Reproducibility of different screening classifications in ultrasonography of the newborn hip

Peterlein, Christian‐Dominik; Schüttler, Karl F.; Lakemeier, Stefan; Timmesfeld, Nina; Görg, Christian; Fuchs-Winkelmann, Susanne; Schofer, Markus D.

doi:10.1186/1471-2431-10-98

Cited by 29 publications

(28 citation statements)

References 32 publications

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“…Several studies have evaluated the reliability and reproducibility of the Graf method 5 , 8 , 9 , 23 . The difference in measurements between the observers was due to variations in defining landmarks on the same sonogram.…”

Section: Discussionmentioning

confidence: 99%

Reliability of Computer‐Assisted and Manual Measurement Methods for Assessment of Graf Type 1 and Type 2 Hip Sonograms

Bilgili

Çetinkaya

et al. 2016

J of Ultrasound Medicine

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Section: Discussionmentioning

confidence: 99%

Reliability of Computer‐Assisted and Manual Measurement Methods for Assessment of Graf Type 1 and Type 2 Hip Sonograms

Bilgili

Çetinkaya

et al. 2016

J of Ultrasound Medicine

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“…Peterlein et al [50] examined 207 newborns with both the Terjesen and Graf techniques and investigated the inter-and intra-observer reliability for the measurements of alpha angle, beta angle and femoral head coverage (FHC). They found better reliability for the alpha angle, followed by the beta angle and finally by the FHC, regardless of the experience level of the investigator.…”

Section: Us Examination Techniquesmentioning

confidence: 99%

International Interdisciplinary Consensus Meeting on the Evaluation of Developmental Dysplasia of the Hip

O’Beirne

Chlapoutakis²,

Alshryda³

et al. 2019

Ultraschall in Med

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In September 2018, an international meeting of doctors of various disciplines, with expertise in the detection and treatment of DDH, was held in Csolyospalos, Hungary. The aim was to achieve consensus on the detection and early treatment of the condition and to develop a standardized system of teaching and training for hip ultrasound. There was strong agreement that US screening is essential. Specifically the Graf technique was selected as the technique of choice. Universal US screening was strongly favored. Screening should be carried out as soon as possible, but not later than the sixth week of age. US screening is cost-effective, does not result in overtreatment, and contributes to a reduction of long-term consequences. The essential principle of treatment is timely application of a device to achieve reduction, retention and maturation, by holding the hips in flexion, and a safe degree of abduction. It was agreed that the effectiveness of any screening policy depends on the correct scanning technique. Therefore, standardization of teaching and training of the Graf technique is mandatory. A unified teaching policy and materials should be developed for this purpose. Certification, re-certification and audit were discussed. The group, which has been formalized as the International Interdisciplinary Consensus Committee On DDH Evaluation (ICODE), will continue to meet and work towards establishing international consensus on DDH, standardizing and developing teaching and training of the Graf technique for hip US, and maintaining standards for detection and management.

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“…Peterlein et al . 17 performed a similar study, in which ultrasonography was performed on each newborn by three investigators with different levels of experience. Interestingly, they found no statistically significant difference between investigators measurements even when the experience levels were highly different from each other.…”

Section: Discussionmentioning

confidence: 99%

“…However, the strength is the performance of the ultrasonography evaluation of the same infant by four different clinicians. The few similarly designed studies that have been performed in the past involved much fewer 14 15 16 17 clinicians.…”

Section: Discussionmentioning

confidence: 99%

The reliability of ultrasonography in developmental dysplasia of the hip

Orak

Onay

Cagirmaz³

et al. 2015

IJOO

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Background:Developmental dysplasia of the hip (DDH) is the most common skeletal dysplasia. Two principal methods used in early diagnosis of DDH are clinical examination and ultrasonographic investigation. Dogruel et al. found a low specificity of clinical examination in patients with DDH. Additionally, Kamath et al. stated that ultrasonography performed by a radiologist in routine clinical practice is more reliable than physical examination performed by the average clinician. In clinical practice, the application and assessment of hip ultrasonography are completed by a single person. This assessment determines the followup of the patient. Thus, hip ultrasonography performed on the same person by different individuals under the same conditions will yield a more accurate assessment of the reliability of ultrasonographic assessment of DDH. Although inter-observer reliability was high in many previous studies of ultrasound image evaluation, reliability rates vary among studies of the application of ultrasonography.Materials and Methods:Inter-examiner reliability of hip ultrasonography was analyzed among four investigators who separately evaluated 100 hips (50 infants). The obtained bone structure angles α, cartilage structure angles β, and distribution of hip types were compared among the investigators. All infants were brought to the hospital for a healthy child followup examination, according to the country's health policy. Babies between 0 and 6 months were included in the study. Babies with any neuromuscular disorders, neural tube defects or any type of genetic anomalies were excluded from the study. The study was explained to the families of all infants and written informed consent was obtained.Results:There was a significant difference in the hip type determined by the investigators with respect to α and β angles (P < 0.01, P < 0.01, P = 0.002). The average alpha measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 67.38 ± 6.24, 65.60 ± 5.84, 65.44 ± 4.59, and 62.59 ± 4.50, respectively. The average beta measurements of the first orthopedist, second orthopedist, first radiologist, and second radiologist were 53.85 ± 8.86, 50.74 ± 7.80, 44.77 ± 6.30, and 44.39 ± 5.81, respectively. Agreement among the results obtained by the clinicians was investigated in dual comparisons. The relative agreement according to the alpha angle ranged from 3.6% to 44.5%, and the relative concordance according to the beta angle ranged from 0.9% to 45.3%. Agreement regarding hip typing was determined to range from 19.1% to 42.6%.Conclusion:Sonographic evaluation of the hip appears to vary depending on the investigator.

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Reproducibility of different screening classifications in ultrasonography of the newborn hip

Cited by 29 publications

References 32 publications

Reliability of Computer‐Assisted and Manual Measurement Methods for Assessment of Graf Type 1 and Type 2 Hip Sonograms

Reliability of Computer‐Assisted and Manual Measurement Methods for Assessment of Graf Type 1 and Type 2 Hip Sonograms

International Interdisciplinary Consensus Meeting on the Evaluation of Developmental Dysplasia of the Hip

The reliability of ultrasonography in developmental dysplasia of the hip

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