Background: We aimed to develop and evaluate a tool for clubfoot therapists in low resource settings to assess the results of Ponseti treatment of congenital talipes equinovarus, or clubfoot, in children of walking age.
Method: A literature review and a Delphi process based on the opinions of 35 Ponseti trainers in Africa were used to develop the Assessing Clubfoot Treatment (ACT) tool and score. We followed up children with clubfoot from a cohort treated between 2011 and 2013, in 2017. A full clinical assessment was conducted to decide if treatment was successful or if further treatment was required. The ACT score was then calculated for each child. Inter-observer variation for the ACT tool was assessed. Sensitivity, specificity, positive and negative predictive values were calculated for the ACT score compared to full clinical assessment (gold standard). Predictors of a successful outcome were explored.
Results: The follow up rate was 31.2% (68 children). The ACT tool consisted of 4 questions; each scored from 0 to 3, giving a total from 0 to 12 where 12 is the ideal result. The 4 questions included one physical assessment and three parent reported outcome measures. It took 5 min to administer and had excellent inter-observer agreement.An ACT score of 8 or less demonstrated 79% sensitivity and 100% specificity in identifying children that required further intervention, with a positive predictive value of 100% and negative predictive value of 90%. Children who completed two or more years of bracing were four times more likely to achieve an ACT score of 9 or more compared to those who did not (OR: 4.08, 95% CI: 1.31-12.65, = 0.02).
Conclusions: The ACT tool is simple to administer, had excellent observer agreement, and good sensitivity and specificity in identifying children who need further intervention. The score can be used to identify those children who definitely need referral and further treatment (score 8 or less) and those with a definite successful outcome (score 11 or more), however further discrimination is needed to decide how to manage children with a borderline ACT score of 9 or 10.
Level Of Evidence: Level II, Diagnostic Study.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399889 | PMC |
| http://dx.doi.org/10.1186/s13047-019-0323-4 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Insulin degludec 100 U/mL for treatment of spontaneous diabetes mellitus in dogs.
J Vet Intern Med
January 2025
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Background: The advantages of insulin degludec 100 U/mL (IDeg100) in the treatment of diabetes mellitus (DM) include consistent release, predictable glucose-lowering effect, and minimal day-to-day variability.
Hypothesis/objectives: To describe the use of IDeg100 in dogs with DM, level of diabetic control and adverse effects.
Animals: Thirty-three client-owned dogs with DM.
MRI Radiomics Analysis in the Diagnostic Differentiation of Malignant Soft Tissue Myxoid Sarcomas From Benign Soft Tissue Musculoskeletal Myxomas.
J Magn Reson Imaging
January 2025
Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
Background: Differentiation of benign myxomas and malignant myxoid sarcomas can be difficult with an overlapping spectrum of morphologic MR findings.
Purpose: To assess the diagnostic utility of MRI radiomics in the differentiation of musculoskeletal myxomas and myxoid sarcomas.
Study Type: Retrospective.
Brain Iron Deposition Alterations in Type 2 Diabetes Mellitus Patients With Mild Cognitive Impairment Based on Quantitative Susceptibility Mapping.
J Diabetes
January 2025
Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing City, Jiangsu Province, China.
Background: Iron is one of the most important elements in brain that may has a direct impact on the stability of central nervous system. The current study devoted to explore the alterations of iron distribution across the whole brain in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI).
Methods: The quantitative susceptibility mapping (QSM) technique was used to quantify the intracranial iron content of 74 T2DM patients with MCI and 86 T2DM patients with normal cognition (NC).
Diagnostic impact of DNA methylation classification in adult and pediatric CNS tumors.
Sci Rep
January 2025
DIAPath, Center for Microscopy and Molecular Imaging (CMMI), Université Libre de Bruxelles (ULB), 6041, Gosselies, Belgium.
Over the past decade, neuropathological diagnosis has undergone significant changes, integrating morphological features with molecular biomarkers. The molecular era has successfully refined neuropathological diagnostic accuracy; however, a substantial number of CNS tumor diagnoses remain challenging, particularly in children. DNA methylation classification has emerged as a powerful machine learning approach for clinical decision-making in CNS tumors.
View Article and Find Full Text PDFPreserving information while respecting privacy through an information theoretic framework for synthetic health data generation.
NPJ Digit Med
January 2025
Institut Curie, CNRS UMR168, PSL University, Sorbonne University, Paris, 75005, France.
Generating synthetic data from medical records is a complex task intensified by patient privacy concerns. In recent years, multiple approaches have been reported for the generation of synthetic data, however, limited attention was given to jointly evaluate the quality and the privacy of the generated data. The quality and privacy of synthetic data stem from multivariate associations across variables, which cannot be assessed by comparing univariate distributions with the original data.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!