The Rational Clinical Examination
David L. Simel, Drummond Rennie
Sexual Abuse, Child
David L. Simel
Prior Probability
Topics Discussed:
child abuse, child behavior, children's health, criterion standard comparisons (diagnostic tests), examination of vagina, female genitalia, gynecological examination, hymen, likelihood ratio, make the diagnosis, pediatrics, physical examination, prior probability, sexual abuse, sexual abuse of child, sexual assault examination
Excerpt:
"The reported prevalence of sexual abuse during childhood is approximately
1.1%.1 However, this estimate is from
population surveys.1 The probability is likely
higher when a caregiver expresses his or her concern about maltreatment.
Some surveys of adult women show that they recall abuse at rates
as high as 25%.2 These values also do
not apply to the child who is brought to the clinician for care
after alleged recent abuse (
72 hours). ..."
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