Name Maartje Schouten
Date defended March 23, 2017
Supervisors Prof. Dr E.E.S. Nieuwenhuis, Prof. Dr Th.J.M. Verheij, Dr E.M. van de Putte, Dr H.F. van Stel
Title of thesis Systematic screening for child abuse in out-of-hours primary care

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Thesis summary
Child abuse is a serious global health problem. This thesis focused on – improving – the detection of child abuse in the out-of-hours primary care (OOH-PC). The main aim was to assess the diagnostic value of the screening instrument SPUTOVAMO-R2 for child abuse. We found that the detection rate of the SPUTOVAMO-R2 checklist for child abuse is low in the OOH-PC (1.8%), with a high false positive rate. It is possible to reduce the length of the checklist to only two questions (SPUTOVAMO-R3), without compromising the diagnostic value. Furthermore, the use of the SPUTOVAMO-R2 checklist in combination with a screening protocol (flowcharts and reporting code) enhances professional performance of general practitioners when there is a suspicion of child abuse, and also increases their competencies. In addition, it guarantees consistent actions and care for the children with a suspicion of child abuse. Because of the low detection rate and the moderate validity of the checklists for child abuse, it is recommended to use the shortened checklist only as a tool to increase the awareness of child abuse.