The utility of follow-up skeletal surveys in child abuse

dc.contributor.authorHarper, N. S., Eddleman, S., & Lindberg, D. M.
dc.date.accessioned2014-12-08T19:42:30Z
dc.date.available2014-12-08T19:42:30Z
dc.date.issued2013
dc.description.abstractFollow-up skeletal surveys (FUSS) are performed frequently in cases of possible physical abuse based on the evidence from small retrospective cohorts. Our objective was to determine the proportion of FUSS that identified new information in a large, multicenter population of children with concerns of physical abuse. This was a prospective secondary analysis of an observational study of all children <10 years of age (120 months) who underwent evaluation for possible physical abuse by 20 US child abuse teams. This analysis included all children in whom FUSS was recommended and measured rates of FUSS completion, results of FUSS, and the change in perceived likelihood of abuse before and after FUSS. Among 2890 children enrolled in the Examining Siblings To Recognize Abuse research network, 2049 underwent skeletal survey and 796 (38.8%) had FUSS. A total of 174 (21.5%) subjects had new information identified by FUSS, including 124 (15.6%) with at least 1 new fracture and 55 (6.9%) with reassuring findings compared with the initial skeletal survey. Among cases with new fractures, the estimated likelihood of abuse increased in 41 (33%) cases, and 51 cases (41%) remained at the maximum likelihood of abuse. FUSS identified new information and affected the perceived likelihood of abuse in a substantial fraction of cases in which it was completed. These data support existing guidelines and, in addition, suggest that FUSS should be considered in cases with lower initial levels of concern for abuse.en_US
dc.identifier.citationHarper, N. S., Eddleman, S., & Lindberg, D. M. (2013). The utility of follow-up skeletal surveys in child abuse. Pediatrics, 131(3), e672-e678.en_US
dc.identifier.urihttp://pediatrics.aappublications.org/content/131/3/e672.long
dc.identifier.urihttp://hdl.handle.net/11212/1930
dc.language.isoen_USen_US
dc.publisherPediatricsen_US
dc.subjectchild abuseen_US
dc.subjectphysical abuseen_US
dc.subjectfracturesen_US
dc.subjectscreeningen_US
dc.subjectskeletal surveyen_US
dc.titleThe utility of follow-up skeletal surveys in child abuseen_US
dc.typeArticleen_US

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