title: Evaluation of a training program for general ultrasound screening for developmental dysplasia of the hip in preventive child health care.
abstract: BACKGROUND
  A research study in the Netherlands showed that general ultrasound (US) screening was cost-effective in the detection of developmental dysplasia of the hip (DDH). This study was followed by a pilot implementation study. Part of this pilot implementation study is to investigate whether professionals of the infant health care (IHC) system, with no previous US experience, would be able to perform US of the hip.
  
  
  OBJECTIVE
  This study looks at health care worker ability to classify US images into a modified Graf system.
  
  
  METHODS
  After theoretical and practical training, seven nurses and physicians of the participating IHC centers reported their findings on sonographic images of 80 children. This was repeated five months later. From the two evaluation moments the intraobserver agreement and the interobserver agreement was determined.
  
  
  RESULTS
  The average estimated interobserver Cohen's kappa for both sessions was for nurses 0.6 and for physicians 0.5. The second evaluation showed a decrease from an average of 4.3% missed cases per screener to 2.3% and an increase of an average of 5% false positives per screener to 9.1%.
  
  
  CONCLUSIONS
  The inter- and intra-observer agreement is comparable to similar studies in which the participants had a professional background in US examination. The level of agreement of the trainees in the perspective of the screening process was considered sufficient for the pilot implementation project.
authors.affiliation: Department of Orthopedics, UMC Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. s.ramwadhdoebe@umcutrecht.nl
authors.forename: S
authors.initials: S
authors.lastname: Ramwadhdoebe
authors.forename: R J B
authors.initials: RJ
authors.lastname: Sakkers
authors.forename: Cuno S P M
authors.initials: CS
authors.lastname: Uiterwaal
authors.forename: Magda M
authors.initials: MM
authors.lastname: Boere-Boonekamp
authors.forename: Frederik J A
authors.initials: FJ
authors.lastname: Beek
mesh_terms: D002648:Child; D004493:Education / Q000592:standards*; D004501:Education, Medical; D004506:Education, Nursing; D006618:Hip Dislocation, Congenital / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D015997:Neonatal Screening; D009426:Netherlands; D011314:Preventive Health Services / Q000379:methods*; D012423:Rural Health; D014463:Ultrasonography; D014504:Urban Health