3 Variable AHT
- 3 Variable Calculator Applying AHT Definitional Criteria
- Estimated probability of abuse based on:
1. Respiratory Compromise
2. Torso, ear, or neck bruising
3. Bilateral or interhemispheric subdural hemorrhage
Frequently Asked Questions about This Project
To develop an effective screening tool for pediatric abusive head trauma (AHT).
An effective screening tool is simple, safe, inexpensive, reliable, readily accessible, evidence-based, and highly sensitive—to minimize missed cases.
PediBIRN investigators conducted sequential, prospective, multicenter studies to derive, validate, and implement an AHT screening tool that demonstrates these qualities. This new AHT screening tool comes in the form of a clinical prediction or decision tool.
A clinical prediction rule is an evidence-based tool that measures and then combines the predictive contributions of multiple clinical variables, test results or findings to estimate the probability of a diagnosis, prognosis, or therapeutic response in an individual patient.
A clinical prediction rule rises to the level of a clinical decision rule if and when the evidence supporting the rule is sufficiently strong that physicians use the rule to guide or direct a specific clinical decision.
Clinical prediction and decision rules are most likely to be useful when clinical decision making is complex, when clinical stakes are high, or when there are opportunities to achieve cost savings without compromising patient care.
Yes. Sometimes the diagnosis of AHT is obvious and straightforward. Sometimes the diagnosis is difficult. Multiple factors can contribute to the uncertainty. The clinical presentations and findings of abusive and non-abusive pediatric head trauma overlap, young victims are usually unable to provide a history of their injury event, and there is no diagnostic gold standard. When uncertainty persists, following the recommendation of a validated, evidence-based screening tool could lessen practice disparities, missed AHT, and the negative impacts of physicians’ inexperience and implicit bias.
At or near the time of hospital admission, after patient stabilization, when the results of initial history, physical examination, and head imaging studies are available.
Your decision to launch or forego a thorough evaluation for abuse in your young, acutely head-injured patient hospitalized for intensive care.