Navigation Links
Study finds primary health care providers fail to report substantial cases of child abuse

Boston A team of researchers from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC), report that primary care providers (PCP) fail to report a substantial number of cases of child maltreatment. The study, which is scheduled to appear in the November-December issue of Academic Pediatrics, is the first to examine the validity of a PCP's decision to suspect child abuse as the etiology of an injury and their decision to report a suspicious injury to child protective services (CPS).

Identifying that a particular injury was caused by child abuse can be difficult. Typically, only the responsible person and child witness the injurious event, and the child may be preverbal or afraid to describe the abuse. The physical abuse of a child may be suspected after a careful history and physical examination, when the clinician determines the injury is not consistent with the history provided, or when the pattern of injuries is highly suspicious for maltreatment.

This study examined the validity of PCP assessment of suspicion that an injury was caused by child abuse and their decision to report suspected child abuse to CPS. By using a subsample of injuries drawn from the national Child Abuse Reporting and Experience Study, PCPs completed telephone interviews using a stratified sample (no suspicion of abuse; suspicious but not reported; and suspicious of abuse and reported) of 111 injury visits.

According to the researchers two techniques were used to validate the PCPs' initial decision: expert review and provider retrospective self-assessment. Five child abuse experts reviewed clinical vignettes created by using data prospectively collected by PCPs about the patient encounter. The PCPs' opinions 6 weeks and 6 months after the injury-related visits were elicited and analyzed.

Upon analysis of the data, the researchers found that PCPs and experts agreed about the suspicion of abuse in 81 percent of the cases of physical injury. PCPs did not report 21 percent of injuries that experts would have reported. Compared with expert reviewers, PCPs had a 68 percent sensitivity and 96 percent specificity in reporting child abuse.

Reporting suspected child physical abuse is a two-step process: assessment of the likelihood of child physical abuse and the decision to report. "Child abuse experts and PCPs are in general agreement concerning the assessment of suspected child physical abuse, yet this study demonstrates that primary care providers decide not to report a substantial proportion of child physical abuse cases," explained lead author Robert Sege, MD, FAAP, professor of pediatrics at BUSM, and director, Division of Ambulatory Pediatrics at BMC.

These results point to several opportunities for improvement in the training of physicians as well as the diagnosis and management of child physical abuse. "To become more certain of their suspicions, PCPs need better education about the recognition of injuries that are suspicious for child abuse, particularly bruises and fractures, and the role of state CPS agencies in investigating the child's circumstances," added Sege.

Contact: Gina DiGravio
Boston University Medical Center

Related medicine news :

1. Space Travel Might Lead to Eye Trouble: Study
2. Seniors Choose Medicare Prescription Plans Wisely: Study
3. Kessler Foundation scientists awarded grants to study cognition in MS
4. Racial Disparities Still Exist for Kidney Recipients, Study Finds
5. UCSB psychology professors study gene-culture interaction
6. Adult living donor liver transplants safe, study finds
7. Bisexual women, more likely than bisexual men, to be depressed and abuse alcohol, new study finds
8. CAMH study suggests increased risk of schizophrenia in heavy methamphetamine users
9. UT MD Anderson study finds advances in breast cancer dont extend to older women
10. Hospital safety climate linked to both patient and nurse injuries: Drexel study
11. UGA researchers develop first mouse model to study important aspect of Alzheimer’s
Post Your Comments:
(Date:6/25/2016)... ... ... On Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health ... of their exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards ... at the BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary ... Dallas that it will receive two significant new grants to support its work ... marked its 25th anniversary by recognizing patients, medical professionals and scientists for their ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San ... Society and the Road To Recovery® program to drive cancer patients to and from ... adults to ensure the highest quality of life and ongoing independence. Getting to ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine presented its ... Emergency Medicine conference in Ponte Vedra Beach, FL. The awards honor the outstanding ... Medicine Practice and Pediatric Emergency Medicine Practice. , “With this award, we ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Research and Markets has ... 2015-2025: Applications, Technologies, Forecasts" report to their ... Electronics, Smart Skin, Structural Health Monitoring, Composite Smart ... electronics involves electronic and/or electrical components and circuits ... structures such as vehicle bodies or conformally placed ...
(Date:6/24/2016)... -- Research and Markets has announced the addition ... report to their offering. ... The World Market for Companion Diagnostics covers the world ... in the report includes the following: , ... by Region (N. America, EU, ROW), 2015-2020 , World ...
(Date:6/24/2016)... 24, 2016  Arkis BioSciences, a leading innovator ... more durable cerebrospinal fluid treatments, today announced it ... funding is led by Innova Memphis, followed by ... private investors.  Arkis, new financing will accelerate the ... market release of its in-licensed Endexo® technology. ...
Breaking Medicine Technology: