# Averting Diagnostic Error Through Improved Recognition of Child Abuse

> **NIH AHRQ K08** · CHILDREN'S HOSP OF PHILADELPHIA · 2024 · $145,324

## Abstract

Project Summary/Abstract
Dr. Irit R. Rasooly’s goal is to become an independent clinician scientist dedicated to promoting accurate,
timely, and equitable pediatric diagnosis. To further develop the novel skillset necessary to apply data-driven,
systems-informed approaches to improve diagnosis, Dr. Rasooly’s career development plan incorporates
mentored research and training in clinical informatics, longitudinal analysis, human factors engineering,
implementation science, and trauma informed care. She will be mentored by experienced investigators with
whom she has established, productive collaborative relationships: Dr. Christopher P. Bonafide (Primary
Mentor) is an expert in developing, evaluating, and implementing interventions at the intersection of patient
safety and technological innovation. Dr. Joanne N. Wood (Co-Mentor) is an expert in child physical abuse
research whose scholarship has focused on racial disparities and variation in abuse evaluations. Dr. Kathy
Shaw (Co-Mentor) is a national and intuitional leader in patient safety science and diagnostic error. The
Children’s Hospital of Philadelphia and University of Pennsylvania are deeply supportive of Dr. Rasooly’s work
and provide an unparalleled research training environment. Missed diagnosis of child abuse, in which abusive
injury goes unrecognized or is misattributed to accidental trauma, is among the gravest examples of pediatric
diagnostic error and a serious threat to pediatric health. While electronic health record (EHR) clinical decision
support (CDS) has shown promise in improving timeliness and reducing disparities in abuse diagnosis in
emergency department settings, there is a critical need for strategies to support diagnosis in primary care,
where most pediatric care is delivered and where there may be opportunity to intervene before children sustain
serious injuries. To lay the groundwork for creation of CDS to improve abuse diagnosis in primary care, the
objective of this work is to apply EHR data- and systems-analysis to inform identification of strategies to
support diagnosis of child physical abuse in primary care. Specific aims are to: (1) Detect and validate markers
of physical abuse in longitudinal, clustered, EHR-derived data to distinguish young children experiencing abuse
from matched controls, (2) Determine causes of abuse-related diagnostic error in primary care by conducting
scenario-based high-fidelity human factors engineering EHR simulations, and (3) Identify and prioritize
feasible, acceptable, and appropriate CDS strategies through a consensus approach. Findings will inform
development of CDS to be tested in a future multi-center, R01 funded clinical trial. Completion of the proposed
research and training will position Dr. Rasooly to launch an independent research career advancing pediatric
diagnostic excellence and reducing health disparities in primary care, thereby addressing multiple AHRQ
research priority areas.

## Key facts

- **NIH application ID:** 10911109
- **Project number:** 5K08HS028682-03
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Irit R Rasooly
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2024
- **Award amount:** $145,324
- **Award type:** 5
- **Project period:** 2022-09-30 → 2027-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10911109

## Citation

> US National Institutes of Health, RePORTER application 10911109, Averting Diagnostic Error Through Improved Recognition of Child Abuse (5K08HS028682-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10911109. Licensed CC0.

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