Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach.
Classifying Injuries in Young Children as Abusive or Accidental: Reliability and Accuracy of an Expert Panel Approach.
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DOI：
10.1016/j.jpeds.2018.01.033
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发表时间：
2018-07
期刊：
影响因子：
--
通讯作者：
Zuckerbraun N
中科院分区：
文献类型：
--
作者：
Lorenz DJ;Pierce MC;Kaczor K;Berger RP;Bertocci G;Herman BE;Herr S;Hymel KP;Jenny C;Leventhal JM;Sheehan K;Zuckerbraun N
评估专家小组根据全面的病例信息将患者伤害分类为虐待或意外伤害的评分者间可靠性和准确性。数据来自一项前瞻性、观察性、多中心研究，调查了4岁以下儿童的瘀伤特征。我们招募了2166名患有各种疾病和损伤的患者，他们在5个儿科急诊科（PED）中的一个，在检查期间发现了瘀伤。我们收集了有关当前和过去的伤害和疾病的全面数据，并向一个由9名在儿科伤害方面具有丰富经验的多学科专家组成的专家小组提供了去识别的标准化病例信息。每个pancreatic分类的情况下，使用5级顺序规模范围从明确的滥用，以明确的事故。小组成员还评估了是否有必要向儿童保护服务（CPS）报告。我们计算了滥用和决定向CPS报告的可能性的可靠性系数。小组成员的评价者间信度较高。滥用可能性的Kendall系数（95% CI）为0.89（0.87，0.91），决定向CPS报告的Kappa系数为0.91（0.87，0.94）。小组成员的配对和分组的可靠性同样高。面板复合分类是几乎完全准确的情况下，有明确的，确证的损伤状态的子集。一个具有不同背景但在儿科损伤方面具有共同专业知识的专家小组是将儿科损伤分类为虐待或意外的可靠和准确的标准。
To assess interrater reliability and accuracy of an expert panel in classifying injuries of patients as abusive or accidental based on comprehensive case information. Data came from a prospective, observational, multi-center study investigating bruising characteristics of children younger than 4 years. We enrolled 2166 patients with broad ranges of illnesses and injuries to one of 5 pediatric emergency departments (PED) in whom bruises were identified during examination. We collected comprehensive data regarding current and past injuries and illnesses, and provided de-identified, standardized case information to a 9-member multi-disciplinary panel of experts with extensive experience in pediatric injury. Each panelist classified cases using a 5-level ordinal scale ranging from Definite Abuse to Definite Accident. Panelists also assessed whether report to child protective services (CPS) was warranted. We calculated reliability coefficients for likelihood of abuse and decision to report to CPS. The interrater reliability of the panelists was high. The Kendall coefficient (95% CI) for the likelihood of abuse was 0.89 (0.87, 0.91) and the kappa coefficient for the decision to report to CPS was 0.91 (0.87, 0.94). Reliability of pairs and subgroups of panelists were similarly high. A panel composite classification was nearly perfectly accurate in a subset of cases having definitive, corroborated injury status. A panel of experts with different backgrounds but common expertise in pediatric injury is a reliable and accurate criterion standard for classifying pediatric injuries as abusive or accidental in a sample of children presenting to a PED.
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DOI：
10.1001/archpedi.1993.02160250089028
发表时间：
1993-01-01
影响因子：
--
作者：
LEVENTHAL, JM;THOMAS, SA;MARKOWITZ, RI
通讯作者：
MARKOWITZ, RI
影响因子：
17.7
作者：
Posner, Kelly;Oquendo, Maria A.;Davies, Mark
通讯作者：
Davies, Mark
影响因子：
8
作者：
Lindberg, Daniel Martin;Lindsell, Christopher John;Shapiro, Robert Allan
通讯作者：
Shapiro, Robert Allan
影响因子：
4.8
作者：
Buesser, Katherine E.;Leventhal, John M.;Sharkey, Melinda S.
通讯作者：
Sharkey, Melinda S.
影响因子：
7.2
作者：
Walter, SD;Irwig, L;Glasziou, PP
通讯作者：
Glasziou, PP