Evidence map›Paper›PMID 33079214›Full record

ArticleNeuroradiology2021

Abusive head trauma: experience improves diagnosis.

Luciana Porto, Marco Baz Bartels, Jonas Zwaschka, Se-Jong You, Christoph Polkowski, Julian Luetkens, Christoph Endler, Matthias Kieslich, Elke Hattingen

Open access · hybridAbstract read
In one paragraph

Article in Neuroradiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
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

3 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Imaging of Abusive Head Trauma : A Radiologists' Perspective.Journal of Korean Neurosurgical Society · 2022
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Luciana PortoInstitute of Neuroradiology, Hospital of Goethe University, University Hospital Frankfurt, Schleusenweg 2 - 16, 60528, Frankfurt am Main, Germany. luciana.porto@kgu.de.
Marco Baz BartelsDepartment of Paediatric Neurology, Hospital of Goethe University, Frankfurt am Main, Germany.
Jonas ZwaschkaInstitute of Neuroradiology, Hospital of Goethe University, University Hospital Frankfurt, Schleusenweg 2 - 16, 60528, Frankfurt am Main, Germany.
Se-Jong YouInstitute of Neuroradiology, Hospital of Goethe University, University Hospital Frankfurt, Schleusenweg 2 - 16, 60528, Frankfurt am Main, Germany.
Christoph PolkowskiInstitute of Neuroradiology, Hospital of Goethe University, University Hospital Frankfurt, Schleusenweg 2 - 16, 60528, Frankfurt am Main, Germany.
Julian LuetkensInstitute of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Christoph EndlerInstitute of Neuroradiology, University Hospital Bonn, Bonn, Germany.
Matthias KieslichDepartment of Paediatric Neurology, Hospital of Goethe University, Frankfurt am Main, Germany.
Elke HattingenInstitute of Neuroradiology, Hospital of Goethe University, University Hospital Frankfurt, Schleusenweg 2 - 16, 60528, Frankfurt am Main, Germany.
Goethe University Frankfurt · DEUniversity Hospital Frankfurt · DEUniversity Hospital Bonn · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe diagnosis of abusive head trauma (AHT) is complex and neuroimaging plays a crucial role. Our goal was to determine whether non-neuroradiologists with standard neuroradiology knowledge perform as well as neuroradiologists with experience in pediatric neuroimaging in interpreting MRI in cases of presumptive AHT (pAHT).

methodsTwenty children were retrospectively evaluated. Patients had been diagnosed with pAHT (6 patients), non-abusive head trauma-NAHT (5 patients), metabolic diseases (3 patients), and benign enlargement of the subarachnoid spaces (BESS) (6 patients). The MRI was assessed blindly, i.e., no clinical history was given to the 3 non-neuroradiologists and 3 neuroradiologists from 2 different institutions.

resultsBlindly, neuroradiologists demonstrated higher levels of sensitivity and positive predictive value in the diagnosis of pAHT (89%) than non-neuroradiologists (50%). Neuroradiologists chose correctly pAHT as the most probable diagnosis 16 out of 18 times; in contrast, non-neuroradiologists only chose 9 out of 18 times. In our series, the foremost important misdiagnosis for pAHT was NAHT (neuroradiologists twice and non-neuroradiologists 5 times). Only victims of motor vehicle accidents were blindly misdiagnosed as pAHT. No usual household NAHT was not misdiagnosed as pAHT. Neuroradiologists correctly ruled out pAHT in all cases of metabolic diseases and BESS.

conclusionMRI in cases of suspected AHT should be evaluated by neuroradiologists with experience in pediatric neuroimaging. Neuroradiologists looked beyond the subdural hemorrhage (SDH) and were more precise in the assessment of pAHT and its differential diagnosis than non-neuroradiologists were. It seems that non-neuroradiologists mainly assess whether or not a pAHT is present depending on the presence or absence of SDH.

Indexed as

Child AbuseCraniocerebral TraumaChildHematoma, SubduralHumansMagnetic Resonance ImagingRetrospective StudiesAbusive head trauma (AHT)Benign enlargement of the subarachnoid spaces (BESS)Differential diagnosisMetabolic diseasesNon-abusive head trauma (NAHT)

Identifiers

PMID33079214
PMCPMC7880981
OpenAlexW3092839422

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.