{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T15:10:12Z","timestamp":1791645012932,"version":"4.3.4"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND AND OBJECTIVES:<\/jats:title>\n                  <jats:p>Abusive head trauma (AHT) may be missed in the clinical setting. Clinical prediction tools are used to reduce variability in practice and inform decision-making. From a systematic review and individual patient data analysis we derived the Predicting Abusive Head Trauma (PredAHT) tool, using multilevel logistic regression to predict likelihood of AHT. This study aims to externally validate the PredAHT tool.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Consecutive children aged &amp;lt;36 months admitted with an intracranial injury, confirmed as abusive or nonabusive, to 2 sites used in the original model were ascertained. Details of 6 influential features were recorded (retinal hemorrhage, rib and long -bone fractures, apnea, seizures, and head or neck bruising). We estimated the likelihood of an unrecorded feature being present with multiple imputation; analysis included sensitivity, specificity, and area under the curve, with 95% confidence intervals (CIs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Data included 133 non-AHT cases and 65 AHT cases, 97% of children were &amp;lt;24 months old. Consistent with original predictions, when \u22653 features were present in a child &amp;lt;36 months old with intracranial injury, the estimated probability of AHT was &amp;gt;81.5% (95% CI, 63.3\u201391.8). The sensitivity of the tool was 72.3% (95% CI, 60.4\u201381.7), the specificity was 85.7% (95% CI, 78.8\u201390.7), area under the curve 0.88 (95% CI, 0.823\u20130.926).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>When tested on novel data, the PredAHT tool performed well. This tool has the potential to contribute to decision-making in these challenging cases. An implementation study is needed to explore its performance and utility within the child protection process.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-3993","type":"journal-article","created":{"date-parts":[[2015,7,28]],"date-time":"2015-07-28T00:19:27Z","timestamp":1438042767000},"page":"290-298","source":"Crossref","is-referenced-by-count":50,"title":["Validation of a Prediction Tool for Abusive Head Trauma"],"prefix":"10.1542","volume":"136","author":[{"given":"Laura Elizabeth","family":"Cowley","sequence":"first","affiliation":[{"name":"Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte Bethan","family":"Morris","sequence":"additional","affiliation":[{"name":"Birmingham Heartlands Hospital, West Midlands, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine Ann","family":"Maguire","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Mark","family":"Farewell","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison Mary","family":"Kemp","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,8,1]]},"reference":[{"issue":"5","key":"2021120906114143000_B1","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1542\/peds.2009-0408","article-title":"Abusive head trauma in infants and children.","volume":"123","author":"Christian","year":"2009","journal-title":"Pediatrics"},{"issue":"1","key":"2021120906114143000_B2","first-page":"1","article-title":"The next innocence project: shaken baby syndrome and the criminal courts.","volume":"87","author":"Tuerkheimer","year":"2009","journal-title":"Wash Univ Law Rev."},{"issue":"2","key":"2021120906114143000_B3","first-page":"209","article-title":"Shaken baby syndrome, abusive head trauma, and actual innocence: getting it right.","volume":"12","author":"Findley","year":"2012","journal-title":"Houst J Health Law Policy"},{"key":"2021120906114143000_B4"},{"issue":"1","key":"2021120906114143000_B5","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1001\/jama.284.1.79","article-title":"Users\u2019 guides to the medical literature: XXII: how to use articles about clinical decision rules.","volume":"284","author":"McGinn","year":"2000","journal-title":"JAMA"},{"issue":"5","key":"2021120906114143000_B6","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1136\/adc.2010.202820","article-title":"Clinical decision rules for children with minor head injury: a systematic review.","volume":"96","author":"Pickering","year":"2011","journal-title":"Arch Dis Child"},{"key":"2021120906114143000_B7","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/2046-4053-2-109","article-title":"Insufficient evidence for the use of a physical examination to detect maltreatment in children without prior suspicion: a systematic review.","volume":"2","author":"Hoytema van Konijnenburg","year":"2013","journal-title":"Syst Rev"},{"issue":"2","key":"2021120906114143000_B8","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1097\/PCC.0b013e3182712b09","article-title":"Derivation of a clinical prediction rule for pediatric abusive head trauma.","volume":"14","author":"Hymel","year":"2013","journal-title":"Pediatr Crit Care Med"},{"key":"2021120906114143000_B9"},{"issue":"2","key":"2021120906114143000_B10","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1097\/PCC.0b013e31827204a8","article-title":"Deciding whether to screen for abusive head trauma: do we need a clinical decision rule?","volume":"14","author":"Berger","year":"2013","journal-title":"Pediatr Crit Care Med"},{"issue":"4","key":"2021120906114143000_B11","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1016\/j.amepre.2008.01.016","article-title":"Incidence and demography of non-accidental head injury in southeast Scotland from a national database.","volume":"34","author":"Minns","year":"2008","journal-title":"Am J Prev Med"},{"issue":"9241","key":"2021120906114143000_B12","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/S0140-6736(00)03130-5","article-title":"Annual incidence of shaken impact syndrome in young children.","volume":"356","author":"Barlow","year":"2000","journal-title":"Lancet"},{"issue":"5","key":"2021120906114143000_B13","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1001\/jama.290.5.621","article-title":"A population-based study of inflicted traumatic brain injury in young children.","volume":"290","author":"Keenan","year":"2003","journal-title":"JAMA"},{"issue":"7172","key":"2021120906114143000_B14","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1136\/bmj.317.7172.1558","article-title":"Subdural haemorrhages in infants: population based study.","volume":"317","author":"Jayawant","year":"1998","journal-title":"BMJ"},{"key":"2021120906114143000_B15","unstructured":"Tuerkheimer D. 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