Response to Lyn∅e: questions about isolated trauma shaking and confessions
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Thank you for your interest in our study and the interesting questions you raise. In this study, our aim was to validate and if possible sharpen the predictive value of clinical findings for the diagnostic of abusive head trauma (AHT) and to escape the “circularity trap” (basing the diagnosis on clinical findings then evaluating the diagnostic value of the same clinical finding).
We had not intent to replace the classical triad with another (and even less to christen it). The reason why we replaced the general notion of “retinal hemorrhage” (RH) by diffuse (or severe) RH (question 2) was that several studies have shown the presence of mild RH in accidental trauma [1, 2], and we found that severe RH, extending to the periphery of the retina were found only in the context of AHT. In our study, we also found that cerebral edema (or encephalopathy), although a strong predictor of AHT, was present only in a minority of cases (the most severe ones), and was thus affected by a high rate of...