Abstract

Probabilistic language is language used to convey mathematical probabilities in narrative form including terms like “highly likely”, “concerning for”, “suspicious of”, and many others). PL can be used in conformance with standards elucidated in Forensic Epidemiology or misused with intentional imprecision, when not justified, to promote a misdiagnosis of abuse, with dire consequences. The application of actual probability analysis using tested mathematical models, like Bayes Theorem, is essential to an analysis of the actual probability of abuse in a specific case to avoid false accusations of abuse. Consideration of the prior odds of abuse combined with calculations the reliability of nonspecific and/or unreliable criteria or “indicators”, is being disregarded by child abuse pediatricians to justify diagnosing abuse with statements of false certainty that depend on the misuse of probabilistic language. These suppositious statements of false certainty are the sine qua non of accusatory expert opinion. Currently, and unfortunately, false certainty is only detected by scientists and physicians with the requisite advanced knowledge of these issues. When probabilities and evidence based science are studied and applied, deep flaws in the fund of knowledge of child abuse pediatrics have been exposed. On balance, there is an emerging reality that the collective suffering of falsely accused families may dwarf the horrific impacts associated with real abuse. It also exposes iatrogenic abuse as possibly the most common form of prosecuted child abuse in the legal system. A false accusation of child abuse is child abuse. The misuse of probabilistic language to convey false certainty and its ramifications for innocent caregivers is discussed herein and must be prevented.

Highlights

  • Probabilistic Language (PL) is language used to convey mathematical probabilities in narrative form

  • Consideration of the prior odds of abuse combined with calculations the reliability of nonspecific and/or unreliable criteria or “indicators”, is being disregarded by child abuse pediatricians to justify diagnosing abuse with statements of false certainty that depend on the misuse of probabilistic language

  • The application of Bayes theorem in some form is essential to an analysis of the probability of abuse

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Summary

Introduction

Probabilistic Language (PL) is language used to convey mathematical probabilities in narrative form. 3.6 The Indicator Component of Bayes Theorem The step is to factor in the reliability of the any indicator proposed to identify abuse (like SDH, RH, bruises, healing fractures, poverty, a lab test, race, age, prior criminal behavior, etc.) When we have statistics from studies about sensitivity and specificity of an indicator, we can calculate the reliability of an indicator expressed as a ratio of two probabilities; generally, the probability of being right compared to the probability of being wrong. If the posterior odds/probability reaches accepted medical or legal standards, does it qualify as evidence If it does not, but is portrayed as such, by misuse of probabilistic language with a false statement like “imitating sex is evidence of abuse”, or other overtly false statements (i.e., short falls never cause serious injury), it is not valid evidence; it is false certainty.

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PL in the Hospital Environment
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