Dataset Information

Point of Care Ultrasound as Performed by the Clinician for the Enhancement of Physical Examination: A Technique Guide for Developmental Hip Dysplasia.

ABSTRACT: Developmental dysplasia of the hip (DDH) is the most common anatomical pathology present in newborns. DDH is the most common orthopaedic disorder in newborns, with incidences cited from 4.4% to 51.8% depending on risk factors, populations and method of reporting. Traditionally, the standard physical exam for newborns includes the Barlow and Ortolani maneuvers. If either is positive by the pediatrician, the baby is then sent for evaluation by a pediatric orthopaedic surgeon. At this stage, either the pediatrician or pediatric orthopaedic surgeon obtains an ultrasound-the gold standard for DDH diagnosis. When early identification and treatment are not in place, it can lead to significant consequences on an individual's health and financial and public health implications for society at large. This is a detailed technique guide aimed to help physicians consistently perform thorough US evaluations of pediatric hips in order to successfully screen, diagnosis and manage treatment of DDH.

Supplementary information

The online version contains supplementary material available at 10.1007/s43465-021-00570-8.

SUBMITTER: Herrero C

PROVIDER: S-EPMC8688612 | biostudies-literature | 2021 Dec

REPOSITORIES: biostudies-literature

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Point of Care Ultrasound as Performed by the Clinician for the Enhancement of Physical Examination: A Technique Guide for Developmental Hip Dysplasia.

Herrero Christina C Jejurikar Neha N Kanakalamedala Ajay A Iban Yhan Colon YC Castañeda Pablo P

Indian journal of orthopaedics 20211121 6

Developmental dysplasia of the hip (DDH) is the most common anatomical pathology present in newborns. DDH is the most common orthopaedic disorder in newborns, with incidences cited from 4.4% to 51.8% depending on risk factors, populations and method of reporting. Traditionally, the standard physical exam for newborns includes the Barlow and Ortolani maneuvers. If either is positive by the pediatrician, the baby is then sent for evaluation by a pediatric orthopaedic surgeon. At this stage, either ...[more]

PMID: 35003546

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Project description:BackgroundPoint-of-care cardiac ultrasound (cardiac POCUS) has potential to become a useful tool for improving cardiovascular care in Tanzania. We conducted a pilot program to train clinicians at peripheral health centers to obtain and interpret focused cardiac POCUS examinations using a hand-held portable device.MethodsOver a 5-day period, didactic and experiential methods were used to train clinicians to conduct a pre-specified scanning protocol and recognize key pathologies. Pre- and post-training knowledge and post-training image acquisition competency were assessed. In their usual clinical practices, trainees then scanned patients with cardiovascular signs/symptoms, recorded a pre-specified set of images for each scan, and documented their interpretation as to presence or absence of key pathologies on a case report form. A cardiologist subsequently reviewed all images, graded them for image quality, and then documented their interpretation of key pathologies in a blinded fashion; the cardiologist interpretation was considered the gold standard.Results8 trainees (6 Clinical Officers, 1 Assistant Medical Officer, and 1 Medical Doctor) initiated and completed the training. Trainees subsequently performed a total of 429 cardiac POCUS examinations in their clinical practices over a 9 week period. Stratified by trainee, the median percent of images that were of sufficient quality to be interpretable was 76.7% (range 18.0-94.2%). For five of eight trainees, 75% or more of images were interpretable. For detection of pre-specified key pathologies, kappa statistics for agreement between trainee and cardiologist ranged from - 0.03 (no agreement) for detection of pericardial effusion to 0.42 (moderate agreement) for detection of tricuspid valve regurgitation. Mean kappa values across the key pathologies varied by trainee from 0 (no agreement) to 0.32 (fair agreement).ConclusionsThe 5-day training program was sufficient to train most clinicians to obtain basic cardiac images but not to accurately interpret them. Proficiency in image interpretation may require a more intensive training program.

Dataset Information

Point of Care Ultrasound as Performed by the Clinician for the Enhancement of Physical Examination: A Technique Guide for Developmental Hip Dysplasia.

Supplementary information

Publications

Point of Care Ultrasound as Performed by the Clinician for the Enhancement of Physical Examination: A Technique Guide for Developmental Hip Dysplasia.

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