ArticleJournal of the American Medical Informatics Association : JAMIA2019
Integration of physical abuse clinical decision support at 2 general emergency departments.
Article in Journal of the American Medical Informatics Association : JAMIA, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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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.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- National guideline for the field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2021.The journal of trauma and acute care surgery · 2022Guideline
- Extracting social determinants of health from electronic health records using natural language processing: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2021Pooled it
- A systematic review of clinicians' acceptance and use of clinical decision support systems over time.NPJ digital medicine · 2025Article
- Barriers to Adoption of a Child-Abuse Clinical Decision Support System in Emergency Departments.The western journal of emergency medicine · 2024Article
- Evaluation of a Child Abuse Screen Performed by Nurses Among Young Children with Fractures Seen in a Pediatric Emergency Department.Rhode Island medical journal (2013) · 2024Observational
- Stressful life events in electronic health records: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Developing and Testing the Usability of a Novel Child Abuse Clinical Decision Support System: Mixed Methods Study.Journal of medical Internet research · 2024Article
- Stressful life events in electronic health records: a scoping review.Research square · 2023Article
- Behavioral Health Decision Support Systems and User Interface Design in the Emergency Department.Applied clinical informatics · 2023Article
- Disseminating child abuse clinical decision support among commercial electronic health records: Effects on clinical practice.JAMIA open · 2023Article
- Combining text mining with clinical decision support in clinical practice: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2023Article
- Development and Validation of a Natural Language Processing Tool to Identify Injuries in Infants Associated With Abuse.Academic pediatrics · 2022Article
- Electronic Health Record Tools to Identify Child Maltreatment: Scoping Literature Review and Key Informant Interviews.Academic pediatrics · 2022Article
- Developing machine learning-based models to help identify child abuse and neglect: key ethical challenges and recommended solutions.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record.International journal of medical informatics · 2021Article
- Combatting human trafficking in the United States: how can medical informatics help?Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Natural Language Processing - A Surveillance Stepping Stone to Identify Child Abuse.Academic pediatricsArticle
- Learning From Experience: Avoiding Common Pitfalls in Multicenter Quality Improvement Collaboratives.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveThe study sought to develop and evaluate an electronic health record-based child abuse clinical decision support system in 2 general emergency departments. MATERIALS AND
methodsA combination of a child abuse screen, natural language processing, physician orders, and discharge diagnoses were used to identify children <2 years of age with injuries suspicious for physical abuse. Providers received an alert and were referred to a physical abuse order set whenever a child triggered the system. Physician compliance with clinical guidelines was compared before and during the intervention.
resultsA total of 242 children triggered the system, 86 during the preintervention and 156 during the intervention. The number of children identified with suspicious injuries increased 4-fold during the intervention (P < .001). Compliance was 70% (7 of 10) in the preintervention period vs 50% (22 of 44) in the intervention, a change that was not statistically different (P = .55). Fifty-two percent of providers said that receiving the alert changed their clinical decision making. There was no relationship between compliance and provider or patient demographics.
conclusionsA multifaceted child abuse clinical decision support system resulted in a marked increase in the number of young children identified as having injuries suspicious for physical abuse in 2 general emergency departments. Compliance with published guidelines did not change; we hypothesize that this is related to the increased number of children identified with suspicious, but less serious injuries. These injuries were likely missed preintervention. Tracking compliance with guidelines over time will be important to assess whether compliance increases as physician comfort with evaluation of suspected physical abuse in young children improves.
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