Abusive head trauma and the triad: a critique on behalf of RCPCH of 'Traumatic shaking: the role of the triad in medical investigations of suspected traumatic shaking'

Arch Dis Child. 2018 Jun;103(6):606-610. doi: 10.1136/archdischild-2017-313855. Epub 2018 Mar 6.

Abstract

The Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) has recently published what they purported to be a systematic review of the literature on 'isolated traumatic shaking' in infants, concluding that 'there is limited evidence that the so-called triad (encephalopathy, subdural haemorrhage, retinal haemorrhage) and therefore its components can be associated with traumatic shaking'. This flawed report, from a national body, demands a robust response. The conclusions of the original report have the potential to undermine medico-legal practice. We have conducted a critique of the methodology used in the SBU review and have found it to be flawed, to the extent that children's lives may be put at risk. Thus, we call on this review to be withdrawn or to be subjected to international scrutiny.

Keywords: child abuse; evidence based medicine; forensic medicine.

Publication types

  • Review

MeSH terms

  • Biomedical Research / standards*
  • Brain Diseases / diagnosis
  • Child Abuse*
  • Craniocerebral Trauma / diagnosis
  • Humans
  • Infant
  • Publications / standards*
  • Research Design / standards*
  • Retinal Hemorrhage / diagnosis
  • Retraction of Publication as Topic
  • Shaken Baby Syndrome / diagnosis*