@article{ref1,
title="Value of Follow-up Examinations of Children and Adolescents Evaluated for Sexual Abuse and Assault",
journal="Pediatrics",
year="2012",
author="Gavril, Amy R. and Kellogg, Nancy D. and Nair, Prakash",
volume="129",
number="2",
pages="282-289",
abstract="OBJECTIVE:The purpose of this study was to determine whether follow-up examinations of suspected victims of child sexual abuse influence medical diagnosis or treatment.METHODS:A retrospective chart review of patients with initial and follow-up examinations (examinations 1 and 2, respectively) over a 5-year study period was conducted. Patient and abuse characteristics, interval between examinations and abuse, and examiner experience levels were collected; examination findings and test results for sexually transmitted infections (STIs) were compared for examinations 1 and 2.RESULTS:Among 727 patients, examination 2 resulted in a change in interpretation of trauma likelihood in 129 (17.7%) patients and identified STIs in 47 (6.5%) patients. Changes in trauma likelihood and detection of additional STIs during follow-up examinations were more likely in adolescent, female, and sexually active patients and those with a history of genital-genital contact, unknown examination 1 findings, or drug-facilitated sexual assault. Although examination 2 was less likely to affect the interpretation of trauma likelihood and STIs in preadolescent patients, a change in interpretation of trauma likelihood was noted for 49 (15.5%) of these patients, and 16 (5.1%) were diagnosed with a new STI on examination 2. The level of clinician experience during examination 1 did affect the likelihood of changes in examination findings during examination 2.CONCLUSIONS:Follow-up examinations by specialists affected the interpretation of trauma and detection of STIs in ∼23% of pediatric patients undergoing sexual abuse assessments.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2011-0804",
url="http://dx.doi.org/10.1542/peds.2011-0804"
}