Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics
| Autor: | Amanda K. Fingarson, Kim Kaczor, Karen Sheehan, Gabriel Meyers, Veena Ramaiah, Bruce E. Herman, Mary Clyde Pierce, Berkeley L. Bennett, Kent P. Hymel, Rachel P. Berger, Douglas J. Lorenz, Sheila Hickey, Melissa Currie, Sandra Herr, Kathi L. Makoroff, Noel S. Zuckerbraun, Shannon Staley, John M. Leventhal, Julia N. Magana, Carole Jenny, Gina Bertocci, Kristine Fortin |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Cross-sectional study Contusions Recursive partitioning Sensitivity and Specificity Clinical Decision Rules Frenulum medicine Humans Child Abuse Prospective Studies Prospective cohort study Child Original Investigation business.industry Research Infant Newborn Infant General Medicine Featured Bruise Online Only Physical abuse Cross-Sectional Studies Physical Abuse Child Preschool Observational study Body region Female medicine.symptom business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question Can bruising characteristics distinguish abusive from nonabusive injury in young children? Findings In this cross-sectional study of 2161 children younger than 4.0 years, the bruising clinical decision rule (BCDR) was 96% sensitive and 87% specific for distinguishing abusive from nonabusive trauma in young children based on the characteristics of their bruising. Meaning According to these findings, young children with an affirmative finding for any of the 3 components of the BCDR are at increased risk of abuse and warrant further evaluation. Importance Bruising caused by physical abuse is the most common antecedent injury to be overlooked or misdiagnosed as nonabusive before an abuse-related fatality or near-fatality in a young child. Bruising occurs from both nonabuse and abuse, but differences identified by a clinical decision rule may allow improved and earlier recognition of the abused child. Objective To refine and validate a previously derived bruising clinical decision rule (BCDR), the TEN-4 (bruising to torso, ear, or neck or any bruising on an infant This cross-sectional study assesses a previously derived bruising clinical decision rule for identifying children at risk of having been physically abused. |
| Databáze: | OpenAIRE |
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