In the non abuse cases, the highest ranked studies had

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pandora necklaces In the absence of a «gold standard» diagnostic test for child abuse, we used ranking schemes that were designed to ensure the best security of diagnosis.11 We judged studies against the highest standard (rank 1), where «a case outcome» of abuse had been made by a multi agency child protection group or a legal panel using all available information relating to the case, a perpetrator had admitted abuse, or the abuse was witnessed. In the non abuse cases, the highest ranked studies had actively excluded the possibility of child abuse.Table 1 Ranking of definitions of child abuse and exclusion of abuse in comparison groupsView this table:View popupView inlineWe estimated the probability of abuse according to individual bony sites. We did a meta analysis of cross sectional studies of consecutive cases of children with fractures seen in a given hospital or regional centre over a given time period.Comparing these studies was not straightforward because many factors differed between them. pandora necklaces

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In the non abuse cases, the highest ranked studies had