A systematic review of the clinical and cost effectiveness of ultrasound in screening for developmental dysplasia of the hip in newborns
BackgroundThe objective of this review was to evaluate the effectiveness, clinical impact and cost effectiveness of ultrasound in screening of newborns for developmental dysplasia of the hip (DDH).
Ultrasound imaging performed initially at age one month appears to be a sensitive diagnostic screening test, however, better quality diagnostic accuracy studies are required. General screening of newborns at birth or at one month of age for DDH using ultrasound rather than clinical examination appears to increase overall treatment rates and may be associated with over treatment. General ultrasound screening of newborns may reduce the severity and invasiveness of the treatments required for DDH. There is no evidence that ultrasound screening reduces the number of clinically relevant cases of DDH diagnosed late. Limited evidence indicates that general ultrasound screening of newborns offers little, if any increased benefit over selective use of ultrasound imaging.
Few economic evaluation data are available and these are of limited value due to the quality of the clinical data upon which they are based. Overall the cost of ultrasound screening of newborns for DDH may be comparable to or better than that of other screening programmesConducted by: Nerys Woolacott1, Milo A Puhan2, Johann Steurer2, Jos Kleijnen1
1. Centre for Reviews and Dissemination; 2. Horten Centre, University of Zurich
Centre for Reviews and Dissemination. Systematic review of the clinical and cost effectiveness of ultrasound in screening for developmental dysplasia of the hip in newborns. CRD Report 28. York: University of York. 2005
Woolacott NF, Puhan MA, Steurer J, Kleijnen J. Ultrasonography in screening for developmental dysplasia of the hip in newborns: systematic review. BMJ. 2005;330(7505):1413-8Puhan MA, Woolacott N, Kleijnen J, Steurer J. [Observational studies on ultrasound screening for developmental dysplasia of the hip in newborns: a systematic review]. Ultraschall in der Medizin 2003;24(6):377-82
PresentationsKleijnen J. Ultrasound screening for hip dysplasia. Swiss Federal Office for Social Security Meeting; 2002 September; Bern, Switzerland
Commissioned by the Swiss Federal Office for Social Security