Libon Jackie, Ng Candice, Bailey Allan, Hareendranathan Abhilash, Joseph Reg, Dulai Sukhdeep
Health Cities, Edmonton, Alberta.
Department of Family Medicine, University of Alberta, Edmonton, Alberta.
Paediatr Child Health. 2023 Apr 12;28(5):285-290. doi: 10.1093/pch/pxad013. eCollection 2023 Aug.
Infant hip dysplasia or Developmental Dysplasia of the Hip (DDH) occurs in 1-2% of births worldwide and leads to hip arthritis if untreated. We sought to evaluate the feasibility of implementing an artificial intelligence-enhanced portable ultrasound tool for infant hip dysplasia (DDH) screening in primary care, through determining its effectiveness in practice and evaluating patient and provider feedback.
A US-FDA-cleared artificial intelligence (AI) screening device for DDH (MEDO-Hip) was added to routine well-child visits from age 6 to 10 weeks. A total of 306 infants were screened during a 1-year pilot study within three family medicine clinics in Alberta, Canada. Patient and provider satisfaction were quantified using the System Usability Survey (SUS), while provider perceptions were further investigated through semi-structured interviews.
Provider and user surveys commonly identified best features of the tool as immediate diagnosis, offering reassurance/knowledge and avoiding travel, and noted technical glitches most frequently as a barrier. A total of 369 scans of 306 infants were performed from Feb 1, 2021 until Mar 31, 2022. Eighty percent of hips scanned were normal on initial scans, 14% of scans required a follow-up study in the primary care clinic, and DDH cases were identified and treated at the expected 2% rate (6 infants).
It is feasible to implement a point-of-care ultrasound AI screening tool in primary care to screen for infants with DDH. Beyond improved screening and detection, this innovation was well accepted by patients and fee-for-service providers with a culture and history of innovation.
婴儿髋关节发育不良或发育性髋关节发育不良（DDH）在全球1%-2%的出生婴儿中出现，若不治疗会导致髋关节关节炎。我们试图通过确定其在实际应用中的有效性并评估患者和医护人员的反馈，来评估在初级保健中使用人工智能增强型便携式超声工具进行婴儿髋关节发育不良（DDH）筛查的可行性。
一种经美国食品药品监督管理局（US-FDA）批准用于DDH筛查的人工智能（AI）设备（MEDO-Hip）被添加到6至10周龄婴儿的常规健康检查中。在加拿大艾伯塔省的三家家庭医学诊所进行的为期1年的试点研究中，共对306名婴儿进行了筛查。使用系统可用性调查（SUS）对患者和医护人员的满意度进行量化，同时通过半结构化访谈进一步调查医护人员的看法。
医护人员和用户调查普遍认为该工具的最佳特性是能够立即诊断、提供安心感/知识并避免出行，且最常指出技术故障是一个障碍。从2021年2月1日至2022年3月31日，共对306名婴儿进行了369次扫描。初始扫描时，80%的髋关节扫描结果正常，14%的扫描需要在初级保健诊所进行后续检查，并且以预期的2%的比例（6名婴儿）识别并治疗了DDH病例。
在初级保健中实施即时超声AI筛查工具来筛查DDH婴儿是可行的。除了改善筛查和检测外，这项创新受到了具有创新文化和历史的患者及按服务收费的医护人员的广泛接受。
