Document Detail


Observational studies on ultrasound screening for developmental dysplasia of the hip in newborns - a systematic review.
MedLine Citation:
PMID:  14658079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To assess whether observational studies provide evidence to support general ultrasound screening for developmental dysplasia of the hip (DDH). METHOD: Systematic Review. Following a predefined study protocol, observational studies on ultrasound screening in unselected newborns were identified by search through 23 electronic databases and by hand search. Two reviewers selected the studies independently of each other and extracted the data. RESULTS: 49 observational studies were included. The prevalence of DDH ranged from 0.5 % to 30 % depending largely on the various possible definitions of DDH. Less than 0.1 % of patients with DDH were missed by ultrasound regardless of the technique employed (Graf or Terjesen). About 90 % of newborns with Graf type IIa hips requiring ultrasound control did not develop DDH. Only six studies with 23 108 newborns reported on complications, and there was only one infant with an avascular necrosis of the femoral head. The effectiveness of a general ultrasound screening cannot be evaluated reliably for several reasons: reports were often incomplete, follow-up of newborns with normal findings at the time of screening was often not carried out, clinically meaningful data about outcome as well as control groups were missing. CONCLUSION: General ultrasound screening for developmental dysplasia of the hip cannot be sufficiently assessed by the observational studies available. The lack of evidence does not mean that ultrasound screening is ineffective, but randomized controlled trials comparing the effectiveness of different screening regimens are needed.
Authors:
M A Puhan; N Woolacott; J Kleijnen; J Steurer
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Ultraschall in der Medizin (Stuttgart, Germany : 1980)     Volume:  24     ISSN:  0172-4614     ISO Abbreviation:  Ultraschall Med     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-05     Completed Date:  2004-03-01     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8303585     Medline TA:  Ultraschall Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  377-82     Citation Subset:  IM    
Affiliation:
Horten Centre for Patient Oriented Research, University Zürich, Switzerland. milo.puhan@evimed.ch
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MeSH Terms
Descriptor/Qualifier:
Costs and Cost Analysis
Hip Dislocation, Congenital / ultrasonography*
Humans
Infant, Newborn
Mass Screening / economics,  methods*
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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