Current studentsExisting staffContact us
 

Performance treatment pathways and effects of alternative policy options for screening for developmental dysplasia of the hip in the United Kingdom

Simple item page
dc.contributor.authorDezateux, C.
dc.contributor.authorBrown, J.
dc.contributor.authorArthur, R.
dc.contributor.authorKarnon, J.
dc.contributor.authorParnaby, A.
dc.date.issued2003
dc.description.abstractAims: To compare, using a decision model, performance, treatment pathways and effects of different newborn screening strategies for developmental hip dysplasia with no screening. Methods: Detection rate, radiological absence of subluxation at skeletal maturity and avascular necrosis of the femoral head, as favourable and unfavourable treatment outcomes respectively, were compared for the following strategies: clinical screening alone using the Ortolani and Barlow tests; the addition of static and dynamic ultrasound examination of the hips of all infants (universal ultrasound) or restricted to infants with defined risk factors (selective ultrasound); “no screening” (that is, clinical diagnosis only). Results: Universal or selective ultrasound detects more more affected children (76% and 60% respectively) than clinical screening alone (35%), results in a higher proportion of affected children with favourable treatment outcomes (92% and 88% respectively) than clinical screening alone (78%) or no screening (75%), and the highest proportion of these achieved without recourse to surgery (64% and 79% respectively) compared with clinical screening alone (18%). However, ultrasound based strategies are also associated with the highest number of unfavourable treatment outcomes arising in unaffected children treated following a false positive screening result. The detection rate of clinical screening alone becomes similar to that reported for universal ultrasound when based on studies using experienced examiners (80%) rather than junior medical staff (35%). Conclusion: From the largely observational data available, ultrasound based screening strategies appear to be most sensitive and effective but are associated with the greatest risk of potential adverse iatrogenic effects arising in unaffected children.
dc.description.statementofresponsibilityC Dezateux, J Brown, R Arthur, J Karnon, and A Parnaby
dc.identifier.citationArchives of Disease in Childhood, 2003; 88(9):753-759
dc.identifier.doi10.1136/adc.88.9.753
dc.identifier.issn0003-9888
dc.identifier.issn1468-2044
dc.identifier.orcidKarnon, J. [0000-0003-3220-2099]
dc.identifier.urihttp://hdl.handle.net/2440/47192
dc.language.isoen
dc.publisherBritish Med Journal Publ Group
dc.rightsCopyright © 2003 by the BMJ Publishing Group Ltd.
dc.source.urihttp://adc.bmj.com/cgi/content/abstract/88/9/753
dc.subjectHumans
dc.subjectHip Dislocation, Congenital
dc.subjectUltrasonography
dc.subjectNeonatal Screening
dc.subjectTreatment Outcome
dc.subjectDecision Trees
dc.subjectChild
dc.subjectChild, Preschool
dc.subjectInfant
dc.subjectInfant, Newborn
dc.titlePerformance treatment pathways and effects of alternative policy options for screening for developmental dysplasia of the hip in the United Kingdom
dc.typeJournal article
pubs.publication-statusPublished

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
hdl_47192.pdf
Size:
193.23 KB
Format:
Adobe Portable Document Format
Description:
Publisher's PDF
Download

Collections

Public Health publications