Abusive Head Trauma

Data

CHAMP Education for Child Abuse Medical Providers

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.”

REFERENCES:

  • Palusci & Botash 2021

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.”