Reliability of International Hip Dysplasia Institute Classification for the Developmental Dysplasia of the Hip Among Different Medical Personnel in Iraq


Background: The international hip dysplasia institute (IHDI) classification is a new method for quantifying the severity of the developmentaldysplasia of the hip (DDH). Objectives: This study aimed to compare the reliability of this classification between different medical personnelsuch as pediatricians, general practitioners, and family doctors in addition to orthopedic surgeons and radiologists. Methods: Hundred pelvicradiographic films (with 200 hips) were randomly selected from the files of children already diagnosed and treated as DDH cases. Thesefilms were analyzed by 12 independent observers of four different specialties: three orthopedic surgeons (Ortho Group), three radiologists(Radio Group), three pediatricians (Pediat Group), and three general practitioners (GP Group). Results: The average measures (Cronbach’salpha) for the intraclass correlation coefficient (ICC) for absolute agreement between all observers was 0.874 (with 95% confidence intervalsbetween 0.780 and 0.925). This was considered as having a good level of reliability and agreement between all observers. The ICC foragreement between the observers of radio group showed the highest score (0.904) while that between those of GP Group had the lowestone (0.826). However, during the comparison between the mean score of each group with that of the other groups by the one‑way ANOVAmethod, there was no statistically significant difference between all groups (P values were 0.563, 0.415, 0.399, and 0.291 respectively).Conclusion: The IHDI classification method for cases of DDH has a good level of reliability among different medical personnel regardlessof their specialties.