Standardising practice can improve identification and reduce bias Even for the most experienced healthcare providers, recognising and evaluating suspected child maltreatment or exploitation is challenging. The pressure to make the correct diagnosis is extremely high. Failing to recognise maltreatment can result in the child experiencing severe harm or even death. Conversely, incorrect diagnoses of accidental injuries as abusive or misinterpretations of poverty as neglect may burden care givers and lead to subsequent mistrust in healthcare providers.1 Unwarranted investigations and subsequent referral to child welfare (social) services affect marginalised populations disproportionately, including children of black, Hispanic, and Aboriginal ethnicity, and visible minorities.23 Two education articles in The BMJ offer healthcare providers guidance to better identify child abuse and neglect and recognise young people experiencing criminal and sexual exploitation.45 They summarise the growing evidence base that should inform consistent, effective practice. Schwartz et al discuss screening using clinical decision rules such as the TEN-4-FACESp, which identifies region, age, and patterns of bruising that are more likely to be caused by abuse than accidental injury.46 Such tools have advanced the ability of busy frontline clinicians to identify injuries suggestive of child maltreatment, but they rely on providers’ ability to remember which bruises, and at what ages, are “high risk.” Also, a positive screening result does not mean that a child is certainly …

中文翻译：

---

虐待、忽视和剥削青少年


标准化实践可以提高识别并减少偏见即使对于最有经验的医疗保健提供者来说，识别和评估可疑的儿童虐待或剥削也具有挑战性。做出正确诊断的压力非常大。不认识到虐待可能会导致孩子遭受严重伤害甚至死亡。相反，将意外伤害错误诊断为虐待或将贫困误解为忽视可能会给护理人员带来负担，并导致随后对医疗保健提供者的不信任。1 无端的调查和随后的转介到儿童福利（社会）服务对边缘化人群的影响不成比例，包括黑人、西班牙裔和原住民族裔的儿童以及有色少数族裔。23 BMJ 中的两篇教育文章为医疗保健提供者提供了更好的指导识别虐待和忽视儿童的行为，并识别遭受犯罪和性剥削的年轻人45。他们总结了不断增长的证据基础，这些证据基础应该为一致、有效的实践提供信息。Schwartz 等人讨论了使用临床决策规则（如 TEN-4-FACESp）进行筛查，该规则可识别比意外伤害更可能由虐待引起的区域、年龄和瘀伤模式。46 这些工具提高了忙碌的一线临床医生识别提示儿童虐待的伤害的能力，但它们依赖于提供者记住哪些瘀伤的能力。 以及在什么年龄是“高风险”。此外，阳性筛查结果并不意味着孩子肯定是......