Comment by salubrioustoxin

Largely agree w article. However I think it's important to mention that there are other validated ways to detect abuse and that clinical decision making is, or at least should be, based on multiple lines of evidence. Especially with abuse.

In ED and clinic I have had kids that screened positive for TEN 4 FACESp (see https://jamanetwork.com/journals/jamanetworkopen/fullarticle...). One of these babies ended up having b/l subdurals, likely abuse. In the end they may have called that "shaken baby", however there were multiple other red flags, the subdurals was only one piece, and the suspected mechanism of the subdurals was repeated drops / falls.

Agreed "shaking" may not be the mechanism but the author lists other mechanisms that can lead to subdurals and retinal hemorrhage where NAT could play role, eg hypoxia via choking, repeated falls from pushing/drops, neglect in unsafe motor vehicle situations.