This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Pediatrics  • Child Abuse  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Keenan and colleagues¹ collected data from 9 hospitals in North Carolina to derive population-based estimates and demographics of inflicted traumatic brain injury (TBI) in children aged 2 years or younger in the United States. I am concerned that the criteria used to make the diagnosis of inflicted TBI were vague and subjective. In the study by Keenan et al, inflicted TBI was diagnosed either if there was a confession or if review by a medical and child protective team deemed that the case was child abuse. However, the authors did not describe how many of their 80 cases of inflicted TBI were based on which of these 2 criteria. Furthermore, they did not describe the background or expertise of the protective teams, what criteria they used to determine whether an inflicted TBI had occurred, or how their decisions were made when the parents/caregivers denied wrongdoing. It . . . [Full Text of this Article]

Marvin Miller, MD
Department of Pediatrics and Obstetrics/Gynecology
Wright State University School of Medicine
Dayton, Ohio

RELATED ARTICLES

Incidence of Inflicted Traumatic Brain Injury in Infants—Reply
Heather T. Keenan and Desmond K. Runyan
JAMA. 2003;290(19):2543.
EXTRACT | FULL TEXT  

A Population-Based Study of Inflicted Traumatic Brain Injury in Young Children
Heather T. Keenan, Desmond K. Runyan, Stephen W. Marshall, Mary Alice Nocera, David F. Merten, and Sara H. Sinal
JAMA. 2003;290(5):621-626.
ABSTRACT | FULL TEXT