Master's Project Title:

Improving Diagnostic Accuracy and Documentation of Child Sexual Abuse Medical Evaluations

MCH Student:

Kori Stephens

Date of Defense:

March 29, 2013


Medical evaluations of child sexual abuse are acknowledged in the child maltreatment field as a valuable part of an investigation as they improve the likelihood of timely medical care to a child victim and can  provide information to support legal decisions. (Adams et al, 2007) Peer review is widely recognized as best practice in the field, however the important problem of misclassification persists. Recent research has indicated that non – Board Certified Child Ab use Pediatricians (CAP) overcall up to 34% of cases (Anderst, 2009).

While diagnostic accuracy and misclassification have been studied in the field, the effect of peer review and quality improvement methods to eliminate error is yet to be determined. Is regular peer review of cases sufficient for minimizing the consequences of misclassification? What would be the potential effect of assigned quality improvement interventions on diagnostic accuracy and misclassification?

Our overall goal is to determine whet her or not completion of assigned quality improvement interventions can positively impact documentation and diagnostic accuracy of child sexual abuse. We propose the following research plan to test the efficacy of quality improvement interventions to improve photodocumentation, written documentation and diagnosis as nationally recognized by Adams et al in the Guidelines for Medical Care of Children Who may have been Sexually Abused. This research plan will utilize the Midwest Regional Medical Academy myCase review program (formerly the Telehealth Institute for Child Maltreatment (THICM)), a web ‐ based, HIPAA compliant application administered through Children ’ s Hospitals and Clinics of Minnesota to manage and deliver the interventions.