聚焦式髋关节超声检查培训对髋关节发育不良婴儿成像质量的影响。
The Impact of Focused Hip Ultrasound Training on Imaging Quality in Infants With Hip Dysplasia.
作者信息
Alawadhi Ahmad, Basha Kenan S, Al-Shryda Jalal, Al Ali Tahani, Dsouza Ajay P, Abdulhadi Hayder S, Khamis Amar H, Majid Ibrar, Alshryda Sattar
机构信息
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Department of Surgery, Collm Klinik Oschatz, Oschatz, DEU.
出版信息
Cureus. 2024 Nov 29;16(11):e74787. doi: 10.7759/cureus.74787. eCollection 2024 Nov.
BACKGROUND
The orthopedic department at Al Jalila Children's Specialty Hospital (AJCH) was opened in April 2018. A focused hip ultrasound training course was conducted in April 2019 to improve hip ultrasound imaging quality.
OBJECTIVES
This study aims to evaluate the impact of focused training courses on predefined image quality criteria of infant hip ultrasound in the context of developmental hip dysplasia. It also seeks to measure the inter- and intra-rater agreement among various disciplines.
METHODS
A retrospective review of 120 hip ultrasound images (60 infants) was performed between April 2018 and April 2020. Based on internationally agreed criteria, 60 hip images obtained before the course were compared to another 60 hip images obtained after the course. Inter-rater and intra-rater agreements were also evaluated using intraclass correlation (ICC).
RESULTS
The study evaluated the impact of a focused training course on the quality of infant hip ultrasound images for developmental dysplasia of the hip. Image quality significantly improved after the training, with optimal images increasing from 48% to 82% (P<0.001). Logistic regression confirmed the training's positive effect, highlighting its clinical and statistical significance. The study has also demonstrated excellent agreement among raters for alpha and beta angles, as reflected by ICC statistics. The agreement for alpha angles was notably higher than for beta angles (ICC 0.970 vs. 0.904; P<0.0001). However, inter-rater agreement for hip types, assessed using kappa statistics, was moderate (κ = 0.512) and targeted to address a limited shortfall or gaps in services.
CONCLUSION
The study confirms the value of focused training in improving the quality of care. This training should be carefully planned and targeted to address limited shortfalls or gaps in services in other areas of service delivery.
LEVEL OF EVIDENCE
The study is a retrospective cohort with evidence level II.
背景
阿吉莱拉儿童专科医院（AJCH）的骨科于2018年4月开业。2019年4月举办了一次聚焦于髋关节超声的培训课程，以提高髋关节超声成像质量。
目的
本研究旨在评估聚焦培训课程对发育性髋关节发育不良背景下婴儿髋关节超声预定义图像质量标准的影响。它还旨在衡量不同学科之间的评分者间和评分者内一致性。
方法
对2018年4月至2020年4月期间的120张髋关节超声图像（60例婴儿）进行回顾性分析。根据国际公认的标准，将课程前获得的60张髋关节图像与课程后获得的另外60张髋关节图像进行比较。还使用组内相关系数（ICC）评估评分者间和评分者内一致性。
结果
该研究评估了聚焦培训课程对婴儿髋关节发育不良超声图像质量的影响。培训后图像质量显著提高，最佳图像从48%增加到82%（P<0.001）。逻辑回归证实了培训的积极效果，突出了其临床和统计学意义。该研究还表明，评分者之间在α角和β角方面具有出色的一致性，这在ICC统计数据中得到了体现。α角的一致性明显高于β角（ICC 0.970对0.904；P<0.0001）。然而，使用kappa统计评估的髋关节类型的评分者间一致性为中等（κ = 0.512），旨在解决服务中有限的不足或差距。
结论
该研究证实了聚焦培训在提高护理质量方面的价值。这种培训应精心规划，并针对服务提供其他领域的有限不足或差距。
证据水平
该研究是一项证据水平为II级的回顾性队列研究。
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