Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault
Date
2012
Journal Title
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Publisher
Pediatrics
Abstract
The purpose of this study was to determine whether
follow-up examinations of suspected victims of child sexual abuse
influence medical diagnosis or treatment.
METHODS: A retrospective chart review of patients with initial and followup
examinations (examinations 1 and 2, respectively) over a 5-year study
period was conducted. Patient and abuse characteristics, interval between
examinations and abuse, and examiner experience levels were collected;
examination findings and test results for sexually transmitted infections
(STIs) were compared for examinations 1 and 2.
RESULTS: Among 727 patients, examination 2 resulted in a change in
interpretation of trauma likelihood in 129 (17.7%) patients and identified
STIs in 47 (6.5%) patients. Changes in trauma likelihood and detection
of additional STIs during follow-up examinations were more
likely in adolescent, female, and sexually active patients and those
with a history of genital2genital contact, unknown examination 1
findings, or drug-facilitated sexual assault. Although examination 2
was less likely to affect the interpretation of trauma likelihood and
STIs in preadolescent patients, a change in interpretation of trauma
likelihood was noted for 49 (15.5%) of these patients, and 16 (5.1%)
were diagnosed with a new STI on examination 2. The level of clinician
experience during examination 1 did affect the likelihood of changes
in examination findings during examination 2.
CONCLUSIONS: Follow-up examinations by specialists affected the
interpretation of trauma and detection of STIs in ∼23% of pediatric
patients undergoing sexual abuse assessments.
Description
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Article
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Keywords
medical examination, child abuse, sexual abuse, adolescents
Citation
Gavril, A. R., Kellogg, N. D., & Nair, P. (2012). Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault. Pediatrics, 129(2), 282-289.