BMJ  2004;328:1317 (29 May), doi:10.1136/bmj.328.7451.1317

Letter

The evidence base for shaken baby syndrome

Authors' reply

The first 150 words of the full text of this article appear below.

EDITOR—It is difficult to understand how Reece et al could interpret our editorial as displaying "a worrisome and persistent bias against the diagnosis of child abuse in general." Child abuse exists, and we know and attest that it exists. The editorial does not discuss "child abuse in general."

Child abuse exists in many forms: our editorial addresses the diagnostic criteria for a specific type of abuse, the so-called shaken baby syndrome. We emphasise, as have Donohoe and Lantz et al,1 2 that the literature to support a diagnosis of shaken baby syndrome/inflicted head injury is based on imprecise and ill-defined criteria, biased selection, circular reasoning, inappropriate controls, and conclusions that overstep the data. If it is the questioning of the criteria that is worrisome, we will continue to do so and to cause worry.

We encouraged the readers to evaluate critically the evidentiary basis for a diagnosis of shaken . . . [Full text of this article]

J F Geddes, retired (formerly reader in clinical neuropathology, Queen Mary, University of London)

London j.f.geddes@doctors.org.uk

J Plunkett, forensic pathologist

Regina Medical Center, 1175 Nininger Road, Hastings, MN 55033, USA


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