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How reliable are SIDS rates? The importance of a standardised, multiprofessional approach to “diagnosis”
  1. P J Fleming,
  2. P S Blair
  1. Institute of Child Life and Health, University of Bristol, UK
  1. Correspondence to:
    Prof. P Fleming
    Institute of Child Life and Health, UBHT Education Centre, Upper Maudlin St, Bristol BS2 8AE, UK; peter.flemingbris.ac.uk

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Commentary on the paper by Sheehan et al (see page1082)

As a “diagnosis”, sudden infant death syndrome (SIDS) is unique in that the definition is reached by exclusion: by failing to show an adequate cause of death. The “diagnosis” of SIDS is inevitably subjective and imprecise as it depends on the knowledge, skill, and thoroughness of the professionals who obtain the clinical history, conduct the evaluation of the circumstances of the death, and perform the postmortem examination, as well as the synthesis and interpretation of this information.

Even if each of these component parts of the investigation have been conducted to a specified standard, the collection of this information is not the end point but should be the starting point for a multidisciplinary review process in which the professionals involved should jointly examine the evidence, highlight concerns, and decide on the cause of death. This multidisciplinary approach has been used effectively in the field of SIDS research,1 has been shown to work in clinical practice,2 and has recently been recommended by the Kennedy Report3 as the routine national approach in the UK. Once the postmortem results are available, usually 8–12 weeks after death, the paediatrician, pathologist, GP, health visitor, senior investigating police officer, and where appropriate, social worker, should meet …

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