Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking
- PMID: 30146789
- PMCID: PMC6585638
- DOI: 10.1111/apa.14473
Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking
Abstract
The Swedish Agency for Health Technology Assessment and Assesment of Social Services (SBU) is an independent national authority, tasked by the government with assessing methods used in health, medical and dental services and social service interventions from a broad perspective, covering medical, economic, ethical and social aspects. The language in SBU's reports are adjusted to a wide audience. SBU's Board of Directors has approved the conclusions in this report. The systematic review showed the following graded results: There is limited scientific evidence that the triad (Three components of a whole. The triad associated with SBS usually comprises subdural haematoma, retinal haemorrhages and encephalopathy.) and therefore, its components can be associated with traumatic shaking (low-quality evidence). There is insufficient scientific evidence on which to assess the diagnostic accuracy of the triad in identifying traumatic shaking (very low-quality evidence). Limited scientific evidence (low-quality evidence) represents a combined assessment of studies of high or moderate quality which disclose factors that markedly weaken the evidence. It is important to note that limited scientific evidence for the reliability of a method or an effect does not imply complete lack of scientific support. Insufficient scientific evidence (very low-quality evidence) represents either a lack of studies or situations when available studies are of low quality or show contradictory results. Evaluation of the evidence was not based on formal grading of the evidence according to GRADE but on an evaluation of the total scientific basis.
Keywords: Brain oedema; Child abuse; Infant; Retinal haemorrhage; Shaken Baby Syndrome; Subdural haematoma.
©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Conflict of interest statement
In accordance with SBU's requirements, the experts and scientific reviewers participating in this project have submitted statements about conflict of interest. These documents are available at SBU's secretariat. SBU has determined that the conditions described in the submissions are compatible with SBU's requirements for objectivity and impartiality.
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