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Using supervised machine learning and ICD10 to identify non-accidental trauma in pediatric trauma patients in the Maryland Health Services Cost Review Commission dataset.
Child Abuse Negl
January 2025
Johns Hopkins School of Medicine, United States of America. Electronic address:
Background: Identifying non-accidental trauma (NAT) in pediatric trauma patients is challenging. We developed a machine learning model that uses demographic characteristics and ICD10 codes to detect the first diagnosis of NAT.
Methods: We analyzed data from the Maryland Health Services Cost Review Commission (2015-2020) for patients aged 0-19 years.
The Prominent Subarachnoid Space in Children: How has a Normal Variant Become Medicolegally Life-Threatening Pathology?
J Med Imaging Radiat Oncol
January 2025
Department of Pediatric, Royal Children's Hospital, Melbourne, Victoria, Australia.
A prominent subarachnoid space (SAS) in infants under 24 months is a very common finding and is a normal variant that can be associated with macrocephaly. This must be differentiated from various pathological conditions that also cause a prominent SAS, including a reduction in brain volume, obstruction to the cerebrospinal fluid (CSF) or malformations of the skull. The inappropriate labelling of normal SAS prominence as enlargement due to pathology and misrepresentation of published literature by some author groups has created confusion medicolegally, contributing to inappropriate conclusions that a normal prominent SAS may cause subdural haemorrhage (SDH) and brain injury.
View Article and Find Full Text PDFUnnecessary Scans Lead to Unnecessary Re-scans: Evaluating Clinical Management of Low and Intermediate Risk Pediatric Traumatic Brain Injuries.
J Pediatr Surg
December 2024
Department of Surgery, New Haven, CT 06510, USA; Yale University School of Medicine, New Haven, CT 06510, USA.
Background: The Pediatric Emergency Care Applied Research Network (PECARN) guidelines provide an algorithm to select patients with mild head trauma at highest risk for clinically important traumatic brain injury (ciTBI) in whom computed tomography (CT) would facilitate management. Failure to follow PECARN criteria exposes children to unnecessary radiation and contributes to increasing hospital costs, length of stay, and parental anxiety. We sought to evaluate the subsequent allocation of resources to low and intermediate risk group patients who underwent an initial Head CT - which was not indicated by PECARN guidelines but which identified cranial or intracranial injury.
View Article and Find Full Text PDFAthlete advocacy: an examination of existing reporting frameworks and next steps.
Phys Sportsmed
December 2024
Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL, USA.
The 2017 USA Gymnastics (USAG) scandal, which revealed that Dr. Larry Nassar, head team physician for US gymnastics, sexually abused countless gymnasts, is one of the most widely recognized cases of sexual abuse in youth sports. Not only did Nassar abuse elite US gymnasts, but he also abused many student-athletes at Michigan State University.
View Article and Find Full Text PDFComputed tomography versus radiography for the detection of rib and skull fractures in paediatric suspected physical abuse: a systematic review.
Eur J Pediatr
December 2024
Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Cork, Ireland.
The diagnosis of suspected physical abuse (SPA) remains a continuous challenge to paediatric healthcare. Several studies have reported that computed tomography (CT) improves the evaluation of SPA. This study aims to systematically review the diagnostic performance of CT compared to radiography in investigating skull and chest fractures for SPA.
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