Defining paediatric abusive head trauma using routinely collected patient datasets: Definition development for a UK primary care cohort

IF 3.4 2区心理学 Q1 FAMILY STUDIES

Child Abuse & Neglect Pub Date : 2025-09-23 DOI:10.1016/j.chiabu.2025.107680

Joni Jackson , Lauren J. Scott , Sarah Dawson , Sharea Ijaz , Rebecca Wilson , Matthew Booker , Kate Birnie , Giles Haythornthwaite , Frank De Vocht , Julie Mytton , Mark D. Lyttle , Jelena Savović , Maria Theresa Redaniel

{"title":"Defining paediatric abusive head trauma using routinely collected patient datasets: Definition development for a UK primary care cohort","authors":"Joni Jackson , Lauren J. Scott , Sarah Dawson , Sharea Ijaz , Rebecca Wilson , Matthew Booker , Kate Birnie , Giles Haythornthwaite , Frank De Vocht , Julie Mytton , Mark D. Lyttle , Jelena Savović , Maria Theresa Redaniel","doi":"10.1016/j.chiabu.2025.107680","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Existing definitions used to identify abusive head trauma (AHT) from routinely collected patient data are developed for use in secondary care or mortality data. Incidence estimates calculated using these definitions do not include mildly symptomatic cases of AHT presenting to primary care, therefore underestimating the true population incidence.</div></div><div><h3>Objective</h3><div>To (1) develop AHT definitions for use with primary care, secondary care and accident and emergency data in the UK setting; (2) compare incidence using these definitions in a UK primary care cohort.</div></div><div><h3>Participants and setting</h3><div>The cohort included all infants in Clinical Practice Research Database (CPRD) Aurum, under 1 year old between January 2013 and June 2021, with linkages to Hospital Episodes Statistics Admitted Patient Care (HES APC), Accident and Emergency (HES AE) data and Diagnostic Imaging Dataset (DID).</div></div><div><h3>Method</h3><div>This study had two parts, (1) definition development via clinical expert consensus, and (2) comparative testing of definitions in a UK primary care cohort.</div></div><div><h3>Results</h3><div>Definitions of AHT were developed based on combinations of traumatic brain injury, abuse and head computerised tomography codes present in UK health records. Our definitions for AHT presenting to general practice, hospital and ED identified higher incidence in our cohort than all ICD-10 based definitions identified in the literature.</div></div><div><h3>Conclusion</h3><div>Inclusion of injuries presenting to GP, ED or admitted to hospital, in our definitions is likely to produce a more accurate estimate of AHT in the population. Caution should be applied, however, regarding potential inclusion of false positives and missed cases due to non-presentation to healthcare.</div></div>","PeriodicalId":51343,"journal":{"name":"Child Abuse & Neglect","volume":"169 ","pages":"Article 107680"},"PeriodicalIF":3.4000,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Child Abuse & Neglect","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0145213425004363","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"FAMILY STUDIES","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Existing definitions used to identify abusive head trauma (AHT) from routinely collected patient data are developed for use in secondary care or mortality data. Incidence estimates calculated using these definitions do not include mildly symptomatic cases of AHT presenting to primary care, therefore underestimating the true population incidence.

Objective

To (1) develop AHT definitions for use with primary care, secondary care and accident and emergency data in the UK setting; (2) compare incidence using these definitions in a UK primary care cohort.

Participants and setting

The cohort included all infants in Clinical Practice Research Database (CPRD) Aurum, under 1 year old between January 2013 and June 2021, with linkages to Hospital Episodes Statistics Admitted Patient Care (HES APC), Accident and Emergency (HES AE) data and Diagnostic Imaging Dataset (DID).

Method

This study had two parts, (1) definition development via clinical expert consensus, and (2) comparative testing of definitions in a UK primary care cohort.

Results

Definitions of AHT were developed based on combinations of traumatic brain injury, abuse and head computerised tomography codes present in UK health records. Our definitions for AHT presenting to general practice, hospital and ED identified higher incidence in our cohort than all ICD-10 based definitions identified in the literature.

Conclusion

Inclusion of injuries presenting to GP, ED or admitted to hospital, in our definitions is likely to produce a more accurate estimate of AHT in the population. Caution should be applied, however, regarding potential inclusion of false positives and missed cases due to non-presentation to healthcare.

查看原文本刊更多论文

使用常规收集的患者数据集定义儿科虐待性头部创伤：英国初级保健队列的定义发展

现有的定义用于从常规收集的患者数据中识别虐待性头部创伤（AHT），用于二级保健或死亡率数据。使用这些定义计算的发病率估计值不包括向初级保健提出的轻度症状的AHT病例，因此低估了真实的人群发病率。(1)制定AHT定义，用于英国的初级保健、二级保健和事故及急诊数据；(2)比较在英国初级保健队列中使用这些定义的发病率。该队列包括2013年1月至2021年6月期间临床实践研究数据库（CPRD） Aurum中所有1岁以下的婴儿，并与医院事件统计入院患者护理（HES APC），事故和急诊（HES AE）数据和诊断成像数据集（DID）相关联。方法本研究分为两部分，(1)通过临床专家共识制定定义，(2)在英国初级保健队列中对定义进行比较检验。结果：AHT的定义是基于英国健康记录中存在的创伤性脑损伤、虐待和头部计算机断层扫描代码的组合而制定的。我们对全科医生、医院和急诊科的AHT定义比文献中所有基于ICD-10的定义确定的AHT发生率更高。结论：在我们的定义中，包括向全科医生、急诊科或住院的损伤，可能会对人群中的AHT产生更准确的估计。然而，对于可能包含假阳性和因未向医疗保健部门报告而遗漏的病例，应谨慎对待。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.