Diagnostic Accuracy in Child Sexual Abuse Medical Evaluation: Role of Experience, Training, and Expert Case Review

• NCJ Number: 240763
• Journal: Child Abuse & Neglect Volume: 36 Issue: 5 Dated: May 2012 Pages: 383-392
• Author(s): Joyce A. Adams; Suzanne P. Starling; Lori D. Frasier; Vincent J. Palusci; Robert Allan Shapiro; Martin A. Finkel; Ann S. Botash
• Date Published: May 2012
• Length: 10 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

Using a Web-based survey of pediatricians who regularly examine children suspected of having been sexually abused, this study assessed these clinicians' ability to distinguish abnormal from normal ano-genital evidence presented in magnified photographs; the study also identified the factors in the clinicians' education, clinical practice, and case review that correlated with the correct identification of children who had been sexually abused.

Abstract

The study found that the clinicians who regularly review suspected cases of child sexual abuse (CSA) with an expert and examiners who regularly update their knowledge of CSA evidence based on current research had higher total scores for correct diagnoses of CSA. Pediatricians with a specialized knowledge of CSA (n = 51) scored higher than the 141 pediatricians inexperienced in diagnosing CSA as well as Sexual Assault Nurse Examiners (SANEs). Based on these findings, the authors recommend that non-specialist clinicians who examine fewer than five children monthly for suspected CSA review such cases with an expert in CSA medical evaluation and regularly update their knowledge of the CSA literature. An invitation to participate in the survey was sent to members of the Ray E. Helfer Society who were members of the Section on Child Abuse and Neglect of the American Academy of Pediatrics, members of the Special Interest Group on Child Abuse of the Academic Pediatrics Association, and members of the International Association of Forensic Nurses who perform child sexual abuse examinations. In addition, these individuals were asked to forward the survey invitation to colleagues who might also be interested in participating. The intent of this method was to obtain a convenience sample of medical providers who were likely to be involved in the medical evaluation of children suspected of having been sexually abused. The survey was conducted between July and December 2007. 2 figures, 4 tables, and 13 references