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Pilot study using machine learning to improve estimation of physical abuse prevalence.

Farah W Brink1, Charmaine B Lo2, Steven W Rust3

  • 1Nationwide Children's Hospital, 700 Childrens Drive, Columbus, OH 43205, United States; The Ohio State University College of Medicine, 370 West Ninth Avenue, Columbus, OH 43210, United States.

Child Abuse & Neglect
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Summary

Machine learning models can improve the accuracy of identifying child abuse using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. This approach enhances abuse detection beyond traditional coding methods.

Keywords:
Child abuseChild maltreatmentInternational classification of diseases codesMachine learningPediatric health information systemPhysical abuse

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Area of Science:

  • Medical Informatics
  • Pediatric Emergency Medicine
  • Machine Learning in Healthcare

Background:

  • International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes often underestimate physical abuse prevalence.
  • Machine learning (ML) offers potential for more accurate abuse estimation by processing diverse data.

Purpose of the Study:

  • To demonstrate the feasibility of using ML to identify ICD-10-CM codes associated with child abuse.
  • To develop a proof-of-concept model for abuse detection.

Main Methods:

  • A LASSO logistic regression model was developed using ICD-10-CM codes and patient age.
  • Data from children under 5 years old, evaluated by a child protection team (CPT) between 2016-2020, were analyzed.
  • Model performance was assessed using cross-validation (CV) and Receiver Operator Characteristic (ROC) curves.

Main Results:

  • The ML model achieved a mean CV AUC of 0.87 in identifying confirmed physical abuse (PA) using diagnosis codes and age.
  • Model performance was slightly lower (mean CV AUC = 0.81) for cases lacking specific abuse ICD-10-CM codes.

Conclusions:

  • A model utilizing ICD-10-CM codes and age can enhance the accuracy of distinguishing abusive from non-abusive injuries.
  • This pilot study represents a foundational step toward improving population-level abuse estimates.