{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:14:58Z","timestamp":1787022898784,"version":"build-2736575974"},"reference-count":20,"publisher":"American Academy of Pediatrics (AAP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To evaluate in a national database the association of race and socioeconomic status with radiographic evaluation and subsequent diagnosis of child abuse after traumatic brain injury (TBI) in infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a retrospective study of infants with non\u2013motor vehicle\u2013associated TBI who were admitted to 39 pediatric hospitals from January 2004 to June 2008. Logistic regression controlling for age, type, and severity of TBI and the presence of other injuries was performed to examine the association of race and socioeconomic status with the principal outcomes of radiographic evaluation for suspected abuse and diagnosis of abuse. Regression coefficients were transformed to probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>After adjustment for type and severity of TBI, age, and other injuries, publicly insured\/uninsured infants were more likely to have had skeletal surveys performed than were privately insured infants (81% vs 59%). The difference in skeletal survey performance for infants with public or no insurance versus private insurance was greater among white (82% vs 53%) infants than among black (85% vs 75%) or Hispanic (72% vs 55%) infants (P = .022). Although skeletal surveys were performed in a smaller proportion of white than black or Hispanic infants, the adjusted probability for diagnosis of abuse among infants evaluated with a skeletal survey was higher among white infants (61%) than among black (51%) or Hispanic (53%) infants (P = .009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>National data suggest continued biases in the evaluation for abusive head trauma. The conflicting observations of fewer skeletal surveys among white infants and higher rates of diagnosis among those screened elicit concern for overevaluation in some infants (black or publicly insured\/uninsured) or underevaluation in others (white or privately insured).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2010-0031","type":"journal-article","created":{"date-parts":[[2010,8,16]],"date-time":"2010-08-16T23:34:45Z","timestamp":1282001685000},"page":"408-414","source":"Crossref","is-referenced-by-count":204,"title":["Disparities in the Evaluation and Diagnosis of Abuse Among Infants With Traumatic Brain Injury"],"prefix":"10.1542","volume":"126","author":[{"given":"Joanne N.","family":"Wood","sequence":"first","affiliation":[{"name":"General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;"},{"name":"Leonard Davis Institute, and"},{"name":"Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hall","sequence":"additional","affiliation":[{"name":"Child Health Corporation of America, Shawnee Mission, Kansas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Schilling","sequence":"additional","affiliation":[{"name":"General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Keren","sequence":"additional","affiliation":[{"name":"General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;"},{"name":"Leonard Davis Institute, and"},{"name":"Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandita","family":"Mitra","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute, and"},{"name":"Departments of Biostatistics and Epidemiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Rubin","sequence":"additional","affiliation":[{"name":"General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania;"},{"name":"Leonard Davis Institute, and"},{"name":"Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,9,1]]},"reference":[{"key":"2021121009433886000_B1","volume-title":"Child Maltreatment 2007","author":"US Department of Health and Human Services, Administration on Children, Youth, and Families","year":"2009"},{"issue":"3","key":"2021121009433886000_B2","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2004-1033","article-title":"Epidemiologic features of the physical and sexual maltreatment of children in the Carolinas","volume":"115","author":"Theodore","year":"2005","journal-title":"Pediatrics"},{"issue":"11","key":"2021121009433886000_B3","first-page":"1864","article-title":"Prevention of unintentional childhood injuries","volume":"74","author":"Schnitzer","year":"2006","journal-title":"Am Fam Physician"},{"issue":"6 pt 1","key":"2021121009433886000_B4","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1542\/peds.111.6.1382","article-title":"Durbin. Occult head injury in high-risk abused children","volume":"111","author":"Rubin","year":"2003","journal-title":"Pediatrics"},{"issue":"2","key":"2021121009433886000_B5","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1542\/peds.75.2.340","article-title":"Serious head injury in infants: accident or abuse","volume":"75","author":"Billmire","year":"1985","journal-title":"Pediatrics"},{"issue":"7","key":"2021121009433886000_B6","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.281.7.621","article-title":"Analysis of missed cases of abusive head trauma","volume":"281","author":"Jenny","year":"1999","journal-title":"JAMA"},{"issue":"2 pt 1","key":"2021121009433886000_B7","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1542\/peds.90.2.179","article-title":"Head injury in very young children: mechanisms, injury types, and ophthalmologic findings in 100 hospitalized patients younger than 2 years of age","volume":"90","author":"Duhaime","year":"1992","journal-title":"Pediatrics"},{"issue":"2","key":"2021121009433886000_B8","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1053\/ajem.2001.21345","article-title":"Use of the skeletal survey in the evaluation of child maltreatment","volume":"19","author":"Belfer","year":"2001","journal-title":"Am J Emerg Med"},{"issue":"1","key":"2021121009433886000_B9","first-page":"11","article-title":"Childhood head injuries: accidental or inflicted?","volume":"154","author":"Reece","year":"2000","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"5","key":"2021121009433886000_B10","doi-asserted-by":"crossref","first-page":"1430","DOI":"10.1542\/peds.2009-0558","article-title":"Diagnostic imaging of child abuse","volume":"123","author":"American Academy of Pediatrics, Section on Radiology","year":"2009","journal-title":"Pediatrics"},{"issue":"10","key":"2021121009433886000_B11","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1136\/adc.2006.100545","article-title":"Forty years later: inconsistencies in reporting of child abuse","volume":"93","author":"Sege","year":"2008","journal-title":"Arch Dis Child"},{"issue":"2","key":"2021121009433886000_B12","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2008-2467","article-title":"Skeletal surveys in infants with isolated skull fractures","volume":"123","author":"Wood","year":"2009","journal-title":"Pediatrics"},{"issue":"13","key":"2021121009433886000_B13","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1001\/jama.288.13.1603","article-title":"Racial differences in the evaluation of pediatric fractures for physical abuse","volume":"288","author":"Lane","year":"2002","journal-title":"JAMA"},{"key":"2021121009433886000_B14","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1097\/BLO.0b013e31805c0849","article-title":"What factors affect the identification and reporting of child abuse-related fractures?","volume":"461","author":"Lane","year":"2007","journal-title":"Clin Orthop Relat Res"},{"issue":"3","key":"2021121009433886000_B15","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1542\/peds.2007-2311","article-title":"From suspicion of physical child abuse to reporting: primary care clinician decision-making","volume":"122","author":"Flaherty","year":"2008","journal-title":"Pediatrics"},{"issue":"8","key":"2021121009433886000_B16","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1111\/j.1651-2227.2007.00356.x","article-title":"Traumatic head injury in infants and toddlers","volume":"96","author":"Myhre","year":"2007","journal-title":"Acta Paediatr"},{"issue":"2","key":"2021121009433886000_B17","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/j.0006-341X.1999.00652.x","article-title":"Predictive margins with survey data","volume":"55","author":"Graubard","year":"1999","journal-title":"Biometrics"},{"key":"2021121009433886000_B18","first-page":"957","author":"Stata Corp [Stata Base reference manual]","year":"2009"},{"issue":"6","key":"2021121009433886000_B19","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.jpedsurg.2009.02.044","article-title":"Eliminating disparity in evaluation for abuse in infants with head injury: use of a screening guideline","volume":"44","author":"Rangel","year":"2009","journal-title":"J Pediatr Surg"},{"key":"2021121009433886000_B20","unstructured":"American College of Radiology. ACR practice guideline for skeletal surveys in children. Available at: www.acr.org\/SecondaryMainMenuCategories\/quality_safety\/guidelines\/pediatric\/skeletal_surveys.aspx. Accessed July 15, 2010"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/3\/408\/846328\/zpe00910000408.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/3\/408\/846328\/zpe00910000408.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T17:58:23Z","timestamp":1685728703000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/126\/3\/408\/66169\/Disparities-in-the-Evaluation-and-Diagnosis-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,9,1]]},"references-count":20,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2010,9,1]]},"published-print":{"date-parts":[[2010,9,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2010-0031","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,9,1]]}}}