A Daubert Analysis of Abusive Head Trauma/Shaken Baby Syndrome — Part II: An Examination of the Differential Diagnosis

S. Narang, John D. Melville, C. Greeley, J. Anderst, S. Carpenter, B. Spivack
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引用次数: 10

Abstract

For reasons inexplicable to many physicians, and unbeknownst to many others, the diagnosis of Abusive Head Trauma/Shaken Baby Syndrome (AHT/SBS) remains a lightning rod for controversy. Recent legal commentary has suggested that there is insufficient science girding this diagnosis. In Part I of the analysis on this topic, Dr. Narang presented a relatively comprehensive analysis of the current science surrounding AHT/SBS, and more specifically, surrounding two of the most common injuries found in AHT/SBS — subdural hemorrhages (SDHs) and retinal hemorrhages (RHs). Dr. Narang asserted that the diagnosis of AHT is supported by "at least 700 peer-reviewed, clinical medical articles comprising thousands of pages of medical literature, published by over one thousand different medical authors, from at least twenty-eight different countries." In response to this article, Findley et al reiterated an insufficient scientific basis for the diagnosis, citing, amongst other things, logical fallacies (such as "circularity" and "the prosecutor's fallacy") as premises for the fallacious literature. In Part II of this analysis, Narang et al swing the microscope in the opposite direction. Narang et al scrutinize the "differential diagnosis" of AHT, and the differential diagnosis methodology itself, to ascertain whether the scientific process of coming to the AHT diagnosis meets reliability and relevancy criteria under Daubert.
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虐待性头部创伤/摇晃婴儿综合征的Daubert分析-第二部分:鉴别诊断的检查
由于许多医生无法解释的原因,以及许多其他人不知道的原因,虐待性头部创伤/摇晃婴儿综合征(AHT/SBS)的诊断仍然是争议的避雷针。最近的法律评论表明,这种诊断没有足够的科学依据。在本专题分析的第一部分中,Narang博士对当前围绕AHT/SBS的科学进行了相对全面的分析,更具体地说,围绕AHT/SBS中最常见的两种损伤-硬膜下出血(SDHs)和视网膜出血(RHs)。Narang博士断言,AHT的诊断得到了“至少700篇同行评议的临床医学文章的支持,这些文章包括数千页的医学文献,由来自至少28个不同国家的1000多名不同的医学作者发表”。在对这篇文章的回应中,Findley等人重申了诊断的科学依据不足,并引用了逻辑谬误(如“循环”和“检察官谬误”)作为谬误文献的前提。在该分析的第二部分中,Narang等人将显微镜朝相反的方向转动。Narang等人仔细研究了AHT的“鉴别诊断”和鉴别诊断方法本身,以确定得出AHT诊断的科学过程是否符合Daubert提出的可靠性和相关性标准。
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