NWT RESEARCH DATABASE

Regions: North Slave Region

Tags: health, health care, health services, children's health

Objective(s): To determine whether it is feasible to integrate a portable ultrasound/AI screening tool for hip dysplasia into routine primary-care practice, particularly in communities where access to tertiary care is difficult; and, to estimate rates of DDH in NWT in non-Indigenous and Indigenous populations.

Project Description: This licence has been issued for the scientific research application No.5539. The objective of this project is to determine whether it is feasible to integrate a portable ultrasound/AI screening tool for hip dysplasia into routine primary-care practice, particularly in communities where access to tertiary care is difficult; and, to estimate rates of DDH in NWT in non-Indigenous and Indigenous populations. Infants brought to primary care clinics by parents for routine wellness check-ups will be screened by a clinic medical professional (generally a nurse or physician) for hip dysplasia, using a portable ultrasound probe with images automatically interpreted by artificial intelligence (US/AI). Results will be provided to the attending physician as a decision support tool allowing them to decide whether to refer the infant for tertiary hospital assessment for possible hip dysplasia. This will be performed on a Waiver of Consent basis, with a short debriefing discussion replacing the full informed consent process. These infants are already being screened for hip dysplasia at wellness checks. Ultrasound is a tool with no known biological harms, which is likely to increase diagnostic accuracy for hip dysplasia over conventional physical examination. The study data will be anonymized and safeguarded to the highest standards. This arm of the study is essentially a clinical audit of the incremental benefit from adding US/AI to conventional physical-examination-only screening for DDH (What is DDH in healthcare? Developmental dysplasia of the hip) in a primary care setting. Obtaining consent from patients introduces bias, limiting access to important subgroups (particularly those with language barriers) that may have a high incidence of DDH relative to the general population. For these reasons, waiver of consent is appropriate. Please see the Appendix for a detailed consideration of Waiver-of-Consent. An ultrasound scan of both hips of each eligible infant including 2D static images and 2D video ‘sweep’ images will be performed by a study team member at the primary care clinic in conjunction with their routine clinical visit. Data will be uploaded for automated artificial intelligence image analysis. Results will be made available to the patient’s physician, who will use this information to help decide whether to refer the patient for further assessment. A continued communication will be done through email, teleconference, and via FaceTime or WhatsApp. Video conference can be done during visits to address any issues during scanning and to assist in patient encounters. The fieldwork for this study will be conducted from August 2, 2023 to December 31, 2023.