HIP DYSPLASIA

A systematic review of the clinical and cost effectiveness of ultrasound in screening for developmental dysplasia of the hip in newborns

Background

The 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).

Findings

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 programmes

Conducted by: Nerys Woolacott1, Milo A Puhan2, Johann Steurer2, Jos Kleijnen1

1. Centre for Reviews and Dissemination; 2. Horten Centre, University of Zurich

Publications

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):1413-8

Puhan 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

Presentations

Kleijnen J. Ultrasound screening for hip dysplasia. Swiss Federal Office for Social Security Meeting; 2002 September; Bern, Switzerland

Funding

Commissioned by the Swiss Federal Office for Social Security