Validation of the reporting bases of the orthopaedic and paediatric surveillance schemes

Area of Science:

• Orthopaedic Surgery
• Public Health Surveillance
• Paediatric Medicine

Background:

• Accurate national estimates of treatment rates for congenital dislocation of the hip (CDH) are crucial for evaluating the UK's current screening policy.
• Ascertainment of CDH cases relied on an active reporting system involving orthopaedic surgeons and the British Paediatric Association Surveillance Unit (BPASU).

Purpose of the Study:

• To detail the methodologies employed in establishing, maintaining, and validating the orthopaedic and BPASU surveillance schemes.
• To assess the completeness and accuracy of the reporting bases for CDH treatment data.

Main Methods:

• Developed the orthopaedic reporting base using multiple data sources, including postal questionnaires sent to surgeons treating children.
• Compared the established orthopaedic and paediatric reporting bases against 1992 manpower census data for surgeons and paediatricians.
• Utilized a combination of active reporting and existing surveillance units for case ascertainment.

Main Results:

• A single ascertainment source would have overlooked 12% of the 517 surgeons treating children with CDH.
• The orthopaedic reporting base achieved 97% completeness, while the paediatric reporting base reached 92% completeness when compared to manpower census data.
• The combined approach demonstrated high coverage and accuracy in identifying treatment cases.

Conclusions:

• Employing multiple sources is essential for robust establishment and maintenance of reporting bases in health surveillance.
• Targeted respondent identification optimizes resource allocation and potentially improves compliance rates.
• Manpower census data provides a reliable method for ongoing validation of surveillance reporting bases.