Increasing clarity for medics in suspected physical abuse cases

March 20, 2012, University of Sheffield

Researchers at the University of Sheffield and The Children's Hospital, Sheffield, are developing techniques which will help clinicians more accurately identify whether injuries sustained by young children are as a result of accident or abuse.

Currently base their decisions on their prior knowledge and experience. This can be subjective – and the ramifications of making the wrong decision can be huge, for both child and parent.

Dr Amaka Offiah, Consultant at Sheffield Children's NHS Foundation Trust, and senior lecturer at Sheffield University's Department of Human Metabolism along with a team of researchers from the Faculty of Engineering, are working together to create a system aimed at providing robust scientific evidence to support clinicians faced with having to assess how an injury may have been sustained.

"There needs to be a more scientific way of determining how an injury might have been caused," says Dr Offiah "Most physically abused children are too young to say how their injuries came about and we, as medics, are reliant on our own experience to make a decision about whether what the parent is saying is realistic or not."

This research is in its early stages and the multidisciplinary team, including engineers and medics, are currently working on creating computerised models which show how children's bones react to different forces. To do this, Dr Offiah, along with Dr Matt Carré and Nick Emerson, from the University's Department of Mechanical Engineering, have been examining the effects of different types of force on pig bones, which are regularly used as a substitute for human bones in laboratory testing.

"This was the first stage of the work," says Nick Emerson. "To see whether we could use readily available animal bone samples for our laboratory testing, and accurately recreate various fractures using predictive software."

The researchers found they were able to predict the force necessary to create a fracture and where the fracture would occur with as much as 90 per cent accuracy. "We've proven that we can adapt the modelling process to match different bones," says Emerson. "To date we've only had a limited number of test scenarios and test samples. With further refinement and more expansive testing, we believe our results will show an even higher level of accuracy."

The next stage of the work is to gather more data to develop the technique and increase its accuracy. Additionally, the researchers need to conduct experiments on bones from younger animals, to assess the effects of age.

"There has been extensive research in locating fracture sites in adult human bones, but limited attempts to determine what causes those fractures," says Emerson. "We want to gain a much clearer understanding of fracture patterns in young bones and apply this to scan data from children. We hope this will provide more certainty in cases where a clinician suspects a child hasn't sustained his or her injuries in the way the carer says."

For medics, this support is vital. "It's sometimes very difficult to determine how an injury has been caused, even for extremely experienced clinicians," says Dr Offiah. "Obviously we don't want to remove a child from a loving, nurturing home, but equally, no-one wants a child to return to a situation where they are being physically abused.

"The most important impact of this research will be to improve the confidence in judgements made when abuse is suspected and ultimately to improve the safety and wellbeing of vulnerable children."

The research project has been funded by The Children's Hospital Charity, who support and enhance the services of Sheffield Children's NHS Foundation Trust, including £250,000 of research each year into the prevention and cure of childhood illnesses. The charity also funded the country's first paediatric Clinical Research Facility which opened at the hospital in 2008.

Explore further: Pioneering research will assess the effects of obesity on bone development

Related Stories

Pioneering research will assess the effects of obesity on bone development

February 3, 2012
Researchers from the University of Sheffield are conducting ground-breaking research to determine how body weight and hormones affect bone health from childhood to adulthood.

Unintentional child injuries, deaths can be prevented, health researchers say

April 29, 2011
Patricia Schnitzer, associate professor in the MU Sinclair School of Nursing, says that most unintentional child injury deaths of young children result from inadequate supervision or failure to protect children from harm. ...

Children hospitalized at alarming rate due to abuse

February 6, 2012
In one year alone, over 4,500 children in the United States were hospitalized due to child abuse, and 300 of them died of their injuries, Yale School of Medicine researchers report in a new study. The findings are published ...

Recommended for you

Early studies of male birth-control pill show promise

March 23, 2018
Well, well, well. The ball has been knocked roundly into your court, gentlemen.

Whether sustained or sporadic, exercise offers same reductions in death risk

March 22, 2018
For decades, Americans have been inundated with a confusing barrage of messages about how best to counteract the health risks of sedentary lifestyles: walk 10,000 steps a day; do a seven-minute workout from a phone app; flip ...

Tai chi as good as or better than aerobic exercise for managing chronic pain

March 21, 2018
The ancient martial art of tai chi has similar or greater benefits than aerobic exercise for people with the chronic pain condition fibromyalgia, finds a trial published by The BMJ today.

Study: Poor health is a less common cause of bankruptcy than commonly thought, but it brings other economic woes

March 21, 2018
A team of researchers led by an MIT economist has found that medical expenses account for roughly 4 percent of bankruptcy filings among nonelderly adults in the U.S.

Study finds bad sleep habits start early in school-age children

March 21, 2018
Bad sleep habits in children begin earlier than many experts assume. That's the takeaway from a new study led by McGill University researchers. The findings suggest that official sleep guidelines for young school children ...

Medical expansion has improved health—with one exception

March 21, 2018
While Americans debate the rising cost of health care, a new study of 30 countries over 27 years found that medical expansion has improved overall health - with one major exception.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.