Shaken Baby Syndrome

doi:10.1017/9781009177894.018

Chapter 17 - Shaken Baby Syndrome

Exploring Concerns about the ‘Triad’ Diagnosis and Its Statistical Validation Using a Causal Bayesian Network

from Section 3 - Science

Published online by Cambridge University Press: 07 June 2023

Norman Fenton and

Edited by

Waney Squier and

Keith A. Findley: Affiliation:
University of Wisconsin, Madison
Cyrille Rossant: Affiliation:
University College London
Kana Sasakura: Affiliation:
Konan University, Japan
Leila Schneps: Affiliation:
Sorbonne Université, Paris
Waney Squier: Affiliation:
John Radcliffe Hospital, Oxford
Knut Wester: Affiliation:
Universitetet i Bergen, Norway

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Summary

When very young children are brought to a doctor or hospital with signs and symptoms consistent with head injury, it is important to determine the cause. For almost 50 years, the triad of subdural haematoma (SDH), retinal haemorrhage (RH) and encephalopathy has been regarded as an accurate predictor of deliberate shaking and widely used to diagnose shaken baby syndrome (SBS). Statistical analyses by Cardiff University researchers and others claim to show that certain combinations of findings are highly predictive of abuse and as a result of this conclusion, protocols such as mandatory reporting to police are invoked in the name of protecting the child. However, concerns have been raised about the circularity of approach used in the statistical analyses which requires each case to be classified explicitly as either abuse or non-abuse. By producing a causal model of the problem, we show that these findings are actually a poor predictor of SBS, even where there is some evidence of risk factors indicative of abuse.

Keywords

subdural haematoma Bayesian networks causal models epidemiology statistics circular logic medical practice guidelines probability analysis

Type: Chapter
Information: Shaken Baby Syndrome
Investigating the Abusive Head Trauma Controversy
, pp. 259 - 274

DOI: https://doi.org/10.1017/9781009177894.018 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2023

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