Chang et al developed the Screening Index for Physical Child Abuse (SIPCA) to help to identify children with physical child abuse. The authors are from Johns Hopkins University, New York Medical College and the University of South Florida.
Age selection: 14 years of age or younger
Parameters:
(1) age group
(2) multiple burns
(3) intracranial bleeding
(4) fracture of the vault or base of the skull
(5) rib fracture
(6) contusion of the eye
Parameter
Finding
Points
age group
0 to 1 year
6
1 to 3 years
2
older
0
multiple burns
no
0
yes
2
intracranial bleeding
no
0
yes
2
fracture of the vault or base of the skull
no
0
yes
1
rib fracture
no
0
yes
2
contusion of the eye
no
0
yes
2
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15 (The authors had a second version of the index scored differently that had a maximum score of 26).
• A score >= 3 was considered positive.
• The cutoff means that any infant who comes in with injuries would be considered as having child abuse.
Performance:
• A cutoff of >=3 or >= 4 showed similar performance characteristics, with a sensitivity of 70% and specificity 94%.
• A cutoff of >= 2 had a slightly better Youden score than >= 3 (0.67 vs 0.65)
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