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Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault.
Pediatrics 2012; 129(2):282-9Ped

Abstract

OBJECTIVE

The purpose of this study was to determine whether follow-up examinations of suspected victims of child sexual abuse influence medical diagnosis or treatment.

METHODS

A retrospective chart review of patients with initial and follow-up examinations (examinations 1 and 2, respectively) over a 5-year study period was conducted. Patient and abuse characteristics, interval between examinations and abuse, and examiner experience levels were collected; examination findings and test results for sexually transmitted infections (STIs) were compared for examinations 1 and 2.

RESULTS

Among 727 patients, examination 2 resulted in a change in interpretation of trauma likelihood in 129 (17.7%) patients and identified STIs in 47 (6.5%) patients. Changes in trauma likelihood and detection of additional STIs during follow-up examinations were more likely in adolescent, female, and sexually active patients and those with a history of genital-genital contact, unknown examination 1 findings, or drug-facilitated sexual assault. Although examination 2 was less likely to affect the interpretation of trauma likelihood and STIs in preadolescent patients, a change in interpretation of trauma likelihood was noted for 49 (15.5%) of these patients, and 16 (5.1%) were diagnosed with a new STI on examination 2. The level of clinician experience during examination 1 did affect the likelihood of changes in examination findings during examination 2.

CONCLUSIONS

Follow-up examinations by specialists affected the interpretation of trauma and detection of STIs in ∼23% of pediatric patients undergoing sexual abuse assessments.

Authors+Show Affiliations

Division of Child Abuse and Neglect, Department of Pediatrics, School of Medicine, University of Texas Health Science Center, San Antonio, TX, USA. amy.r.gavril.mil@health.milNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22291113

Citation

Gavril, Amy R., et al. "Value of Follow-up Examinations of Children and Adolescents Evaluated for Sexual Abuse and Assault." Pediatrics, vol. 129, no. 2, 2012, pp. 282-9.
Gavril AR, Kellogg ND, Nair P. Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault. Pediatrics. 2012;129(2):282-9.
Gavril, A. R., Kellogg, N. D., & Nair, P. (2012). Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault. Pediatrics, 129(2), pp. 282-9. doi:10.1542/peds.2011-0804.
Gavril AR, Kellogg ND, Nair P. Value of Follow-up Examinations of Children and Adolescents Evaluated for Sexual Abuse and Assault. Pediatrics. 2012;129(2):282-9. PubMed PMID: 22291113.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Value of follow-up examinations of children and adolescents evaluated for sexual abuse and assault. AU - Gavril,Amy R, AU - Kellogg,Nancy D, AU - Nair,Prakash, Y1 - 2012/01/30/ PY - 2012/2/1/entrez PY - 2012/2/1/pubmed PY - 2012/3/28/medline SP - 282 EP - 9 JF - Pediatrics JO - Pediatrics VL - 129 IS - 2 N2 - OBJECTIVE: The purpose of this study was to determine whether follow-up examinations of suspected victims of child sexual abuse influence medical diagnosis or treatment. METHODS: A retrospective chart review of patients with initial and follow-up examinations (examinations 1 and 2, respectively) over a 5-year study period was conducted. Patient and abuse characteristics, interval between examinations and abuse, and examiner experience levels were collected; examination findings and test results for sexually transmitted infections (STIs) were compared for examinations 1 and 2. RESULTS: Among 727 patients, examination 2 resulted in a change in interpretation of trauma likelihood in 129 (17.7%) patients and identified STIs in 47 (6.5%) patients. Changes in trauma likelihood and detection of additional STIs during follow-up examinations were more likely in adolescent, female, and sexually active patients and those with a history of genital-genital contact, unknown examination 1 findings, or drug-facilitated sexual assault. Although examination 2 was less likely to affect the interpretation of trauma likelihood and STIs in preadolescent patients, a change in interpretation of trauma likelihood was noted for 49 (15.5%) of these patients, and 16 (5.1%) were diagnosed with a new STI on examination 2. The level of clinician experience during examination 1 did affect the likelihood of changes in examination findings during examination 2. CONCLUSIONS: Follow-up examinations by specialists affected the interpretation of trauma and detection of STIs in ∼23% of pediatric patients undergoing sexual abuse assessments. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/22291113/Value_of_follow_up_examinations_of_children_and_adolescents_evaluated_for_sexual_abuse_and_assault_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=22291113 DB - PRIME DP - Unbound Medicine ER -