Zusman Natalie L, Castañeda Pablo G, Goldstein Rachel Y
Jackie and Gene Autry Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
J Child Orthop. 2024 Feb 14;18(4):393-398. doi: 10.1177/18632521241229978. eCollection 2024 Aug.
Developmental hip dysplasia is a prevalent pediatric musculoskeletal condition that lacks international standardized screening. We sought to characterize developmental hip dysplasia screening practices in countries with the top global health indices. We also explored diverse definitions in reported epidemiologic rates of this condition.
We performed a scoping review of developmental hip dysplasia screening protocols utilizing countries ranked in the top 25 of the Bloomberg Global Health Index using a protocolized search strategy, progressing from academic to layperson sources. A reference was eligible for inclusion if it mentioned the countries' screening program and developmental hip dysplasia was the pathology of concern. Incidence rates, when present, were also recorded. The United States Census Bureau's International Database tool provided countries' populations. We compiled the data and performed descriptive statistics and appropriate validation methods.
Twenty countries (80%) had searchable screening programs. Clinical screening with selective universal screening was the most commonly observed (n = 16). Four countries had universal ultrasound screening: Switzerland, Austria, Germany, and Slovenia. Five countries did not have searchable programs. No countries employed radiographic screening. Incidence rates were expressly stated in the literature for nine countries; however, the cohort of interest varied from developmental hip dysplasia versus severity of developmental hip dysplasia versus miscellaneous (e.g. requiring hospitalization).
The findings of this investigation highlight international inconsistencies regarding developmental hip dysplasia screening and epidemiologic data. Screening variations exist despite consensus statements calling for uniformity. We agree with prior literature advocating for increasing consistency in developmental hip dysplasia management or, at a minimum, increasing transparency regarding how we manage these young patients.
发育性髋关节发育不良是一种常见的儿童肌肉骨骼疾病,缺乏国际标准化筛查。我们试图描述全球健康指数排名靠前的国家的发育性髋关节发育不良筛查实践。我们还探讨了该疾病报告的流行病学发病率的不同定义。
我们对发育性髋关节发育不良筛查方案进行了范围审查,利用彭博全球健康指数排名前25的国家,采用程序化搜索策略,从学术来源到大众来源。如果参考文献提到了该国的筛查计划,且发育性髋关节发育不良是关注的病理状况,则该参考文献符合纳入标准。如有发病率数据,也会记录下来。美国人口普查局的国际数据库工具提供了各国的人口数据。我们汇总了数据并进行了描述性统计和适当的验证方法。
20个国家(80%)有可搜索的筛查计划。最常见的是选择性普遍筛查的临床筛查(n = 16)。四个国家进行普遍超声筛查:瑞士、奥地利、德国和斯洛文尼亚。五个国家没有可搜索的计划。没有国家采用X线筛查。文献中明确给出了九个国家的发病率;然而,感兴趣的队列从发育性髋关节发育不良与发育性髋关节发育不良的严重程度与其他情况(如需要住院治疗)有所不同。
这项调查的结果突出了发育性髋关节发育不良筛查和流行病学数据方面的国际不一致性。尽管有共识声明呼吁统一,但筛查仍存在差异。我们同意先前的文献主张在发育性髋关节发育不良的管理上提高一致性,或者至少在我们如何管理这些年轻患者方面提高透明度。