{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T12:48:35Z","timestamp":1792759715115,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>Previous research has shown racial, ethnic, and socioeconomic disparities in provider medical evaluations and reporting to child protective services (CPS) and law enforcement (LE) for cases of suspected child physical abuse. Our hospital standardized evaluation and reporting of high-risk bruising using a clinical pathway. We aimed to assess whether standardization impacted disparity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We performed a retrospective observational study including children evaluated in the emergency department who had a social work consult for concern for child abuse or neglect between June 2012 and December 2019. From this group, we identified children with high-risk bruising. We compared outcomes (receipt of skeletal survey, CPS report, or LE report) before and after implementation of a standard bruising evaluation pathway to determine how the intervention changed practice among various racial, ethnic, and socioeconomic groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>During the study period, 2129 children presented to the ED and received a social work consult for child abuse or neglect. Of these, 333 had high-risk bruising. Children without private insurance had a higher risk of having a CPS (adjusted relative risk, 1.32; 95% confidence interval, 1.09\u20131.60) or LE (adjusted relative risk, 1.48; 95% confidence interval, 1.11\u20131.97) report prepathway, but not after pathway implementation. No significant associations were seen for race or ethnicity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>A standardized clinical pathway for identification and evaluation of high-risk bruising may help to decrease socioeconomic disparities in reporting high-risk bruising. Larger studies are needed to fully evaluate disparities in assessment and reporting of child abuse.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002998","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:09Z","timestamp":1688169609000},"page":"580-585","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["The Impact of an Emergency Department Bruising Pathway on Disparities in Child Abuse Evaluation"],"prefix":"10.1097","volume":"39","author":[{"given":"Caitlin E.","family":"Crumm","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily C.B.","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surabhi B.","family":"Vora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Lowry","sequence":"additional","affiliation":[{"name":"Seattle Children's Research Institute, Seattle Children\u2019s Hospital, Seattle, WA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Schlatter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori E.","family":"Rutman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,7,1]]},"reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1542\/peds.2015-1487","article-title":"Testing for abuse in children with sentinel injuries","volume":"136","year":"2015","journal-title":"Pediatrics"},{"key":"bib2-20250504","first-page":"e43","article-title":"A prospective study of the causes of bruises in premobile infants","volume":"36","year":"2010","journal-title":"Pediatr Emerg Care"},{"key":"bib3-20250504","first-page":"383","article-title":"Additional injuries in young infants with concern for abuse and apparently isolated bruises","volume":"162","year":"2014","journal-title":"J Pediatr"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1136\/archdischild-2013-304339","article-title":"Bruising in children who are assessed for suspected physical abuse","volume":"99","year":"2014","journal-title":"Arch Dis Child"},{"key":"bib5-20250504","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1542\/peds.2012-2780","article-title":"Sentinel injuries in infants evaluated for child physical abuse","volume":"131","year":"2013","journal-title":"Pediatrics"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1136\/adc.2003.044065","article-title":"Are there patterns of bruising in childhood which are diagnostic or suggestive of abuse? 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