@article{ref1,
title="A standardized definition of near-fatal child maltreatment: results of a multidisciplinary Delphi process",
journal="Child abuse and neglect",
year="2020",
author="Campbell, Kristine A. and Wood, Joanne N. and Lindberg, Daniel M. and Berger, Rachel P.",
volume="112",
number="",
pages="e104893-e104893",
abstract="BACKGROUND: The 2016 Presidential Commission to Eliminate Child Abuse and Neglect Fatalities identified systematic review of all cases of near-fatal child  maltreatment as a necessary step towards prevention of child maltreatment  fatalities. A critical barrier to adoption of this recommendation is the lack of a  standard definition of &quot;near-fatality&quot; in the context of suspected child  maltreatment. <br><br>OBJECTIVE: To develop a consensus definition of near-fatal child  maltreatment to be used in practice, policy, and research. PARTICIPANTS AND SETTING:  A multidisciplinary expert panel of 23 individuals from across the U.S. including  child abuse pediatricians, pediatric intensivists, pediatric emergency medicine  physicians, child welfare administrators, child welfare researchers, and child  injury/fatality researchers. <br><br>METHODS: A modified Delphi process reflecting an  iterative process of 3 rounds of surveys of expert opinion, statistical summary of  survey response, and feedback of summary statistics. Consensus was defined as 75 %  of panelists ranking an element as required (≥80 on a scale of 0-100) to meet a  definition of near-fatality (75th% threshold). <br><br>RESULTS: Experts defined near-fatal  child maltreatment as life-threatening cardiopulmonary dysfunction directly  attributable to suspected abuse or neglect as evidenced by (a) respiratory  insufficiency/failure requiring intubation and mechanical ventilation, (b)  respiratory insufficiency/failure requiring medications to reverse effects of toxic  ingestion, or (c) cardiac arrhythmia with/without cardiopulmonary resuscitation  (CPR). <br><br>CONCLUSIONS: A consensus definition of near-fatal child maltreatment should  be introduced in child protective services processes and in child  fatality/near-fatality reviews to improve our ability to identify, review, and  respond to trends in near-fatal child maltreatment at local, regional, and national  levels.<p /> <p>Language: en</p>",
language="en",
issn="0145-2134",
doi="10.1016/j.chiabu.2020.104893",
url="http://dx.doi.org/10.1016/j.chiabu.2020.104893"
}