PubMed · 3430209
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K B Green. 1987. Testing for hepatotoxicity.. https://pubmed.ncbi.nlm.nih.gov/3430209/
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Ortolani's manoeuvre is used to detect hip instability. It is intended to be used to establish the mobility of a dislocated femoral head with respect to the acetabulum in newly-born infants. Barlow's modification attempts to dislocate a reduced but unstable hip out of the acetabulum. Ortolani's manoeuvre is a primarily tactile, proprioceptive sensation and has nothing to do with the usually inconsequential audible and palpable clicks in infant hips. It has been found that widespread use of Ortolani's manoeuvre cannot prevent all late diagnoses of hip dysplasia. This is because neonatal hip instability is only part of the total spectrum of hip dysplasia, and because the examination requires a relaxed newly-born infant and an experienced examiner. In the Dutch situation, general screening with Ortolani's manoeuvre is not advisable as this will lead to many false-positive and false-negative outcomes due to this neonatal examination being carried out by various physicians and midwives with insufficient experience. Better results may be expected from ultrasound screening at child welfare clinics. This is presently being investigated in a large population study.
PURPOSE: To compare the sensitivity and the specificity of the Heidelberg Retina Tomograph (HRT) classification of "Glaucoma" or "Normal" with that derived from clinical impression (CI) based on several parameters. DESIGN: Consecutive observational case series. METHODS: In a retrospective chart review of 200 left eyes of 200 consecutive patients referred to the Glaucoma Service Diagnostic Laboratory of the Wills Eye Hospital, we compared the HRT-based classification of "Glaucoma" or "Normal" with a CI classification of "Definite glaucoma," "Probably glaucoma," "Probably no glaucoma," and "No glaucoma." RESULTS: The HRT-based diagnosis of "Glaucoma" or "Normal" had an 86% sensitivity and 68% specificity when compared with a clinical impression (CI) of "Definite glaucoma," used as a strict gold standard definition of glaucoma; an 83% sensitivity and 57% specificity when the CI "Definite glaucoma" and "Probably glaucoma" were combined as a more liberal definition of glaucoma; a 76% sensitivity and 69% specificity when the CI "Definite glaucoma," "Probably glaucoma," and "Probably no glaucoma" were combined as the most liberal definition of glaucoma. The HRT diagnosis had an 86% sensitivity and 51% specificity when compared with the groups "Probably glaucoma," "Probably no glaucoma," and "No glaucoma" combined and considered as no glaucoma. CONCLUSIONS: In this study, HRT-based classification of "Glaucoma" or "Normal" was moderately sensitive, but not very specific when compared with the clinical impression as the gold standard. Clinicians should not rely on the HRT diagnosis alone, but should use it to supplement the impression based on an eye examination and other ancillary tests.
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