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September 1985

Where You Stand Depends on Where You Sit: The Need for Improved Skills in Evaluating Children and Families

Author Affiliations

Department of Pediatrics University of Colorado School of Medicine The C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse and Neglect 1205 Oneida St Denver, CO 80220

Am J Dis Child. 1985;139(9):867-868. doi:10.1001/archpedi.1985.02140110021019

There are numerous examples in pediatrics where, depending on one's perspective, data will either reassure us or alarm us. A public health official will be delighted with the 95% efficacy of a vaccine, while an individual practitioner may lie awake at night worrying about the 20 to 30 susceptible children in his or her practice. In another example, the lack of a foolproof method of diagnosing acute appendicitis has caused us to accept a false-positive rate; we are willing to remove a few normal appendixes as a consequence of our desire not to miss any "hot" ones.

Since the publication of the article "The Battered Child Syndrome,"1 numerous reports have been published that highlight the many ways that abuse can mimic organic and psychosocial disease, as well as the many ways that organic disease and social/cultural practices can mimic abuse.

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