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 Vol. 22 No. 4, October 2009
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AAP Grand Rounds 22:37 (2009)
© 2009 American Academy of Pediatrics

ORTHOPAEDICS

What Is the Optimal Strategy To Screen for Hip Dysplasia?

Source: Mahan ST, Katz JN, Kim Y-J. To screen or not to screen? A decision analysis of the utility of screening for developmental dysplasia of the hip. J Bone Joint Surg Am. 2009;91(7):1705–1719; doi:10.2106/JBJS.H.00122[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.


PICO

Question: Among normal newborn infants, does physical examination and/or hip sonogram, compared to no screening tests, reduce the rate of adult osteoarthritis caused by developmental dysplasia of the hip?

Question type: Decision analysis

Study design: Decision analysis

 

Investigators from Children’s Hospital, Boston, used decision analysis to evaluate three different screening decision strategies to detect newborn developmental dysplasia of the hip (DDH): no screening (NS); universal physical examination and ultrasound screening (universal PE/US); and universal physical examination and selective ultrasound screening (universal PE/selective US). With decision analysis, outcomes in a hypothetical group of patients who undergo various diagnostic assessments and treatments are compared based on probabilities derived from literature review and clinical practice guidelines. Where uncertainty exists, analyses using a range of probabilities are conducted.

For this study, DDH in the immature hip was defined as a continuum . . . [Full Text of this Article]

Richard M. Schwend, MD, FAAP
Pediatric Orthopaedics, Children’s Mercy Hospital, Kansas City, MO