Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.

Autor: Hoytema van Konijnenburg EM; Department of Paediatrics, Emma Children's Hospital/Academic Medical Centre, University of Amsterdam, Postbus 22660, Amsterdam, 1100 DD, The Netherlands. eva.hoytemavankonijnenburg@amc.nl., Teeuw AH, Sieswerda-Hoogendoorn T, Leenders AG, van der Lee JH
Jazyk: angličtina
Zdroj: Systematic reviews [Syst Rev] 2013 Dec 06; Vol. 2, pp. 109. Date of Electronic Publication: 2013 Dec 06.
DOI: 10.1186/2046-4053-2-109
Abstrakt: Background: Although it is often performed in clinical practice, the diagnostic value of a screening physical examination to detect maltreatment in children without prior suspicion has not been reviewed. This article aims to evaluate the diagnostic value of a complete physical examination as a screening instrument to detect maltreatment in children without prior suspicion.
Methods: We systematically searched the databases of MEDLINE, EMBASE, PsychINFO, CINAHL, and ERIC, using a sensitive search strategy. Studies that i) presented medical findings of a complete physical examination for screening purposes in children 0-18 years, ii) specifically recorded the presence or absence of signs of child maltreatment, and iii) recorded child maltreatment confirmed by a reference standard, were included. Two reviewers independently performed study selection, data extraction, and quality appraisal using the QUADAS-2 tool.
Results: The search yielded 4,499 titles, of which three studies met the eligibility criteria. The prevalence of confirmed signs of maltreatment during screening physical examination varied between 0.8% and 13.5%. The designs of the studies were inadequate to assess the diagnostic accuracy of a screening physical examination for child maltreatment.
Conclusions: Because of the lack of informative studies, we could not draw conclusions about the diagnostic value of a screening physical examination in children without prior suspicion of child maltreatment.
Databáze: MEDLINE
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