Baronciani D, Atti G, Andiloro F, Bartesaghi A, Gagliardi L, Passamonti C, Petrone M
Divisione Patologia Neonatale-Ospedale di Lecco, Lecco, Italy.
Pediatrics. 1997 Feb;99(2):E5. doi: 10.1542/peds.99.2.e5.
To evaluate an organizational model for neonatal population screening for developmental dysplasia of the hip.
In 4648 neonates born in six hospitals of the Lombardy region, screening for developmental dysplasia of the hip was done using the Ortolani-Barlow maneuver and ultrasonography.
The frequency of positive results of clinical and ultrasound examinations carried out in the hospitals varied considerably as a result of difficulties in the Ortolani-Barlow test reproducibility and in the low sensitivity of the clinical examination when compared to ultrasonography. Neonatal screening results implied a large number of subjects with a IIa hip, according to Graf's system; as these subjects require follow-up, the cost of this type of screening is high. Ultrasound findings were normal at 69 days of life in 88% and 75% of subjects, respectively, with unilateral and bilateral type IIa hip.
This study evaluated various organizational models for screening (for different time periods and for selected populations) in relation to the cost-benefit ratio and demonstrated the different problems that still impede identification of a correct screening model.
评估一种用于新生儿髋关节发育不良群体筛查的组织模式。
在伦巴第地区六家医院出生的4648名新生儿中，采用奥尔托拉尼 - 巴洛手法和超声检查对髋关节发育不良进行筛查。
由于奥尔托拉尼 - 巴洛试验的可重复性存在困难，且与超声检查相比临床检查的敏感性较低，各医院进行的临床和超声检查阳性结果的频率差异很大。根据格拉夫系统，新生儿筛查结果显示有大量IIa型髋关节患儿；由于这些患儿需要随访，此类筛查成本很高。分别有88%和75%的单侧和双侧IIa型髋关节患儿在出生69天时超声检查结果正常。
本研究评估了各种筛查组织模式（针对不同时间段和特定人群）的成本效益比，并证明了仍然阻碍确定正确筛查模式的不同问题。
