A Preliminary Screening Instrument for Early Detection of Medical Child Abuse

Greiner, Mary V.; Palusci, Vincent J.; Keeshin, Brooks; Kearns, Stephen C.; Sinal, Sara H.

doi:10.1542/hpeds.2012-0044

Cited by 31 publications

(15 citation statements)

References 31 publications

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“…1). From this set of results, 93 full-text articles were reviewed for inclusion, of which 19 new articles (representing 18 studies) were included [24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42]. In addition, the 13 studies evaluated in the Bailhache et al review [43][44][45][46][47][48][49][50][51][52][53][54][55] were included in this review update, for a total of 32 articles (31 studies).…”

Section: Resultsmentioning

confidence: 99%

“…The authors found that "no instrument had adequate levels of evidence for all criteria, and no criteria were met by all instruments" [64]. Our review also resulted in similar findings to the original review by Bailhache et al [13], in that 1) most studies did not report sufficient information to judge all criteria in the risk of bias tool; 2) most studies did not clearly blind the analysis of the reference standard from the index test (or the reverse); 3) some studies [26,36,37,39] included the index test as part of the reference standard (incorporation bias), which can overestimate the accuracy of the index test; and 4) some studies used a case-control design [29,31,36], which can overestimate the performance of the index test. A particular challenge, also noted by Bailhache et al [13], was the quality of reporting in many of the included studies.…”

Section: Discussionmentioning

confidence: 99%

“…Greiner et al [31] evaluated a "medical child maltreatment" instrument (also known as caregiver fabricated illness in a child [57] or factitious disorder imposed on another [58]), where a positive answer to four or more of the 15 questions indicated suspicion of medical child maltreatment (e.g., caregiver has features of Munchausen syndrome (multiple diagnoses, surgeries, and hospitalizations, with no specific diagnosis)).…”

Section: Medical Child Maltreatment Instrumentmentioning

confidence: 99%

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Identifying children exposed to maltreatment: a systematic review update

et al. 2020

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Background: Child maltreatment affects a significant number of children globally. Strategies have been developed to identify children suspected of having been exposed to maltreatment with the aim of reducing further maltreatment and impairment. This systematic review evaluates the accuracy of strategies for identifying children exposed to maltreatment. Methods: We conducted a systematic search of seven databases: Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Libraries, Sociological Abstracts and the Education Resources Information Center. We included studies published from 1961 to July 2, 2019 estimating the accuracy of instruments for identifying potential maltreatment of children, including neglect, physical abuse, emotional abuse, and sexual abuse. We extracted data about accuracy and narratively synthesised the evidence. For five studies-where the population and setting matched known prevalence estimates in an emergency department setting-we calculated false positives and negatives. We assessed risk of bias using QUADAS-2. Results: We included 32 articles (representing 31 studies) that evaluated various identification strategies, including three screening tools (SPUTOVAMO checklist, Escape instrument, and a 6-item screening questionnaire for child sex trafficking). No studies evaluated the effects of identification strategies on important outcomes for children. All studies were rated as having serious risk of bias (often because of verification bias). The findings suggest that use of the SPUTOVAMO and Escape screening tools at the population level (per 100,000) would result in hundreds of children being missed and thousands of children being over identified. Conclusions: There is low to very low certainty evidence that the use of screening tools may result in high numbers of children being falsely suspected or missed. These harms may outweigh the potential benefits of using such tools in practice (PROSPERO 2016:CRD42016039659).

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Medical Child Maltreatment Instrumentmentioning

confidence: 99%

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Identifying children exposed to maltreatment: a systematic review update

et al. 2020

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“…Although the literature has coalesced around the term MSbP, other terms are still used, confounding efforts to assemble a historical scientific picture of the evolution of understanding this condition. Terms used in history as well as today for this syndrome include Polle syndrome [16,17], terms that include the word "factitious" such as "factitious disorder by proxy" [18][19][20][21], "illness induction" [22,23], and more recently, "medical child abuse" [24,25]. Scientific writers struggled to find the right term to use [26][27][28][29][30] and also with "who" was being diagnosed with the disorder -the child victim, the perpetrator, the duo together, or the entire family [31,32].…”

Section: The Evolution Of Names Of Msbpmentioning

confidence: 99%

Patient-Centered Medicine and Prevention of Munchausen Syndrome by Proxy

Wahi¹,

Stone²,

Chance³

et al. 2017

Patient Centered Medicine

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Munchausen syndrome by proxy (MSbP) is known by many names and is considered the deadliest form of child abuse. Although the condition was named in 1976 and there is now a substantial body of scientific literature about this type of abuse, to date, patientcentered approaches to early identification, intervention, and prevention have been absent from this literature. The purpose of this chapter is to recommend patient-centered approaches to identifying MSbP in the clinical setting to facilitate prevention and early intervention. It also recommends patient-centered practices that can be implemented to reduce the MSbP-related morbidity and mortality contributed by the healthcare system. The evolving nomenclature and definition of MSbP abuse has been an obstacle to achieving scientific consensus on the topic. Yet, the body of scientific literature on the subject is large. This literature is reviewed to enumerate the healthcare system's contribution to MSbP abuse. The Haddon matrix, a public health framework, is applied to MSbP abuse in order to guide the development of recommendations of patient-centered approaches that should be implemented to reduce the healthcare system's contribution to the morbidity and mortality that MSbP victims face.

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“…This clinical report shares practical guidelines for the indicators of possible fabricated illness. Greiner et al [11] also published a 15-item screening instrument that was 94.7% sensitive and 95.6% specific for medical child abuse with a score at least 4 in their small sample. Flaherty and Macmillan's [2 && ] AAP clinical report is helpful in that it provides a template for the complicated, extensive chart review that is required in one of these cases.…”

Section: Caregiver Fabricated Illness In a Child/ Medical Child Abusementioning

confidence: 99%