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Abusive head trauma and the triad: a critique on behalf of RCPCH of ‘Traumatic shaking: the role of the triad in medical investigations of suspected traumatic shaking’
  1. Geoffrey David Debelle1,
  2. Sabine Maguire2,
  3. Patrick Watts3,
  4. Rosa Nieto Hernandez4,
  5. Alison Mary Kemp2
  6. On behalf of the Child Protection Standing Committee, Royal College of Paediatrics and Child Health
  1. 1 Department of General Paediatrics, Birmingham Women and Children’s Hospital, Birmingham, UK
  2. 2 Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, Cardiff, UK
  3. 3 Department of Ophthalmology, University Hospital of Wales, Cardiff, UK
  4. 4 Department of Research and Policy, Royal College of Paediatrics and Child Health, London, UK
  1. Correspondence to Dr Alison Mary Kemp, Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, University Hospital of Wales, Heath Park, CF14 4XW, UK; kempam{at}cardiff.ac.uk

Abstract

The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on ‘isolated traumatic shaking’ in infants, concluding that ‘there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking’. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice. We have conducted a critique of the methodology used in the SBU review and have found it to be flawed, to the extent that children’s lives may be put at risk. Thus, we call on this review to be withdrawn or to be subjected to international scrutiny.

  • child abuse
  • evidence based medicine
  • forensic medicine

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

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