Raising suspicion of maltreatment from burns: Derivation and validation of the BuRN-Tool

Kemp, Alison; Hollén, Linda; Emond, Alan; Nuttall, Diane; Rea, David; Maguire, Sabine

doi:10.1016/j.burns.2017.08.018

Cited by 33 publications

(32 citation statements)

References 27 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%

“…Kemp et al [40] investigated the Burns Risk Assessment for Neglect or Abuse Tool, a clinical prediction rule to assist with the recognition of suspected maltreatment, especially physical abuse or neglect. Hymel et al evaluated a five-variable clinical prediction rule (derivation study) [34] and a four-variable clinical prediction rule (validation study) [33] in identifying potential abusive head trauma in children less than 3 years of age who were admitted to the post-intensive care unit for management of intracranial injuries.…”

Section: Clinical Predication Rules and Predictive Symptomsmentioning

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: Clinical Predication Rules and Predictive Symptomsmentioning

confidence: 99%

Identifying children exposed to maltreatment: a systematic review update

et al. 2020

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“…Possible scores range from 0-12. A score of three or more acts as the threshold above which maltreatment is suspected 7 . The variables in the tool were identified following a systematic review and an epidemiological study 8,9 .…”

Section: Members Of the Children's Burns Research Network Have Develomentioning

confidence: 99%

“…Data collection for these studies utilised a proforma called the BaSAT (Burns and Scalds Assessment Template -Appendix 2). As well as its role as a research template, the BaSAT acts as a clinical record, aiding the identification of key features of maltreatment and works in synergy with the BuRN-Tool which has been prospectively validated 7 . The next stage in the development of a CPT is to undertake an implementation study to ensure that the CPT has the desired effect in the clinical setting 10 .…”

Section: Members Of the Children's Burns Research Network Have Develomentioning

confidence: 99%

Qualitative analysis of clinician experience in utilising the BuRN Tool (Burns Risk assessment for Neglect or abuse Tool) in clinical practice

Mullen

Quinn-Scoggins

Nuttall

et al. 2018

Burns

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“…The BuRN Tool is a CPT developed to aid clinicians in identifying child safeguarding concerns in children with burns 17. The tool is currently undergoing an implementation evaluation and pending these results, it may play a significant future role in the assessments of burns injuries.…”

Section: Clinical Prediction Tool (Cpt)mentioning

confidence: 99%

Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental

Mullen

Begley

Roberts

et al. 2018

Arch Dis Child Educ Pract Ed

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Burns are a relatively common injury in children accounting for over 50 000 emergency department attendances each year. An estimated 1 in 10 of these are due to maltreatment. These may present in the form of physical abuse or neglect with a reported ratio of 1:9. A burn associated with maltreatment may be a marker for future abuse or neglect and it is paramount that concerns are identified and addressed at the initial visit. Paediatricians need to be confident to identify safeguarding concerns specific to childhood burns and investigate accordingly. In this review, key variables that may aid in differentiating maltreatment from accidental burns are discussed in a case-based format, utilising up-to-date evidence to support the recommendations. Despite a proportion of burns resulting from physical abuse, the rate of child protection investigations in these patients are significantly lower than for children who present with other forms of physical injuries despite a similar proportion of positive findings. Our objective is to review the available evidence to support the safe assessment and management of children presenting with scalds or contact burns.

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Raising suspicion of maltreatment from burns: Derivation and validation of the BuRN-Tool

Abstract: The BuRN-Tool is a potential adjunct to clinical decision-making, predicting which children warrant investigation for child maltreatment. The score is simple and easy to complete in an emergency department setting.

Cited by 33 publications

References 27 publications

Identifying children exposed to maltreatment: a systematic review update

Identifying children exposed to maltreatment: a systematic review update

Qualitative analysis of clinician experience in utilising the BuRN Tool (Burns Risk assessment for Neglect or abuse Tool) in clinical practice

Fifteen-minute consultation: Childhood burns: inflicted, neglect or accidental

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