splinting versus ultrasonographic surveillance in congenitally dislocatable hips. Lancet. 1990;336:1553-1556. https://doi.org/10.1016/0140-6736(90)93318-J
Barlow TG. Early diagnosis and treatment of congenital dislocation of the hip. J Bone Joint Surg Br. 1962;44-B(2):292-301. https://doi.org/10.1302/0301-620X.44B2.292
National Health Service. Newborn and infant physical examination (NIPE) screening programme n.d. https://www.gov.uk/topic/population-screening-programmes/newborn-infant-physical-examination. Accessed August 6, 2020.
Düppe H, Danielsson LG. Screening of neonatal instability and of developmental dislocation of the hip. A survey of 132 601 living newborn infants between 1956 and 1999. J Bone Joint Surg Br. 2002;84:878-885.
Rosendahl K, Markestad T, Lie RT. Ultrasound screening for developmental dysplasia of the hip in the neonate: the effect on treatment rate and prevalence of late cases. Pediatrics. 1994;94:47-52.
Holen KJ, Surgeon Tegnander OA, Resident Bredland OT, et al. Universal or selective screening of the neonatal hip using ultrasound? J Bone Jt Surg [Br]. 2002;84-B:886-890. https://doi.org/10.1302/0301-620x.84b6.0840886
Talbot CL, Paton RW. Screening of selected risk factors in developmental dysplasia of the hip: an observational study. Arch Dis Child. 2013;98:692-696. https://doi.org/10.1136/archdischild-2013-303647