Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients

Horn, Joachim; Rasmussen, H; Bukholm, Ida Rashida Khan; Røise, Olav; Terjesen, Terje

doi:10.1080/17453674.2021.1932922

Cited by 2 publications

(2 citation statements)

References 18 publications

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“…This is particularly concerning given that over half (57%) of all UK paediatric orthopaedic-related litigation cases relate to undetected or incorrectly diagnosed injuries, costing £3.5 million, with an average pay-out of between £28,000 and £57,000 per case [ 9 , 10 ]. These results are not limited to UK practice, with similar results from Norway [ 11 ] and the USA [ 12 , 13 ], where paediatric claims resulted in higher indemnity paid per case compared with adults [ 12 , 14 ].…”

Section: Introductionsupporting

confidence: 61%

Artificial intelligence for radiological paediatric fracture assessment: a systematic review

et al. 2022

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Background Majority of research and commercial efforts have focussed on use of artificial intelligence (AI) for fracture detection in adults, despite the greater long-term clinical and medicolegal implications of missed fractures in children. The objective of this study was to assess the available literature regarding diagnostic performance of AI tools for paediatric fracture assessment on imaging, and where available, how this compares with the performance of human readers. Materials and methods MEDLINE, Embase and Cochrane Library databases were queried for studies published between 1 January 2011 and 2021 using terms related to ‘fracture’, ‘artificial intelligence’, ‘imaging’ and ‘children’. Risk of bias was assessed using a modified QUADAS-2 tool. Descriptive statistics for diagnostic accuracies were collated. Results Nine eligible articles from 362 publications were included, with most (8/9) evaluating fracture detection on radiographs, with the elbow being the most common body part. Nearly all articles used data derived from a single institution, and used deep learning methodology with only a few (2/9) performing external validation. Accuracy rates generated by AI ranged from 88.8 to 97.9%. In two of the three articles where AI performance was compared to human readers, sensitivity rates for AI were marginally higher, but this was not statistically significant. Conclusions Wide heterogeneity in the literature with limited information on algorithm performance on external datasets makes it difficult to understand how such tools may generalise to a wider paediatric population. Further research using a multicentric dataset with real-world evaluation would help to better understand the impact of these tools.

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Section: Introductionsupporting

confidence: 61%

Artificial intelligence for radiological paediatric fracture assessment: a systematic review

et al. 2022

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“…The risk of gradual hip displacement and subsequent hip dislocation in children with cerebral palsy (CP) increases substantially with decreasing gross motor function 1 , 2 as measured by the 5-level Gross Motor Function Classification System (GMFCS). 3 Children classified with GMFCS level IV or V are nonambulatory and rely on a wheelchair for transportation.…”

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confidence: 99%

Treatment of Hip Displacement in Children With Cerebral Palsy: A 5-year Comparison of Proximal Femoral Osteotomy and Combined Femoral-Pelvic Osteotomy in 163 Children

Kiapekos,

von Heideken,

Broström

et al. 2024

Journal of Pediatric Orthopaedics

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Background: This study compared the 5-year outcomes of isolated proximal femoral varus osteotomy (FO) and combined proximal femoral varus and pelvic osteotomy (FPO) for the treatment of hip displacement in children with cerebral palsy (CP) in Sweden, focusing on the number of reoperations and residual hip displacement. Methods: The study included 163 children with a 5-year follow-up after FO or FPO in the national Swedish CP surveillance program, CPUP. Descriptive statistics and univariate and multivariate Cox regression analyses were used to identify whether the age at surgery, sex, Gross Motor Function Classification System level, CP dominant symptom, hip migration percentage (MP), type of surgery (unilateral/bilateral), and history of soft tissue hip surgery were related to the 5-year outcomes after surgery. Failure after hip surgery was defined as a skeletal reoperation involving the hip and/or MP >50%. Results: During the period 2001 to 2017, 163 children (65 girls) underwent 246 femoral and/or pelvic osteotomies (154 FO, 47 bilaterally; 92 FPO, 16 bilaterally) and had a 5-year follow-up; 95 and 74 children had ≥1 FO or FPO as the primary skeletal surgery, respectively. The mean preoperative MP (51%±18% for FO and 59%±17% for FPO, P=0.001) and age at surgery (6.2±2.5 years for FO and 7.3±2.8 years for FPO, P=0.014) differed between procedures. At the 5-year follow-up, 5 hips (5%) had reoperations and 5 hips (5%) had radiological failure among the 92 FPOs, and 33 (21%) had reoperations and 14 (9%) radiological failure among the 154 FOs. The difference in outcome failure rate was significant (P<0.001). Multivariate Cox regression analysis showed a lower risk for failure with FPO [hazard ratio (HR)=0.32, 95% CI: 0.15-0.68] compared with FO. A higher preoperative MP increased the risk for outcome failure (HR=1.21, 95% CI: 1.15-1.36 for each 5% increment). Conclusions: FPO had a higher mean preoperative MP but a lower 5-year outcome failure rate compared with FO. A higher preoperative MP was associated with an increased risk of failure. Level of Evidence: Level II—prospective comparative study.

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Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients

Cited by 2 publications

References 18 publications

Artificial intelligence for radiological paediatric fracture assessment: a systematic review

Artificial intelligence for radiological paediatric fracture assessment: a systematic review

Treatment of Hip Displacement in Children With Cerebral Palsy: A 5-year Comparison of Proximal Femoral Osteotomy and Combined Femoral-Pelvic Osteotomy in 163 Children

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