Evidence map›Paper›PMID 30121837›Full record

ArticleInternational orthopaedics2019

Screening program for neonates at risk for developmental dysplasia of the hip: comparing first radiographic evaluation at five months with the standard twelve week ultrasound. A prospective cross-sectional cohort study.

Dorien Geertsema, Joris E Meinardi, Dagmar R J Kempink, Marta Fiocco, Michiel A J van de Sande

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in International orthopaedics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Dorien GeertsemaDepartment of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, Postzone J11, PO Box 9600, 2300 RC, Leiden, The Netherlands. d.geertsema@mchaaglanden.nl.ORCID 0000-0002-7239-6855
Joris E MeinardiDepartment of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, Postzone J11, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Dagmar R J KempinkDepartment of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, Postzone J11, PO Box 9600, 2300 RC, Leiden, The Netherlands.
Marta FioccoMedical Statistics, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
Michiel A J van de SandeDepartment of Orthopaedics, Leiden University Medical Center, Albinusdreef 2, Postzone J11, PO Box 9600, 2300 RC, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess whether delayed radiological hip screening at five months (versus ultrasound at 3 months) results in a higher incidence of persistent developmental dysplasia of the hip (DDH) at 18 months.

methodsWe analyzed 3536 screened neonates (2009-2013) at age two to three weeks. In the case of risk factors for DDH, 460 infants were assigned to a pelvic radiograph at five months between 2009 and 2010 and 651 infants were assigned to an ultrasound at three months (2011-2013). In the case of DDH, appropriate treatment was started and radiological follow-up occurred at eight, ten, 12, and 18 months. We compared incidence and severity of persistent DDH at 18 months. Analysis was performed using linear regression.

resultsBoth groups were comparable for risk factors (breech, gender, twins, family history). Eighty-nine patients (2.5%) showed DDH (n = 43 (group 1), n = 46 (group 2)). At 18 months, ten patients showed persistent DDH (n = 8 (group 1), n = 2 (group 2) (7.7% vs. 0.3% respectively)). The mean acetabular index (AI) at 18 months in group 1 (left hip) is 22.4° (95% CI 20.6-24.3°) vs. group 2 at 22.3° (95% CI 21.2-23.4°) (p = 0.098). The mean AI in group 1 (right hip) is 21.9° (95% CI 18.9-24.9°) vs. 21.2° (95% CI 20.5-22.0°) in group 2 (p = 0.293). Adjusted for risk factors, there is no difference in incidence of persistent DDH between both groups after 18 months (OR 0.519; 0.07, 3.845). DISCUSSION: This study revealed no significant difference in incidence or severity of persistent DDH at 18 months between the two screening groups. These results suggest justification for delayed screening to prevent overtreatment of immature hips.

conclusionIn clinically stable hips, delayed ultrasound between three and five months is regarded as safe and could prevent for overtreatment of mild dysplastic hips.

Indexed as

Cross-Sectional StudiesFemaleHip Dislocation, CongenitalHumansIncidenceInfantInfant, NewbornMaleNeonatal ScreeningNetherlandsProspective StudiesRadiographyUltrasonographyHip dysplasiaScreeningTreatmentUltrasound

Identifiers

PMID30121837
PMCPMC6647175

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.