The objective of screening for DDH is to prevent it being diagnosed late, when treatment is more invasive and can be less successful. Ultrasound screening is standard practice in some European countries but not in the United Kingdom, United States, or Scandinavia.
A systematic review conducted by researchers at the Centre for Reviews and Dissemination, University of York, and the Horten Centre, University of Zurich, found that the diagnostic accuracy of ultrasound imaging for DDH in the screening population has not been investigated adequately.
Furthermore, evidence is insufficient to support or reject general ultrasound screening of newborns for DDH. Good quality studies that investigate the natural course of the disorder, the optimal treatment for DDH, and the best strategy for ultrasound screening are needed, they stated.
Lead researcher, Nerys Woolacott said: “To date, a huge body of literature describes ultrasound imaging as a useful and accurate diagnostic tool for DDH, but it fails to provide clear evidence either for or against its use in the general screening of newborn infants. Our review of the available evidence provides us with a good example of how early acceptance of an intervention or technology can inhibit or even preclude good quality research, resulting in long term if not permanent uncertainty.”
The findings of this review have informed the decision to remove ultrasound screening for DDH in newborns from insurance coverage in Switzerland; saving £30million per year.
MEDICA.de; Source: NHS Centre for Reviews and Dissemination