{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:23:13Z","timestamp":1784629393047,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2017,6,21]],"date-time":"2017-06-21T00:00:00Z","timestamp":1498003200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","award":["PCORI-AD-12-11-4956"],"award-info":[{"award-number":["PCORI-AD-12-11-4956"]}],"id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Triggers to identify children\u2009&amp;lt;\u20092 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center. The system was run in \u201csilent mode\u201d; physicians were unaware of the system, but study personnel received data on children who triggered the alert system. Sensitivity, specificity, and negative and positive predictive values of the child abuse alert system for identifying physical abuse were calculated.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Thirty age-specific triggers were embedded into the electronic medical record. From October 21, 2014, through April 6, 2015, the system was in silent mode. All 226 children who triggered the alert system were considered subjects. Mean (SD) age was 9.1 (6.5) months. All triggers were activated at least once. Sensitivity was 96.8% (95% CI, 92.4\u2013100.0%), specificity was 98.5% (95% CI, 98.3.5\u201398.7), and positive and negative predictive values were 26.5% (95% CI, 21.2\u201332.8%) and 99.9% (95% CI, 99.9\u2013100.0%), respectively, for identifying children\u2009&amp;lt;\u20092 years old with possible, probable, or definite physical abuse.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion\/Conclusion<\/jats:title>\n                  <jats:p>Triggers embedded into the electronic medical record can identify young children with who need to be evaluated for physical abuse with high sensitivity and specificity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocx063","type":"journal-article","created":{"date-parts":[[2017,6,10]],"date-time":"2017-06-10T01:30:56Z","timestamp":1497058256000},"page":"142-149","source":"Crossref","is-referenced-by-count":48,"title":["Development of an electronic medical record\u2013based child physical abuse alert system"],"prefix":"10.1093","volume":"25","author":[{"given":"Rachel P","family":"Berger","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A","family":"Saladino","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet","family":"Fromkin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Heineman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Suresh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Children\u2019s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"McGinn","sequence":"additional","affiliation":[{"name":"Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2017,6,21]]},"reference":[{"key":"2020110612450443400_ocx063-B1","unstructured":"American Cancer Society. Cancer in Children. 2012. http:\/\/www.cancer.org\/Cancer\/CancerinChildren\/DetailedGuide\/cancer-in-children-key-statistics. 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