Diagnostic Accuracy of Graf’s Method Ultrasonography in Detecting Developmental Dysplasia of the Hip: A Meta-Analysis and Systematic Review

Purpose: This study was designed to perform a meta-analysis on Graf’s ultrasonography method’s performance in the detection of developmental dysplasia of the hip (DDH). Methods: Electronic bibliographic databases were searched until the end of October 2020. The inclusion criteria were: 1. Using Graf method in less than 12 weeks of age. 2. Using follow-up as reference test 3. Providing crude data. Pooled diagnostic performance measures were calculated. QUADAS-2 tool was utilized to assess the quality of included studies. The HSROC curves were also drawn. Results: Six articles (including seven populations, 11012 patients) were considered eligible. The pooled sensitivity and specificity were 93% (95% CI: 0.57-0.99) and 97% (95% CI:0.86-0.99), respectively (area under curve= 0.99). The pooled positive and negative likelihood ratio and diagnostic odds ratio was 28.4, 0.07, and 396, in turn. Conclusion: Graf's method is a useful ultrasonography technique with acceptable accuracy for screening DDH in neonates.