Diagnosing DHH in infants: an ethnography of general practice. V1
Research type
Research Study
Full title
Diagnosing hip dyplasia in general practice: an ethnographic study to support an evaluation of a diagnosis aid for the 6 week check of newborns.
IRAS ID
248639
Contact name
Reza Razavi
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
1 years, 6 months, 31 days
Research summary
Diagnosing infant hip dysplasia in general practice: an ethnography to inform an evaluation of a decision aid.\n\nDevelopmental dysplasia of the hip (DHH), which can lead to disability later in life, is commonly misdiagnosed in newborn babies. If diagnosed correctly DHH can be treated fairly easily. However, at both the mandatory checks of newborns – at the hospital when they are born, and by their GPs when they are 6 weeks old – missing a diagnosis or diagnosing DHH incorrectly is common. It is not well understood why this is the case. \n\nMissed diagnoses and infants incorrectly labelled with DHH are an important public health problem, potentially leading to adverse consequences for infants, their families and the NHS. National policy states that infants should be referred to hospital if the 6-week check ‘suggests DHH’, but there is no available tool to aid examination or offer guidelines for referral. \n\nThe aim of this qualitative study is to explore the understanding and practice of GPs, health visitors, other health professionals and carers of infants undergoing the 6-week check, to inform the development and evaluation of an intervention tailored to improve the diagnosis of DHH in primary care. \n\nObservations of the 6-week check of newborns in GP practices will be performed. In-depth interviews will be undertaken with GPs, other relevant healthcare staff such as Health Visitors and orthopaedic surgeons, and carers of infants. This will provide understanding of the context in which diagnoses are made or missed. More focused interviews with GPs and relevant healthcare staff will explore the design and development of the diagnostic aid for DHH, assess whether it is appropriate to implement the aid in GP settings and to help design its evaluation in a larger study.\n\nThe study is funded by a NIHR Health Technology Assessment programme grant.\n
REC name
South West - Central Bristol Research Ethics Committee
REC reference
18/SW/0168
Date of REC Opinion
20 Jul 2018
REC opinion
Further Information Favourable Opinion