Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years

Objective Combined paediatric and forensic medical expertise to interpret physical findings is not available in Dutch healthcare facilities. The Dutch Expertise Centre for Child Abuse (DECCA) was founded in the conviction that this combination is essential in assessing potential physical child abuse...

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Main Authors: Rick Robert van Rijn, Marjo J Affourtit, Wouter A Karst, Mascha Kamphuis, Leonie C de Bock, Elise van de Putte, R A C Bilo, Mirjam Kruijsen-Jaarsma, H.G.T. Nijs, H.C. Terlingen, S. de Vries, L. van der Berg, A.C.M. van Bellegem, M. Bouman, M.H. Loos, A.S. Smeijers, A.H. Teeuw, P.J. Puiman, F.M.C. van Berkestijn, F. Kamberg, S.L. Nijhof, J.M. Ruskamp, I.M.B. Russel-Kampschoer, M. Schouten, K. Sijstermans, S.A.A. Wolt-Plompen
Format: Article
Language:English
Published: BMJ Publishing Group 2019-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/8/e031008.full
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author Rick Robert van Rijn
Marjo J Affourtit
Wouter A Karst
Mascha Kamphuis
Leonie C de Bock
Elise van de Putte
R A C Bilo
Mirjam Kruijsen-Jaarsma
H.G.T. Nijs
H.C. Terlingen
S. de Vries
L. van der Berg
A.C.M. van Bellegem
M. Bouman
M.H. Loos
A.S. Smeijers
A.H. Teeuw
P.J. Puiman
F.M.C. van Berkestijn
F. Kamberg
S.L. Nijhof
J.M. Ruskamp
I.M.B. Russel-Kampschoer
M. Schouten
K. Sijstermans
S.A.A. Wolt-Plompen
author_facet Rick Robert van Rijn
Marjo J Affourtit
Wouter A Karst
Mascha Kamphuis
Leonie C de Bock
Elise van de Putte
R A C Bilo
Mirjam Kruijsen-Jaarsma
H.G.T. Nijs
H.C. Terlingen
S. de Vries
L. van der Berg
A.C.M. van Bellegem
M. Bouman
M.H. Loos
A.S. Smeijers
A.H. Teeuw
P.J. Puiman
F.M.C. van Berkestijn
F. Kamberg
S.L. Nijhof
J.M. Ruskamp
I.M.B. Russel-Kampschoer
M. Schouten
K. Sijstermans
S.A.A. Wolt-Plompen
author_sort Rick Robert van Rijn
collection DOAJ
description Objective Combined paediatric and forensic medical expertise to interpret physical findings is not available in Dutch healthcare facilities. The Dutch Expertise Centre for Child Abuse (DECCA) was founded in the conviction that this combination is essential in assessing potential physical child abuse. DECCA is a collaboration between the three paediatric hospitals and the Netherlands Forensic Institute. DECCA works with Bayes’ theorem and uses likelihood ratios in their conclusions.Design We present the implementation process of DECCA and cross-sectional data of the first 4 years.Participants Between 14 December 2014 and 31 December 2018, a total of 761 advisory requests were referred, all of which were included in this study. An advisee evaluation over the year 2015 was performed using a self-constructed survey to gain insight in the first experiences with DECCA.Results 761 cases were included, 381 (50.1%) boys and 361 (47.4%) girls (19 cases (2.5%) sex undisclosed). Median age was 1.5 years (range 1 day to 20 years). Paediatricians (53.1%) and child safeguarding doctors (21.9%) most frequently contacted DECCA. The two most common reasons for referral were presence of injury/skin lesions (n=592) and clinical history inconsistent with findings (n=145). The most common injuries were bruises (264) and non-skull fractures (166). Outcome of DECCA evaluation was almost certainly no or improbable child abuse in 35.7%; child abuse likely or almost certain in 24.3%, and unclear in 12%. The advisee evaluations (response rate 50%) showed that 93% experienced added value and that 100% were (very) satisfied with the advice.Conclusion Data show growing interest in the expertise of DECCA through the years. DECCA seems to be a valuable addition to Dutch child protection, since advisee value the service and outcome of DECCA evaluations. In almost half of the cases, DECCA concluded that child abuse could not be substantiated.
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spelling doaj-art-e8d88ce5482c45efa00cb13f8e8e47372024-11-25T21:35:12ZengBMJ Publishing GroupBMJ Open2044-60552019-08-019810.1136/bmjopen-2019-031008Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 yearsRick Robert van Rijn0Marjo J Affourtit1Wouter A Karst2Mascha Kamphuis3Leonie C de Bock4Elise van de Putte5R A C BiloMirjam Kruijsen-JaarsmaH.G.T. NijsH.C. TerlingenS. de VriesL. van der BergA.C.M. van BellegemM. BoumanM.H. LoosA.S. SmeijersA.H. TeeuwP.J. PuimanF.M.C. van BerkestijnF. KambergS.L. NijhofJ.M. RuskampI.M.B. Russel-KampschoerM. SchoutenK. SijstermansS.A.A. Wolt-Plompen2 Forensic Medicine, Nederlands Forensisch Instituut, Den Haag, The Netherlands3 Pediatrics, Erasmus MC Sophia Children`s Hospital, Rotterdam, The NetherlandsForensic Medicine, GGD Branbant Zuidoost, Eindhoven, Netherlands4 Dutch Expertise Center for Child Abuse, Utrecht, The Netherlands4 Dutch Expertise Center for Child Abuse, Utrecht, The NetherlandsDepartment of Paediatrics, Wilhelmina Children`s Hospital University Medical Centre Utrecht, Utrecht University, Utrecht, The NetherlandsObjective Combined paediatric and forensic medical expertise to interpret physical findings is not available in Dutch healthcare facilities. The Dutch Expertise Centre for Child Abuse (DECCA) was founded in the conviction that this combination is essential in assessing potential physical child abuse. DECCA is a collaboration between the three paediatric hospitals and the Netherlands Forensic Institute. DECCA works with Bayes’ theorem and uses likelihood ratios in their conclusions.Design We present the implementation process of DECCA and cross-sectional data of the first 4 years.Participants Between 14 December 2014 and 31 December 2018, a total of 761 advisory requests were referred, all of which were included in this study. An advisee evaluation over the year 2015 was performed using a self-constructed survey to gain insight in the first experiences with DECCA.Results 761 cases were included, 381 (50.1%) boys and 361 (47.4%) girls (19 cases (2.5%) sex undisclosed). Median age was 1.5 years (range 1 day to 20 years). Paediatricians (53.1%) and child safeguarding doctors (21.9%) most frequently contacted DECCA. The two most common reasons for referral were presence of injury/skin lesions (n=592) and clinical history inconsistent with findings (n=145). The most common injuries were bruises (264) and non-skull fractures (166). Outcome of DECCA evaluation was almost certainly no or improbable child abuse in 35.7%; child abuse likely or almost certain in 24.3%, and unclear in 12%. The advisee evaluations (response rate 50%) showed that 93% experienced added value and that 100% were (very) satisfied with the advice.Conclusion Data show growing interest in the expertise of DECCA through the years. DECCA seems to be a valuable addition to Dutch child protection, since advisee value the service and outcome of DECCA evaluations. In almost half of the cases, DECCA concluded that child abuse could not be substantiated.https://bmjopen.bmj.com/content/9/8/e031008.full
spellingShingle Rick Robert van Rijn
Marjo J Affourtit
Wouter A Karst
Mascha Kamphuis
Leonie C de Bock
Elise van de Putte
R A C Bilo
Mirjam Kruijsen-Jaarsma
H.G.T. Nijs
H.C. Terlingen
S. de Vries
L. van der Berg
A.C.M. van Bellegem
M. Bouman
M.H. Loos
A.S. Smeijers
A.H. Teeuw
P.J. Puiman
F.M.C. van Berkestijn
F. Kamberg
S.L. Nijhof
J.M. Ruskamp
I.M.B. Russel-Kampschoer
M. Schouten
K. Sijstermans
S.A.A. Wolt-Plompen
Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
BMJ Open
title Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
title_full Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
title_fullStr Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
title_full_unstemmed Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
title_short Implementation of the Dutch expertise centre for child abuse: descriptive data from the first 4 years
title_sort implementation of the dutch expertise centre for child abuse descriptive data from the first 4 years
url https://bmjopen.bmj.com/content/9/8/e031008.full
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