Potential Child Abuse Screening in Emergency Department; a Diagnostic Accuracy Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e8
https://doi.org/10.22037/aaem.v5i1.111
Abstract
Introduction: Designing a tool that can differentiate those at risk of child abuse with great diagnostic accuracy is of great interest. The present study was designed to evaluate the diagnostic accuracy of Escape instrument in triage of at risk cases of child abuse presenting to emergency department (ED).
Method: The present diagnostic accuracy study performed on 6120 of the children under 16 years old presented to ED during 3 years, using convenience sampling. Confirmation by the child abuse team (pediatrician, a social worker, and a forensic physician) was considered as the gold standard. Screening performance characteristics of Escape were calculated using STATA 21.
Results: 6120 children with the mean age of 2.19 ± 1.12 years were screened (52.7% girls). 137 children were suspected victims of child abuse. Based on child abuse team opinion, 35 (0.5%) children were confirmed victims of child abuse. Sensitivity, specificity, positive and negative likelihood ratio and positive and negative predictive values of this test with 95% CI were 100 (87.6 – 100), 98.3 (97.9 – 98.6), 25.5 (18.6 – 33.8), 100 (99.9 – 100), 0.34 (0.25 – 0.46), and 0 (0 – NAN), respectively. Area under the ROC curve was 99.2 (98.9 – 99.4).
Conclusion: It seems that Escape is a suitable screening instrument for detection of at risk cases of child abuse presenting to ED. Based on the results of the present study, the accuracy of this screening tool is 99.2%, which is in the excellent range.
- Child abuse
- diagnosis
- emergency service
- hospital
- risk assessment
- decision support techniques
How to Cite
References
http://www.who.int/topics/child_abuse/en/. 2007.
Hobbs CJ, Hanks HG, Wynne JM. Child abuse and neglect:
a clinician’s handbook: Elsevier Health Sciences;
Kemp A. Abuse in the family: An introduction:
Wadsworth Publishing Company; 1998.
Ludwig S, Kornberg AE. Child abuse: a medical reference:
Churchill Livingstone New York; 1992.
McMillan JA, Feigin RD, DeAngelis C, Jones MD. Oski’s
pediatrics: principles & practice: Lippincott Williams &
Wilkins; 2006.
Sayyari AA, Bagheri Yazdi SA, Jalili B, Khoshabi K, Shahmohammadi
D, Imanzadeh F, et al. Physical childabuse
in Tehran, Iran. Journal of rehabilitation (UWRS).
;6(6-7):7-13.
Farhoudian A, Izadian ES, Goodarzi RR, Sharifi V, Mohammadi
M-R, Nejatisafa A-A, et al. Iran’s Contribution
to Child and Adolescent Mental HealthResearch (1973–
: A Scientometric Analysis. Iranian Journal of Psychiatry.
;1(3):93-7.
Louwers EC, Affourtit MJ, Moll HA, de Koning HJ, Korfage
IJ. Screening for child abuse at emergency departments:
a systematic review. Archives of disease in childhood.
;95(3):214-8.
Woodman J, Pitt M, Wentz R, Taylor B, Hodes D, Gilbert
R. Performance of screening tests for child physical abuse
in accident and emergency departments. 2008.
Raffle AE, Gray JAM. Screening: evidence and practice:
Oxford University Press; 2007.
Louwers EC, Korfage IJ, Affourtit MJ, Ruige M, van den
Elzen AP, de Koning HJ, et al. Accuracy of a screening instrument
to identify potential child abuse in emergency
departments. Child abuse & neglect. 2014;38(7):1275-81.
Butchart A, Harvey AP, Mian M, Furniss T. Preventing
child maltreatment: a guide to taking action and generating
evidence. 2006.
Hampton RL, Newberger EH. Child abuse incidence and
reporting by hospitals: significance of severity, class, and
race. American Journal of Public Health. 1985;75(1):56-
Hussey JM, Chang JJ, Kotch JB. Child maltreatment in the
United States: prevalence, risk factors, and adolescenthealth consequences. Pediatrics. 2006;118(3):933-42.
Benger JR, Pearce AV. Quality improvement report: Simple
intervention to improve detection of child abuse in
emergency departments. BMJ: British Medical Journal.
:780-2.
Chang DC, Knight V, Ziegfeld S, Haider A, Warfield
D, Paidas C. The tip of the iceberg for child abuse:
the critical roles of the pediatric trauma service and
its registry. Journal of Trauma and Acute Care Surgery.
;57(6):1189-98.
Holter JC, Friedman SB. Child abuse: early case finding in
the emergency department. Pediatrics. 1968;42(1):128-
Kempe CH, Silverman FN, Steele BF, Droegemueller
W, Silver HK. The battered-child syndrome. Jama.
;251(24):3288-94.
Pless IB, Sibald A, Smith MA, Russell M. A reappraisal of
the frequency of child abuse seen in pediatric emergency
rooms. Child abuse & neglect. 1987;11(2):193-200.
Louwers EC, Korfage IJ, AffourtitMJ, Scheewe DJ, Van De
Merwe MH, Vooijs-Moulaert A-FS, et al. Effects of systematic
screening and detection of child abuse in emergency
departments. Pediatrics. 2012;130(3):457-64.
Bleeker G, Vet NJ, Haumann TJ, van Wijk IJ, Gemke
RJ. [Increase in the number of reported cases of child
abuse following adoption of a structured approach in
the VU Medical Centre, Amsterdam, in the period
-2004]. Nederlands tijdschrift voor geneeskunde.
;149(29):1620-4.
Hosseinkhani Z, Nedjat S, Majdzadeh R, Mahram M,
Aflatooni A. Design of the child abuse Questionnaire in
Iran. Journal of School of Public Health and Institute of
Public Health Research. 2014;11(3):29-38.
- Abstract Viewed: 329 times
- PDF Downloaded: 154 times
- HTML Downloaded: 53 times
