Circularity bias in abusive head trauma studies could be diminished with a new ranking scale
Causality in abusive head trauma has never been fully established and hence no gold standard exists for the diagnosis. Implications hereof include bias introduced by circular reasoning and a shift from a trustful doctor patient relationship to a distrustful one when the caregiver statement is questi...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2016-03-01
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| Series: | Egyptian Journal of Forensic Sciences |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2090536X15000982 |
| _version_ | 1818969894824181760 |
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| author | Göran Högberg Bonnie Colville-Ebeling Ulf Högberg Peter Aspelin |
| author_facet | Göran Högberg Bonnie Colville-Ebeling Ulf Högberg Peter Aspelin |
| author_sort | Göran Högberg |
| collection | DOAJ |
| description | Causality in abusive head trauma has never been fully established and hence no gold standard exists for the diagnosis. Implications hereof include bias introduced by circular reasoning and a shift from a trustful doctor patient relationship to a distrustful one when the caregiver statement is questioned. In this paper we examine seven recent abusive head trauma studies including 476 diagnosed abuse cases for circular reasoning as well as the role of the caregiver statement in the diagnosis. Secondly, we present a novel ranking scale for the diagnosis of abusive head trauma designed to minimize circular reasoning. We found circularity to be a potential source of bias in all seven studies. The caregiver statement (lack of trauma mechanism or trauma mechanism considered incompatible with clinical findings) was listed as a diagnostic item in 329 (69%) of 476 cases. Applying our ranking scale to the abuse cases showed that the demands of our ranking scale were not fulfilled in 440 (92%) cases. We conclude that most abuse cases in the studies were, to some extent, diagnosed on criteria based on circular reasoning. The caregiver statement was one of the most frequently used diagnostic items. Hypothetically, caregivers offer no or inadequate explanation to the clinical findings in assumed abuse cases. Thus, when this feature is encountered, it is regarded as indicative of abuse adding further to the risk of circularity bias.
We propose the use of our novel ranking scale in abusive head trauma research in an effort to minimize circular reasoning. |
| first_indexed | 2024-12-20T14:27:50Z |
| format | Article |
| id | doaj.art-b489d1089e114ac68430b95364374326 |
| institution | Directory Open Access Journal |
| issn | 2090-536X |
| language | English |
| last_indexed | 2024-12-20T14:27:50Z |
| publishDate | 2016-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Journal of Forensic Sciences |
| spelling | doaj.art-b489d1089e114ac68430b953643743262022-12-21T19:37:44ZengSpringerOpenEgyptian Journal of Forensic Sciences2090-536X2016-03-016161010.1016/j.ejfs.2015.12.001Circularity bias in abusive head trauma studies could be diminished with a new ranking scaleGöran Högberg0Bonnie Colville-Ebeling1Ulf Högberg2Peter Aspelin3Department of Women’s and Children’s Health, Child and Adolescent Psychiatric Unit, Karolinska Institutet, Astrid Lindgren Children’s Hospital, 171 76 Stockholm, SwedenUniversity of Copenhagen, Department of Forensic Medicine, Fredrik den V’s Vej 11, 2100 Copenhagen, DenmarkDepartment of Women’s and Children’s Health, Uppsala University, SE-751 85 Uppsala, SwedenDivision of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Insitutet/Karolinska University Hospital, SE-14186 Stockholm, SwedenCausality in abusive head trauma has never been fully established and hence no gold standard exists for the diagnosis. Implications hereof include bias introduced by circular reasoning and a shift from a trustful doctor patient relationship to a distrustful one when the caregiver statement is questioned. In this paper we examine seven recent abusive head trauma studies including 476 diagnosed abuse cases for circular reasoning as well as the role of the caregiver statement in the diagnosis. Secondly, we present a novel ranking scale for the diagnosis of abusive head trauma designed to minimize circular reasoning. We found circularity to be a potential source of bias in all seven studies. The caregiver statement (lack of trauma mechanism or trauma mechanism considered incompatible with clinical findings) was listed as a diagnostic item in 329 (69%) of 476 cases. Applying our ranking scale to the abuse cases showed that the demands of our ranking scale were not fulfilled in 440 (92%) cases. We conclude that most abuse cases in the studies were, to some extent, diagnosed on criteria based on circular reasoning. The caregiver statement was one of the most frequently used diagnostic items. Hypothetically, caregivers offer no or inadequate explanation to the clinical findings in assumed abuse cases. Thus, when this feature is encountered, it is regarded as indicative of abuse adding further to the risk of circularity bias. We propose the use of our novel ranking scale in abusive head trauma research in an effort to minimize circular reasoning.http://www.sciencedirect.com/science/article/pii/S2090536X15000982Abusive head traumaCircularity biasRanking scaleCaregiver |
| spellingShingle | Göran Högberg Bonnie Colville-Ebeling Ulf Högberg Peter Aspelin Circularity bias in abusive head trauma studies could be diminished with a new ranking scale Egyptian Journal of Forensic Sciences Abusive head trauma Circularity bias Ranking scale Caregiver |
| title | Circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| title_full | Circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| title_fullStr | Circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| title_full_unstemmed | Circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| title_short | Circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| title_sort | circularity bias in abusive head trauma studies could be diminished with a new ranking scale |
| topic | Abusive head trauma Circularity bias Ranking scale Caregiver |
| url | http://www.sciencedirect.com/science/article/pii/S2090536X15000982 |
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