Self-reported knowledge of national guidelines for clinical screening for hip dysplasia: a web-based survey of midwives and GPs in Denmark

BACKGROUND: The positive predictive value of clinical hip examinations performed by generalist health professionals in screening for developmental dysplasia of the hip (DDH) is low and declining.

AIM: To assess the self-reported recognition of nationally recommended clinical hip examinations in the screening programme for DDH in Denmark among midwives, GPs, and GPs in training.

DESIGN & SETTING: A cross-sectional, web-based open survey study among Danish midwives, GPs, and GPs in training.

METHOD: Responders were asked to identify which of six written statements of clinical hip examinations were featured in the national Danish guidelines on DDH screening. Three statements were the official statements of the Ortolani, Galeazzi, and hip abduction examinations from the national guidelines, and three statements were false and constructed by the author group. Participants were asked to select up to six statements.

RESULTS: A total of 178 (58 GPs, 97 midwives, and 23 GPs in training) responses were included. Overall, 89% of responders correctly identified the Ortolani manoeuvre and 92% correctly identified one of the constructed descriptions as being false. The remaining four descriptions had significantly lower correct answer percentages ranging from 41%-58%, with significantly lower correct answer percentages of midwives for three out of all six descriptions when compared with GPs.

CONCLUSION: The recognition of two out of three recommended clinical hip examinations in the Danish screening programme for DDH is low overall among current screeners. Efforts should be made to heighten the knowledge level by further education of screeners.