Efectividad de los diferentes programas de tamización en el diagnóstico de displasia del desarrollo de la cadera antes de las 8 semanas de edad: revisión sistemática de literatura
Thesis
Introduction: Developmental dysplasia of the hip (DDH) is a pathology that, if not diagnosed and treated in time, is associated with complications and long-term morbidity, including gait disturbances, the need for complex interventions to correct sequelae, chronic pain and even degenerative osteoarthritis. Objective: To establish the effectiveness of the different screening programs for the diagnosis of DDH before 8 weeks of age. Methodology: A systematic review of the literature was carried out, which included analytical and descriptive secondary, intervention and observational studies with primary data that will address the implementation of screening programs for the diagnosis of DDH before 8 weeks of age. The quality of the evidence was evaluated with the methodology of the University of Oxford. A synthesis of the evidence was carried out according to the recommendations of the Cochrane guidelines and the possibility of a meta-analysis to estimate a global measure was evaluated. Results: 23 articles of 3,641 screened were included, with a total population of 498,664 neonatal and infant patients. The main types of studies were cohort and cross-sectional, very little evidence from clinical studies. Ultrasound was the test in screening programs most used to diagnose DDH, through universal or selective screening mainly in patients with a positive physical examination. The quality of the studies was generally low, and the studies were very diverse in relation to population, outcomes, and screening methods. Conclusions: Screening programs are a good tool for detecting CDD; however, clinical studies are needed to compare them to have conclusive and comparative evidence between universal, selective screening or other methods.