[Complementary exams in child abuse: A French national study in 2015]

Area of Science:

• Pediatrics
• Child Abuse and Neglect
• Medical Practice Evaluation

Background:

• Existing French National Health Authority (HAS) guidelines primarily address shaken baby syndrome, leaving other child abuse scenarios under-addressed.
• Significant gaps exist in current recommendations for complementary examinations in various child abuse situations.

Purpose of the Study:

• To identify and evaluate complementary examinations used in child abuse cases in France.
• To compare current medical practices against existing HAS guidelines.

Main Methods:

• A multicenter study involving 104 French hospitals (81% response rate) surveyed 274 physicians via email.
• Clinical case scenarios in a multiple-choice format assessed diagnostic test utilization for physical, sexual, and neglect-related child abuse.

Main Results:

• Practices for complementary exams in child abuse cases demonstrated significant heterogeneity among physicians.
• While 99% performed systematic explorations for physical abuse, only 27% did so for serious neglect.
• Adherence to HAS guidelines was below 50% for most complementary exams in physical abuse cases, with underutilization of abdominal imaging and insufficient examination of siblings.

Conclusions:

• The study highlights considerable variability in the application of complementary examinations for child abuse across France.
• Development of national, standardized protocols for relevant exams is crucial for medical-legal consistency and improved inter-center collaboration.