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To the Editor: The article by Dr Jenny and colleagues¹ raises a critical question: how can practicing physicians improve their ability to recognize inflicted head trauma in young children? Unfortunately, their study does not provide enough information to solve the practitioner's constant question: what is the predictive value of the symptom or sign at hand? Jenny et al address the question of if a child has an inflicted head trauma, then what is the chance the child will have facial bruising, nonspecific vomiting, fever, or irritability? In fact, these probabilities reported in their article were high enough to be of interest.

However, the practitioner needs to know if a child has facial bruising, nonspecific vomiting, fever, or irritability, then what is the chance the child has sustained inflicted head trauma? The data presented by Jenny et al in no way answer this critical question. For instance, if a child has . . . [Full Text of this Article]

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