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Post-publication Peer Reviews to:

ARTICLES:
Matthew Trokel, Anthony Waddimba, John Griffith, and Robert Sege
Variation in the Diagnosis of Child Abuse in Severely Injured Infants
Pediatrics 2006; 117: 722-728 [Abstract] [Full text] [PDF]
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P3Rs published:

[Read P3R] Coding, CPS reporting need study
William N. Marshall, Jr.   (13 March 2006)

Coding, CPS reporting need study 13 March 2006
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William N. Marshall, Jr.,
Professor Clinical Pediatrics
University of Arizona

Send letter to journal:
Re: Coding, CPS reporting need study

marshall{at}peds.arizona.edu William N. Marshall, Jr.

Trokel et. al. have reinforced the need for child abuse education for all health professionals. The percentage of infants wiith subdurals/epidurals diagnosed with child abuse (Table 2) is quite low in general and children's hospitals. This may reflect problems with coding, as the authors note in the discussion; the E codes, even when used, may not reflect the medical staff's true suspicions. It would be ideal to know how many cases were referred to child protective services. Many clinicians and hospitals may recognize child abuse, treat and report appropriately, but not document the diagnosis adequately for the coding staff. Children's hospital coding staff are more likely to be accurate here.

The large number of "other" head injury also needs explanation. A chart study would be interesting here.

Conflict of Interest:

None declared