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J Clin Forensic Med. 2002 Dec;9(4):171-4.

Lack of agreement on colour description between clinicians examining childhood bruising.

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1
Royal Hospital for Sick Children, Edinburgh EH9 1LF, UK.

Abstract

INTRODUCTION:

In child protection cases clinicians are often asked to describe and age bruises. This paper looks at both intra- and inter-observer variability in the description of childhood bruising.

METHODS:

Fifty-eight bruises on 44 children were described by three observers, the bruises were then photographed and the same observers described the bruises at a later date. The descriptions were compared and classified in terms of complete, partial, or no agreement, both between observers and between the in vivo and photographic descriptions.

RESULTS:

Complete agreement on colour description between two observers in vivo occurred in 27% of descriptions in vivo and 24% of photographs. Only 31% of descriptions completely agreed with the later description of a photograph of the same bruise.

CONCLUSIONS:

This marked variability in colour description, severely questions the practice of estimating the age of bruises especially from clinical photographs as evidence in child protection proceedings.

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