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Existing data on screening questions and outcomes (diagnosis of child maltreatment) from three large observational screening studies at eight different EDs in the Netherlands were harmonized. A multivariate logistic regression was performed to develop the Screening instrument for Child Abuse and Neglect (SCAN). The SCAN was validated by performing a cross-validation and calculating the discriminative ability. A total of 24,963 patients were included. Out of the potential screening questions the following questions were included in the final instrument: is the injury compatible with the history, and does it correspond to the child\u2019s developmental level? (aOR 10.40, 95% CI 5.69\u201319.02), was there an unnecessary delay in seeking medical help? (aOR 3.45, 95% CI 1.73\u20136.88) and is the behaviour\/interaction of the child and parents (carers) appropriate? (aOR 14.67, 95% CI 7.93\u201327.13). The SCAN had a pooled AUC of 0.75 (95% CI 0.63\u20130.87) in the cross-validation. The question \u201cAre there other signals that make you doubt the safety of the child and\/or family?\u201d (available in only one of the original datasets, OR 182.9; 95% CI 102.3\u2013327.4) was by consensus added to the final SCAN.<\/jats:p><jats:p><jats:italic>Conclusion<\/jats:italic>: This validated and brief Screening instrument for Child Abuse and Neglect (SCAN) is designed to improve early recognition of child maltreatment in the ED. A positive screening result of the SCAN warrants a thorough work-up for child maltreatment, including a top-toe examination, if necessary additional diagnostics and adequate safety measures.\n<jats:table-wrap><jats:table><jats:tbody>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is Known:<\/jats:bold><jats:italic>\u2022 Screening instruments increase the detection of possible cases of child maltreatment in the emergency department and support health care professionals to identify these cases.<\/jats:italic><jats:italic>\u2022 The application of different screening instruments led to the need for one brief validated instrument.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                    <jats:tr>\n                      <jats:td colspan=\"2\"><jats:bold>What is New:<\/jats:bold><jats:italic>\u2022 This study presents a validated and brief Screening instrument for Child Abuse and Neglect (SCAN), consisting of four questions.<\/jats:italic><jats:italic>\u2022 The SCAN supports professionals in detecting signals of child maltreatment, and a positive screening result should lead to a thorough work-up, including a top-toe examination, complete history, additional diagnostic tests and consultation of a child abuse expert.<\/jats:italic><\/jats:td>\n                    <\/jats:tr>\n                  <\/jats:tbody><\/jats:table><\/jats:table-wrap><\/jats:p>","DOI":"10.1007\/s00431-022-04635-0","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T21:02:37Z","timestamp":1665003757000},"page":"79-87","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A validated Screening instrument for Child Abuse and Neglect (SCAN) at the emergency department"],"prefix":"10.1007","volume":"182","author":[{"given":"F.","family":"Hoedeman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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AMC: this study was exempt from ethics approval under Dutch law, no informed consent was needed, and data could be analysed anonymously, Statement of No Objection, Ethics Committee Academic Medical Centre, 19 February 2008. EMC: this study was approved by the Medical Ethics Committee of the Erasmus MC (MEC\u20132007\u2013195). Informed consent was waived. UMC: this study was reviewed and approved by the Medical Ethics Committee of the University Medical Centre Utrecht (reference 08\u2013378).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}