LCAST 1.0.131

The Lurie Children’s Child Injury Plausibility Assessment Support Tool (LCAST) is an application that implements a validated Bruising Clinical Decision Rule (BCDR) known as TEN-4-FACESp. This tool has the potential to enhance the identification of abuse in young children exhibiting bruising. It must be noted that the app serves solely as a screening instrument and should not be employed for diagnosing abuse. The tool is applicable to children under 4.0 years of age with bruising; children older than 4.0 years or without bruising do not match the criteria for usage, requiring alternative screening methods.

WHY THE FOCUS ON BRUISING? Bruising represents the most prevalent injury arising from physical abuse, often being overlooked or incorrectly diagnosed prior to abuse-related fatalities or near-fatalities in young children. Bruising can stem from accidental or abusive trauma; however, distinctions identified by the TEN-4-FACESp bruising clinical decision rule could lead to improved and earlier identification of an abused child.

ABOUT THE APPLICATION: Intended for clinical use by licensed healthcare professionals and providers, this app can guide decision-making and serve as an educational resource for understanding bruising characteristics usually associated with abusive and accidental injuries. The primary feature comprises an interactive 3D body model allowing users to input clinical observations using visual cues of the human body. This feature enables comparisons between a child's bruise findings and evidence derived from a multi-center study funded by the NIH, involving data from 2,161 patients—410 (19%) identified as abuse cases and 1,713 (79%) as accidents by a panel of multidisciplinary medical experts.

The TEN-4-FACESp bruising clinical decision rule, created after analyzing 35 body regions, exhibits a specificity of 96% and sensitivity of 87% in differentiating between bruises from abuse versus accidental causes. Comprising three components, the TEN-4-FACESp rule is based on specific body regions with bruising, patterned bruising, and bruising on non-mobile infants. An affirmative finding for any of these components without a reasonable explanation highlights a potential abuse risk, necessitating further evaluation of the child with possible consultation from a child abuse specialist.

While utilizing the data within this app, users are advised to consult with a physician before making any medical decisions.