Slingshot is very lucky to work on projects we’re passionate about, especially when they help the community. The Ann & Robert H. Lurie Children’s Hospital of Chicago’s Child Injury Plausibility Assessment Support Tool, or LCAST, was no exception.
Across the US, a report of child abuse is made every ten seconds. Kentucky is the worst state in America for child abuse cases corrected for population; 20 out of every 1,000 children will experience some kind of abuse. For comparison, the national average is around ~9 cases per 1,000 children. (“Child Maltreatment 2019” report).
Slingshot is very lucky to work on projects we’re passionate about, especially when they help the community. The Ann & Robert H. Lurie Children’s Hospital of Chicago’s Child Injury Plausibility Assessment Support Tool, or LCAST, was no exception.
Across the US, a report of child abuse is made every ten seconds. Kentucky is the worst state in America for child abuse cases corrected for population; 20 out of every 1,000 children will experience some kind of abuse. For comparison, the national average is around ~9 cases per 1,000 children. (“Child Maltreatment 2019” report).
Lurie’s Children’s Hospital of Chicago, Dr. Mary Clyde Pierce, and Slingshot have developed a healthcare app that will save children’s lives and keep families together.
Dr. Mary Clyde Pierce
Dr. Pierce has been working in the field of child abuse for over 30 years. Her passion to save children from abuse as well as keep families together who have been unjustly accused flows throughout everything she does.
She has countless publications that tackle all aspects of this issue, helping others to learn more about the under-researched field. One tactic for fighting child abuse Dr. Pierce developed is the TEN-4 Bruising Rule. A child who is 4 months or younger with bruises on their Torso, Ears, or Neck should raise concern.
She’s not just an amazing physician; she’s a Big Kid and Daredevil too! In her spare time, Mary likes to drive her motorcycle across the country. She also enjoys playing her guitar and writing songs.
“Bruising on a young child is often dismissed as a minor injury, but depending on where the bruise appears, it can be an early sign of child abuse,” said Dr. Pierce. “We need to look at bruising in terms of risk. Our new app, LCAST, helps clinicians identify high-risk cases that warrant evaluation for child abuse. This is critical, since abuse tends to escalate, and earlier recognition can save children’s lives.
Lurie Children’s Child Injury Plausibility Assessment Support Tool
What is it?
The Lurie Children’s Child Injury Plausibility Assessment Support Tool, or LCAST, is a decision support tool that helps identify potential abuse in children. It can also alleviate suspicion by presenting clinicians with factual research data on injuries to specific areas of the body. The doctor can then use that information to help guide whether it makes sense to place a call to child protective services or feel better about an injury that may be benign and accidental.
By giving clinicians a tool based solely on evidence-based peer-reviewed research data, the app stops discrimination based on gender, race, and attitude. Ultimately, it will help identify abuse cases that otherwise could have been missed and prevent misdiagnosis, leading to unnecessary family separation.
Why is this app important?
Education and access to information is lacking surrounding the study of child abuse injuries. Unless a clinician has specialized in child abuse, many of the signs are missed, and children could be put back into unsafe homes. Currently, doctors could be making calls on a child based on innate personal biases and subjective opinions.
The app helps educate providers about the subtleties and injury locations that should be concerning. There is nothing currently on the market that allows doctors to input their patient’s injuries and see the statistics and findings for their particular situation. This app, quite literally, will save lives.
When asked about the project, Slingshot’s CEO David Galownia said: “It’s been incredibly gratifying to be the tech company behind such an impactful vision. Dr. Mary Clyde Pierce is a leader in the field of child abuse and she brings a wealth of passion and knowledge to the project. My favorite part of this app is the impact it can have. I love that this project was donor-funded and made possible entirely by people who want to make a difference.”
How does LCAST work?
The app allows clinicians to input a patient’s age, cause of injury, and symptoms. They then plot the patient’s injuries on a 3D human model. Based on the data collected, the app provides the likelihood of accident vs. abuse. The determination is based on several published research papers, including (but not limited to) Bruising Characteristics Discriminating Physical Child Abuse From Accidental Trauma, Validation of a Clinical Decision Rule to Predict Abuse in Young Children Based on Bruising Characteristics, and More than Just a Bruise: Recognizing Child Physical Abuse.
3D-Model
The most advanced feature of the app is the fully accurate 3D Model of a child that a user can rotate and zoom and visually document where injuries occur. The visual aspect of the model helps powerfully tell a story about the data around abuse.
Utilizing a complex, layered 3D model is not typical. Due to the extensive nature of navigating the model and the desire for the model to be anatomically correct and realistic, we partnered with BioDigital, a medical 3D studio. We designed the UX around the model navigation, which allows users to plot injuries directly on the model while moving the model in space.
Results
As mentioned above, the results the app provides are based on several peer-reviewed journal articles and studies co-written and conducted by Dr. Mary Clyde Pierce. Once you’ve answered a few questions and plotted the child’s injuries, the app will display the probability that an injury comes from abuse or if likely accidental.
The clinician can further drill into each individual region of the body and see the actual research statistics of each.
Additionally, the app will display any contributing factors that lead to a higher likelihood of abuse, recommended next steps including relevant study links from PubMed, and any recommendations by the American Academy of Pediatrics.
For the future of the app, the tool will incorporate the Head Injury PediBIRN decision support rule and upcoming results from Dr. Pierce’s currently ongoing fracture study.
Who is this app for?
The LCAST mobile app is for any clinician who may come across children and want to do a quick assessment of a concerning injury. This would include physicians, nurse practitioners, nurses, pediatricians, EMTs, and even social workers with some medical background.
“It was very important to us to make sure that the app screening tool captures potential abuse without over-capturing innocent cases of children with bruising caused by accidental or incidental injury,” said Dr. Pierce. “We are excited that LCAST is based on highly reliable evidence, and it is practical enough to be used by clinicians in Emergency Departments, paramedics, social workers from the Department of Children and Family Services, and during any clinical encounter.”
Conclusion
With the help of LCAST, anyone will be able to quickly and effectively document children’s injuries to determine if they were caused by abuse or accident.
If you are a nurse, doctor, pediatrician, social worker, or anyone that works with children, please consider downloading this free app.
We’re eager to see how Dr. Mary Clyde Pierce, Ann & Robert H. Lurie Children’s Hospital of Chicago, and the Lurie Children’s Child Injury Plausibility Assessment Support Tool can help save and change the lives of children across the country.
