Related Experiment Video
Updated: May 28, 2026
An Experimental Analysis of Children's Ability to Provide a False Report about a Crime
Published on: May 3, 2016
Child abuse inventory at emergency rooms: CHAIN-ER rationale and design
Judith S Sittig1, Cuno S P M Uiterwaal, Karel G M Moons
1General Pediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, The Netherlands. J.S.Sittig@umcutrecht.nl
Insights
This study assesses the SPUTOVAMO-R questionnaire for accurately detecting child abuse in emergency rooms. The CHAIN-ER study aims to provide crucial data on the effectiveness of this screening tool for child maltreatment.
Area of Science:
- Pediatrics
- Emergency Medicine
- Child Health
Background:
- Child abuse and neglect present significant global health challenges with severe consequences.
- Accurate detection of child maltreatment in emergency rooms is critical due to the substantial impact of missed cases and false suspicions.
- Current diagnostic instruments for child abuse in emergency settings have an unknown diagnostic value.
Purpose of the Study:
- To evaluate the diagnostic accuracy of active, structured inquiry by emergency room staff in detecting physical child abuse.
- To assess the predictive value of the SPUTOVAMO-R questionnaire in identifying physical maltreatment in children presenting with injuries.
Main Methods:
- The Child Abuse Inventory at Emergency Rooms (CHAIN-ER) is a multi-center, cross-sectional study with a 6-month follow-up.
- Five thousand children aged 0-7 with injuries will be enrolled, with the SPUTOVAMO-R questionnaire as the index test.
- A systematic diagnostic workup and an expert panel decision serve as the reference standard to determine true child abuse presence.
Main Results:
- The study will determine the positive and negative predictive values of the SPUTOVAMO-R child abuse detection instrument.
- Data will be collected through pediatrician history, questionnaires for healthcare providers, and follow-up information.
- The study acknowledges challenges like the lack of a universally accepted reference standard and potential non-response.
Conclusions:
- The CHAIN-ER study is expected to yield accurate data on the predictive value of the SPUTOVAMO-R questionnaire.
- The findings will inform the effectiveness of using an expert panel and complete data in child abuse detection.
- This research addresses scientific hurdles to provide reliable insights into emergency room-based child abuse screening.
Background:
Child abuse and neglect is an important international health problem with unacceptable levels of morbidity and mortality. Although maltreatment as a cause of injury is estimated to be only 1% or less of the injured children attending the emergency room, the consequences of both missed child abuse cases and wrong suspicions are substantial. Therefore, the accuracy of ongoing detection at emergency rooms by health care professionals is highly important. Internationally, several diagnostic instruments or strategies for child abuse detection are used at emergency rooms, but their diagnostic value is still unknown. The aim of the study 'Child Abuse Inventory at Emergency Rooms' (CHAIN-ER) is to assess if active structured inquiry by emergency room staff can accurately detect physical maltreatment in children presenting at emergency rooms with physical injury.
Methods/Design:
CHAIN-ER is a multi-centre, cross-sectional study with 6 months diagnostic follow-up. Five thousand children aged 0-7 presenting with injury at an emergency room will be included. The index test - the SPUTOVAMO-R questionnaire- is to be tested for its diagnostic value against the decision of an expert panel. All SPUTOVAMO-R positives and a 15% random sample of the SPUTOVAMO-R negatives will undergo the same systematic diagnostic work up, which consists of an adequate history being taken by a pediatrician, inquiry with other health care providers by structured questionnaires in order to obtain child abuse predictors, and by additional follow-up information. Eventually, an expert panel (reference test) determines the true presence or absence of child abuse.
Discussion:
CHAIN-ER will determine both positive and negative predictive value of a child abuse detection instrument used in the emergency room. We mention a benefit of the use of an expert panel and of the use of complete data. Conducting a diagnostic accuracy study on a child abuse detection instrument is also accompanied by scientific hurdles, such as the lack of an accepted reference standard and potential (non-) response. Notwithstanding these scientific challenges, CHAIN-ER will provide accurate data on the predictive value of SPUTOVAMO-R.
Related Concept Videos
01:21Methods of Documentation III: PIE
01:23Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
01:27Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders
01:30Methods of Documentation VII: EMR