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Development of a screening tool for pediatric sexual assault may reduce emergency-department visits.
Pediatrics 2011; 128(2):221-6Ped

Abstract

OBJECTIVE

To define the characteristics of a novel screening tool used to identify which prepubertal children should potentially receive an initial evaluation for alleged sexual assault in a nonemergent setting.

METHODS

Electronic medical records were retrospectively reviewed from 2007 to 2008. Visits with a chief complaint or diagnosis of alleged sexual assault for patients aged 12 years or younger were identified. Complete records, those with no evaluation before pediatric emergency-department arrival, and those with child advocacy center follow-up were included. Records were reviewed to answer the following: (1) Did the incident occur in the past 72 hours, and was there oral or genital to genital/anal contact? (2) Was genital or rectal pain, bleeding, discharge, or injury present? (3) Was there concern for the child's safety? (4) Was an unrelated emergency medical condition present? An affirmative response to any of the questions was considered a positive screen (warranting immediate evaluation); all others were considered negative screens. Those who had positive physical examination findings of anogenital trauma or infection, a change in custody, or an emergency medical condition were defined as high risk (having a positive outcome).

RESULTS

A total of 163 cases met study criteria; 90 of 163 (55%) patients had positive screens and 73 of 163 (45%) had negative screens. No patients with negative screens were classified as high risk. The screening tool has sensitivity of 100% (95% confidence interval: 93.5-100.0).

CONCLUSIONS

This screening tool may be effective for determining which children do not require emergency-department evaluation for alleged sexual assault.

Authors+Show Affiliations

Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30329, USA. rebecca_floyed@oz.ped.emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21788216

Citation

Floyed, Rebecca L., et al. "Development of a Screening Tool for Pediatric Sexual Assault May Reduce Emergency-department Visits." Pediatrics, vol. 128, no. 2, 2011, pp. 221-6.
Floyed RL, Hirsh DA, Greenbaum VJ, et al. Development of a screening tool for pediatric sexual assault may reduce emergency-department visits. Pediatrics. 2011;128(2):221-6.
Floyed, R. L., Hirsh, D. A., Greenbaum, V. J., & Simon, H. K. (2011). Development of a screening tool for pediatric sexual assault may reduce emergency-department visits. Pediatrics, 128(2), pp. 221-6. doi:10.1542/peds.2010-3288.
Floyed RL, et al. Development of a Screening Tool for Pediatric Sexual Assault May Reduce Emergency-department Visits. Pediatrics. 2011;128(2):221-6. PubMed PMID: 21788216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Development of a screening tool for pediatric sexual assault may reduce emergency-department visits. AU - Floyed,Rebecca L, AU - Hirsh,Daniel A, AU - Greenbaum,Virginia J, AU - Simon,Harold K, Y1 - 2011/07/25/ PY - 2011/7/27/entrez PY - 2011/7/27/pubmed PY - 2011/10/14/medline SP - 221 EP - 6 JF - Pediatrics JO - Pediatrics VL - 128 IS - 2 N2 - OBJECTIVE: To define the characteristics of a novel screening tool used to identify which prepubertal children should potentially receive an initial evaluation for alleged sexual assault in a nonemergent setting. METHODS: Electronic medical records were retrospectively reviewed from 2007 to 2008. Visits with a chief complaint or diagnosis of alleged sexual assault for patients aged 12 years or younger were identified. Complete records, those with no evaluation before pediatric emergency-department arrival, and those with child advocacy center follow-up were included. Records were reviewed to answer the following: (1) Did the incident occur in the past 72 hours, and was there oral or genital to genital/anal contact? (2) Was genital or rectal pain, bleeding, discharge, or injury present? (3) Was there concern for the child's safety? (4) Was an unrelated emergency medical condition present? An affirmative response to any of the questions was considered a positive screen (warranting immediate evaluation); all others were considered negative screens. Those who had positive physical examination findings of anogenital trauma or infection, a change in custody, or an emergency medical condition were defined as high risk (having a positive outcome). RESULTS: A total of 163 cases met study criteria; 90 of 163 (55%) patients had positive screens and 73 of 163 (45%) had negative screens. No patients with negative screens were classified as high risk. The screening tool has sensitivity of 100% (95% confidence interval: 93.5-100.0). CONCLUSIONS: This screening tool may be effective for determining which children do not require emergency-department evaluation for alleged sexual assault. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/21788216/Development_of_a_screening_tool_for_pediatric_sexual_assault_may_reduce_emergency_department_visits_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=21788216 DB - PRIME DP - Unbound Medicine ER -