Abusive Head Trauma
Missed cases
- Jenny found 31.2% of 173 children with abusive head trauma had been previously seen by physicians. The diagnosis was more likely to be missed in young children from white, “intact” families. Worse, 27.8% were reinjured after the missed diagnosis, and 4 of 5 deaths were preventable.
- Wood noted fewer skeletal surveys among white infants evaluated for traumatic brain injury.
- Hymel observed significant race- and ethnicity-based disparities in abusive head trauma evaluation and reporting, concluding, “in the absence of local confounders, these disparities likely represent the impact of local physicians’ implicit bias.”
Accessible Version
Studies finding these biases include Carole Jenny’s landmark study in 1999 where the authors found that 31.2% of 173 children with abusive head trauma had been previously seen by physicians. The diagnosis was more likely to be missed in young children from white, “intact” families. Worse, 27.8% were reinjured after the missed diagnosis, and 4 of 5 deaths were preventable. Later, Joanne Wood noted fewer skeletal surveys among white infants evaluated for traumatic brain injury and Kent Hymel observed significant race- and ethnicity-based disparities in abusive head trauma evaluation and reporting, concluding, “in the absence of local confounders, these disparities likely represent the impact of local physicians’ implicit bias.”