%0 Journal Article
%T Missed and missing cases of abusive injuries: The magnitude and the measurement of the problem
%J Child abuse and neglect
%D 2010
%A Chadwick, David L.
%A Castillo, Edward M.
%A Kuelbs, Cynthia
%A Cox, Susan A.
%A Lindsay, Suzanne P.
%V 34
%N 12
%P 943-950
%X OBJECTIVE: The authors' objective is to describe the disparity between the case-fatality rates for inflicted versus unintentional injuries of children, and to emphasize its utility as a way of estimating the effectiveness of the ascertainment of inflicted injuries of children. METHOD: Determination, comparison, and explanation of the case-fatality-rate disparity in four injury databases were derived from hospitalized injury cases. RESULTS: The CFR disparity is 6-14-fold in the 4 injury databases. The CFR disparity varies strongly and inversely with the observed incidence of inflicted injuries in the databases. CONCLUSIONS: A large disparity between the case fatality rates (CFRs) of inflicted and unintentional injuries exists in a number of injury databases. Inflicted injuries have much higher CFRs than unintentional injuries. The disparity can be accounted for by "missed" (incorrectly diagnosed) and "missing" (unseen) cases. PRACTICE IMPLICATIONS: Present diagnostic criteria for physically abusive (inflicted) injuries are forensically-driven and too conservative for public health purposes. New public-health-oriented case definitions for "inflicted injury" are needed. Programs to reduce injury recidivism in young children should be a part of overall injury prevention.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0145-2134
%U http://dx.doi.org/10.1016/j.chiabu.2010.08.001