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The Impact of Focused Hip Ultrasound Training on Imaging Quality in Infants With Hip Dysplasia
Ahmad Alawadhi1, Kenan S Basha1, Jalal Al-Shryda2
1College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Insights
Focused hip ultrasound training significantly improved infant hip image quality and rater agreement for developmental dysplasia of the hip. This highlights the value of targeted training in enhancing pediatric orthopedic care.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Radiology Training
Background:
- The orthopedic department at Al Jalila Children's Specialty Hospital (AJCH) established a hip ultrasound training course in April 2019.
- The training aimed to enhance the quality of hip ultrasound imaging for infants.
Purpose of the Study:
- To evaluate the impact of focused training on infant hip ultrasound image quality criteria.
- To assess inter- and intra-rater agreement among healthcare professionals using hip ultrasound for developmental hip dysplasia.
Main Methods:
- A retrospective review compared 60 pre-training hip ultrasound images with 60 post-training images from 60 infants.
- Inter- and intra-rater agreements for imaging parameters were assessed using intraclass correlation (ICC) and kappa statistics.
Main Results:
- Image quality significantly improved post-training, with optimal images increasing from 48% to 82% (P<0.001).
- Excellent inter-rater agreement was observed for alpha and beta angles (ICC 0.970 and 0.904, respectively).
- Moderate inter-rater agreement was found for hip type classification (κ = 0.512).
Conclusions:
- Focused training demonstrably enhances infant hip ultrasound image quality.
- Targeted training programs are valuable for improving the quality of care in pediatric orthopedic services.
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.
