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Chapter 10 - The Swedish Systematic Literature Review on Suspected Traumatic Shaking (Shaken Baby Syndrome) and Its Aftermath

from Section 3 - Science

Published online by Cambridge University Press:  07 June 2023

By
Niels Lynøe  and
Anders Eriksson
Edited by
Keith A. Findley ,
Cyrille Rossant ,
Kana Sasakura ,
Leila Schneps ,
Waney Squier  and
Knut Wester
Keith A. Findley
Affiliation:
University of Wisconsin, Madison
Cyrille Rossant
Affiliation:
University College London
Kana Sasakura
Affiliation:
Konan University, Japan
Leila Schneps
Affiliation:
Sorbonne Université, Paris
Waney Squier
Affiliation:
John Radcliffe Hospital, Oxford
Knut Wester
Affiliation:
Universitetet i Bergen, Norway
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Summary

This is a brief presentation of the evidence from a systematic literature review of the diagnostic accuracy in suspected traumatic shaking. The national and international reaction to this systematic literature review is also addressed, along with rebuttal of the criticism and an interpretation of the hostile reception of the review. We argue that despite the fact that a scientific controversy often includes competing theories about mechanisms, the shaken baby controversy also includes a controversy about correlation knowledge, because its function is to corroborate (or falsify) the applied theories about mechanisms. Moreover, we argue that long personal experience and groupthink within child protection teams have influenced the development of biased gold standards, resulting in turn in circular reasoning: hence most of the shaken baby literature is flawed.

Keywords

controversysystematic reviewevidence-based medicinecircular reasoningdiagnostic accuracy
Type
Chapter
Information
Shaken Baby Syndrome
Investigating the Abusive Head Trauma Controversy
 , pp. 161 - 178
Publisher: Cambridge University Press
Print publication year: 2023

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References

Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU).SBU reports’ influence of the healthcare system. Stockholm, 2012 (in Swedish). https://bit.ly/3NBrBow.Google Scholar
Guthkelch, AN. Infantile subdural haematoma and its relationship to whiplash injuries British Medical Journal. 1971;2:430–1.Google Scholar
Caffey, J. On the theory and practice of shaking infants: Its potential residual effects of permanent brain damage and mental retardation. American Journal of Diseases of Children. 1972;124:161–9.Google Scholar
Eisenbrey, AB. Retinal hemorrhage in the battered child. Pediatric Neurosurgery. 1979; 5:40–4.Google Scholar
Squier, W, Mack, J, Green, A, Azis, T. The pathophysiology of brain swelling associated with subdural hemorrhage: The role of the trigeminovascular system. Child’s Nervous System. 2012;28:2005–15.Google Scholar
Duhaime, AC, Christian, CW, Rorke, LC, Zimmerman, RA. Nonaccidental head injury in infants: The ‘shaken-baby syndrome’. New England Journal of Medicine. 1998;338:1822–9.CrossRefGoogle ScholarPubMed
Prange, MT, Coats, B, Duhaime, AC, Margulies, SS. Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants. Journal of Neurosurgery. 2003;99:143–50.Google Scholar
Duhaime, AC, Alario, A, Lewander, WJ et al. Head injuries in very young children: Mechanism, injury type and ophthalmological findings in 100 hospitalized patients younger than 2 years of age. Pediatrics. 1992;90:179–85.CrossRefGoogle Scholar
Lynøe, N, Juth, N, Eriksson, A. From child protection to paradigm protection: The genesis, development and defence of a scientific paradigm. Journal of Medicine and Philosophy. 2019;44:378–90.Google Scholar
Lynøe, N, Eriksson, A. The unspoken shaken baby lie detector algorithm: An analysis of diagnostic procedures in cases of allegedly abusive head trauma without external signs of trauma. Journal of Research in Philosophy and History. 2020;3(2). www.scholink.org/ojs/index.php/jrph/article/view/3224.CrossRefGoogle Scholar
Choudhary, AK, Servaes, S, Slovis, TL et al. Consensus statement on abusive head trauma in infants and young children. Pediatric Radiology. 2018;48(8):1048–65.CrossRefGoogle ScholarPubMed
Strouse, PJ. Child abuse: We have problems. Pediatric Radiology. 2016;46:587–90.CrossRefGoogle ScholarPubMed
Ludvigsson, J, Steinwall Larsen, S, Van Agthoven, G et al. The presence of shaken baby syndrome is scientifically robust. Swedish Medical Journal. 2015;112:DE6U.Google Scholar
Geddes, JF, Hackshaw, AK, Vowles, GH, Nickols, CD, Whitwell, HL. Neuropathology of inflicted head injury in children. I. Patterns of brain damage. Brain. 2001;124:1290–8.Google Scholar
Geddes, JF, Vowles, GH, Hackshaw, A et al. Neuropathology of inflicted head injury in children. II. Microscopic brain injury in infants. Brain. 2001;124:1299–1306.Google Scholar
Geddes, JF, Whitwell, HL. Inflicted head injury in infants. Forensic Science International. 2004;146:83–8.Google Scholar
Zahl, SM, Wester, K, Gabaeff, S. Examining perinatal subdural haematoma as an aetiology of extra-axial hygroma and chronic subdural haematoma. Acta Paediatrica. 2020;109(4):659–66.Google Scholar
Guthkelch, AN. Problems of infant retino-dural hemorrhage with minimal external injury. Houston Journal of Health Law and Policy. 2012;12:201–8.Google Scholar
Findley, KA, Barnes, PD, Moran, DA et al. Shaken baby syndrome, abusive head trauma, and actual innocence: Getting it right. Houston Journal of Health Law and Policy. 2012;12:209–312.Google Scholar
Donohoe, M. Evidence-based medicine and shaken baby syndrome: Part I. Literature review, 1966–1998. American Journal of Forensic Medicine and Pathology. 2003;24(3):239–42.Google Scholar
Riggs, JE, Hobbs, GR. Infant homicide and accidental death in the United States, 1940–2005: Ethics and epidemiological classification. Journal of Medical Ethics. 2011;37:445–8.Google Scholar
Acres, M, Morris, JA. The pathogenesis of retinal and subdural haemorrhage in non-accidental head injury in infancy: Assessment using Bradford Hill criteria. Medical Hypotheses. 2014;82:1–5.8.CrossRefGoogle ScholarPubMed
Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU). Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking. A systematic review. SBU assessment. Report 255E/2016 (in Swedish and English). https://bit.ly/3DGrvaC.Google Scholar
Lynøe, N, Elinder, G, Hallberg, B et al. Insufficient evidence for ‘shaken baby syndrome’: A systematic review. Acta Paediatrica. 2017;106(7):1021–7.Google Scholar
Elinder, G, Eriksson, A, Hallberg, B et al. Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking. Acta Paediatrica. 2018;107(S472):3–23.Google Scholar
Elinder, G, Eriksson, A, Hallberg, B et al. Gaisho sei no yusaburi: Gaishosei no yusaburi ga utagawareru jian no igakuteki chosa ni okeru san. Choko no yakuwari [Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking. A systematic review]. (Translation by Kana Sasakura). Ryukoku Hogaku. 2018;50(3):670–95.Google Scholar
SBU Handbook (including appendix 10 regarding statistical concepts and chapter 10, page 130, regarding the assessment of grading studies). www.sbu.se/upload/ebm/metodbok/SBUsHandbok.pdf.Google Scholar
Whiting, P, Rutjes, AW, Reitsma, JB, et al. The development of QUADAS: A tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Medical Research Methodology. 2003;3:25.Google Scholar
Shea, BJ, Grimshaw, JM, Wells, GA et al. Development of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews. BMC Medical Research Methodology. 2007;7:10. https://doi.org/10.1186/1471-2288-7-10.Google Scholar
Gordon Guyatt, G, Oxman, AD, Elie, A et al. GRADE guidelines: 1. Introduction. GRADE evidence profiles and summary of findings tables. Journal of Clinical Epidemiology. 2011;64:383–94.Google Scholar
Rutjes, AWS, Reitsma, JB, Coomarasamy, A, et al. Evaluation of diagnostic tests when there is no gold standard. A review of methods. Health Technology Assessment. 2007;11(50).CrossRefGoogle Scholar
Adamsbaum, C, Grabar, S, Mejean, N, Rey-Salmon, C. Abusive head trauma: Judicial admissions highlight violent and repetitive shaking. Pediatrics. 2010;126:546–55.Google Scholar
Vinchon, M, de Foort-Dhellemmens, S, Desurmont, M, Delestret, I. Confessed abuse versus witnessed accidents in infants: Comparison of clinical, radiological, and ophthalmological data in corroborated cases. Child’s Nervous System. 2010;26:637–45.Google Scholar
Gardner, HB. A witnessed short fall mimicking presumed shaken baby syndrome. Pediatric Neurosurgery. 2007;43:433–5.CrossRefGoogle ScholarPubMed
Denton, S, Mileusnic, D. Delayed sudden death in an infant following an accidental fall: A case report with review of the literature. American Journal of Forensic Medicine and Pathology. 2003;24(4):371–6.Google Scholar
Clarke, M, Chalmers, I. Reflections on the history of systematic reviews. BMJ Evidence-Based Medicine. 2018;23(4):121–2.CrossRefGoogle ScholarPubMed
Högberg, U, Eriksson, G, Högberg, G, Wahlberg, Å. Parents’ experiences of seeking health care and encountering allegations of shaken baby syndrome: A qualitative study. PLoS One. 2020;15(2):e0228911.CrossRefGoogle ScholarPubMed
Freudenthal, G. A rational controversy over compounding forces. In Scientific controversies: Philosophical and historical perspectives. Machamer, P, Pera, M, Baltas, A, eds. Oxford University Press, 2000.Google Scholar
Johansson, I, Lynøe, N. Medicine & philosophy: A twenty-first century introduction. Ontos, 2008.Google Scholar
Cowley, LE, Maguire, S, Farewell, DM et al. Acceptability of the predicting abuse head trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals. Child Abuse and Neglect. 2018;81:192–205.Google Scholar
Breger, ML. Making waves or keeping the calm: Analyzing the institutional culture of family courts through the lens of social psychology groupthink theory. Law and Psychology Review. 2010;34:55–90.Google Scholar
Offiah, AC, Servaes, S, Adamsbaum, CS et al. Initial response of the European Society of Paediatric Radiology and Society for Pediatric Radiology to the Swedish Agency for Health Technology Assessment and Assessment of Social Services’ document on the triad of shaken baby syndrome. Pediatric Radiology. 2017;47:369–71.Google Scholar
Debelle, GD, Maguire, S, Watts, P, et al. Abusive head trauma and the triad. A critique on behalf of RCPCH of ‘Traumatic shaking: The role of the triad in medical investigations of suspected traumatic shaking’. Archives of Disease in Childhood. 2018;103(6):606–10.CrossRefGoogle Scholar
Lynøe, N, Eriksson, A. No similarities between the Wakefield report on measles, mumps and rubella vaccine and the Swedish report on traumatic shaking. Acta Paediatrica. 2020;109(7):1326–9.Google Scholar
Saunders, D, Raissaki, M, Servaes, S et al. Throwing the baby out with the bath water: Response to the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) report on traumatic shaking. Pediatric Radiology. 2017;47(11):1386–9.Google Scholar
Bilo, RAC. The Swedish Agency for Health Technology. Report about traumatic shaking: Much ado about nothing? Forensic Science, Medicine and Pathology. 2018;14(4):541–4.CrossRefGoogle ScholarPubMed
Laurent-Vannier, A, Adamsbaum, C, Raul, JS, et al. Flawed Swedish study on traumatic shaking is already being used by defence lawyers and its findings must be ignored. Acta Paediatrica. 2018;107(12):2048–50.Google Scholar
Lynøe, N, Eriksson, A. Is focusing on the triad really irrelevant and of no practical use? Acta Paediatrica. 2018;107(10):1675–6.CrossRefGoogle ScholarPubMed
Laurent-Vannier, A, Nathanson, M, Quiriau, F et al. A public hearing on ‘Shaken baby syndrome: Guidelines on establishing a robust diagnosis and the procedures to be adopted by healthcare and social services staff’. Guidelines issued by the Hearing Commission. Annals of Physical and Rehabilitation Medicine. 2011;54:600–25.Google Scholar
Lynøe, N, Eriksson, A. Why programs for managing colicky crying fail to prevent abusive head trauma and suggestions for improvement. JAMA Pediatrics. 2021, 26 April. https://doi.org/10.1001/jamapediatrics.2021.0455.Google Scholar
Keenan, HT, Leventhal, JM. A case-control study to evaluate Utah’s shaken baby prevention program. Academic Pediatrics. 2010;10:389–94.Google Scholar
Wester, K, Wikström, J, Lynøe, N, Eriksson, A. Unsubstantiated belief in the diagnostic accuracy of the triad of abusive head trauma may lead to incorrect diagnoses of alleged abuse cases. Acta Paediatrica. 2021. https://doi.org/10.1111/apa.15892.Google Scholar
Wester, K. Two infant boys misdiagnosed as ‘shaken baby’ and their twin sisters: A cautionary tale. Pediatric Neurology. 2019;97:3–11. https://doi.org/10.1016/j.pediatrneurol.2019.02.024.Google Scholar
Levin, AV. The SBU report: A different view. Acta Paediatrica. 2017;106(7):1037–9.CrossRefGoogle ScholarPubMed
Hellgren, K, Hellström, A, Hård, AL et al. The new Swedish report on shaken baby syndrome is misleading. Acta Paediatrica. 2017;106(7):1040.Google Scholar
Hylton, C, Goldberg, MF. Circumpapillary retinal ridge in the shaken-baby syndrome. New England Journal of Medicine. 2004;351:170.Google Scholar
Narang, SK, Estrada, C, Greenberg, S, Lindberg, D. Acceptance of shaken baby syndrome and abusive head trauma as medical diagnoses. Journal of Pediatrics. 2016;177:273–8.CrossRefGoogle ScholarPubMed
Mulvihill, AO, Jones, P, Tandon, A, Fleck, BW, Minns, RA. An inter-observer and intra-observer study of a classification of RetCam images of retinal haemorrhages in children. British Journal of Ophthalmology. 2011;95:99–104.Google Scholar
Minns, RA, Jones, PA, Tandon, A et al. Raised intracranial pressure and retinal haemorrhages in childhood encephalopathies. Developmental Medicine and Child Neurology. 2017;59:597–604.Google Scholar
Squier, W. Retinal haemorrhage: A red flag for raised intracranial pressure. Developmental Medicine and Child Neurology. 2017;59:565.CrossRefGoogle ScholarPubMed
Medele, RJ, Stummer, W, Mueller, AJ, et al. Terson’s syndrome in subarachnoid hemorrhage and severe brain injury accompanied by acutely raised intracranial pressure. Journal of Neurosurgery. 1998;88(5):851–4.Google Scholar
Frayser, R, Houston, C, Bryan, AC, et al. Retinal hemorrhage at high altitude. New England Journal of Medicine. 1970;282(21):1183–4.Google Scholar
Thiblin, I, Andersson, J, Wester, K et al. Medical findings and symptoms in infants exposed to witnessed or admitted abusive shaking: A nationwide registry study. PLoS One. 2020 15(10):e0240182.Google Scholar
Thiblin, I, Andersson, J, Wester, K, et al. Retinal haemorrhage in infants investigated for suspected maltreatment is strongly correlated with intracranial pathology. Acta Paediatrica. 2022;111(4):800–8. https://doi.org/10.1111/apa.16139.CrossRefGoogle ScholarPubMed
Lynøe, N, Eriksson, A. A diagnostic test can prove anything if you use incorrect assumptions and circular reasoning. Acta Paediatrica. 2018;107(12):2051–3.Google Scholar
Lynøe, N, Elinder, G, Hallberg, B et al. Is accepting circular reasoning in shaken baby studies bad science or misconduct? Acta Paediatrica. 2017;106(9):1445–6.Google Scholar
Squier, W, Mack, J, Lantz, PE et al. Circular reasoning. Minnesota Medicine. 2010;93(3):8.Google Scholar
Leestma, J. Case analysis of brain-injured admittedly shaken infants. 54 cases, 1969–2001. American Journal of Forensic and Medical Pathology. 2005;26:199–212.Google Scholar
Ludvigsson, J. Extensive shaken baby syndrome review provides a clear signal that more research is needed. Acta Paediatrica. 2017;106(7):1028–30.Google Scholar
Lynøe, N, Eriksson, A. Hidden clinical values and overestimation of shaken baby cases. Clinical Ethics. 2019;14(3):151–4.Google Scholar
Lynøe, N, Brooks, CB, Juth, N, Eriksson, A. Do child abuse pediatricians search for a ‘Pediatric Vulcan planet’? Comparison of controversies about the Vulcan-must-exist-theory and the infant-must-have-been-shaken-theory. Journal of Research in Philosophy and History. 2020;3(2):162–93.Google Scholar
Lynøe, N, Eriksson, A. Can a prolonged unexplained event change a reliable resuscitator into an unreliable perpetrator? Submitted.Google Scholar

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