Evidence map›Paper›PMID 29550228›Full record

Observational studyThe Journal of pediatrics2018

Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach.

Douglas J Lorenz, Mary Clyde Pierce, Kim Kaczor, Rachel P Berger, Gina Bertocci, Bruce E Herman, Sandra Herr, Kent P Hymel, Carole Jenny, John M Leventhal and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Douglas J LorenzDepartment of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville, KY. Electronic address: djlore01@louisville.edu.
Mary Clyde PierceDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Kim KaczorDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Rachel P BergerDepartment of Pediatrics, University of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.
Gina BertocciDepartment of Bioengineering, J.B. Speed School of Engineering, University of Louisville, Louisville, KY.
Bruce E HermanDepartment of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT.
Sandra HerrDivision of Pediatric Emergency Medicine, University of Louisville, Louiville, KY.
Kent P HymelDepartment of Pediatrics, Division of Child Abuse Pediatrics, Hershey, PA.
Carole JennyDepartment of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA.
John M LeventhalDepartment of Pediatrics, Yale School of Medicine, New Haven, CT.
Karen SheehanDivision of Emergency Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL.
Noel ZuckerbraunDepartment of Pediatrics, University of Pittsburgh, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA.

Funding

Clinical Decision Rules to Discriminate Bruising Caused by Physical Child AbuseR01HD060997 · NICHD · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI PIERCE, MARY CLYDE · 2011 to 2015
$2.9M
NICHD NIH HHS R01 HD060997
6 · The paper itself

Abstract

objectiveTo assess interrater reliability and accuracy of an expert panel in classifying injuries of patients as abusive or accidental based on comprehensive case information. STUDY

designData came from a prospective, observational, multicenter study investigating bruising characteristics of children younger than 4 years. We enrolled 2166 patients with broad ranges of illnesses and injuries presenting to one of 5 pediatric emergency departments in whom bruises were identified during examination. We collected comprehensive data regarding current and past injuries and illnesses, and provided deidentified, standardized case information to a 9-member multidisciplinary panel of experts with extensive experience in pediatric injury. Each panelist classified cases using a 5-level ordinal scale ranging from definite abuse to definite accident. Panelists also assessed whether report to child protective services (CPS) was warranted. We calculated reliability coefficients for likelihood of abuse and decision to report to CPS.

resultsThe interrater reliability of the panelists was high. The Kendall coefficient (95% CI) for the likelihood of abuse was 0.89 (0.87, 0.91) and the kappa coefficient for the decision to report to CPS was 0.91 (0.87, 0.94). Reliability of pairs and subgroups of panelists were similarly high. A panel composite classification was nearly perfectly accurate in a subset of cases having definitive, corroborated injury status.

conclusionsA panel of experts with different backgrounds but common expertise in pediatric injury is a reliable and accurate criterion standard for classifying pediatric injuries as abusive or accidental in a sample of children presenting to a pediatric emergency department.

Indexed as

AccidentsChild AbuseChild, PreschoolEmergency Service, HospitalFemaleHumansInfantMaleProspective StudiesReproducibility of ResultsWounds and Injurieschild abusecriterion standard classification

Identifiers

PMID29550228
PMCPMC6019119

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.