Impact of Uncertainty on Non-Medical Professionals' Estimates of Sexual Abuse Probability

ABSTRACT The study assesses how an educational intervention describing uncertainty m child sexual abuse assessments affects estimates of sexual abuse probability by non-physician child abuse professionals (CAP). It evaluates whether CAP incorporate medical information into abuse estimates in concordance with Bayes' Theorem. Eighty-nine CAP estimated the abuse probability for a hypothetical preadolescent female: (1) randomly selected; (2) disclosing abuse; (3) with physical evidence of abuse; and (4) disclosing abuse but with a normal physical examination. CAP then attended a workshop that included discussion of uncertainty in abuse assessment. Post-lecture questionnaires, identical to pre-lecture questionnaires except for estimates of the examination sensitivity and specificity, were administered. Expected responses for post-lecture Scenarios (3) and (4) were generated using Bayes' Theorem and compared to actual responses. Respondents estimated a high abuse prevalence (average 32%, range 5 to 75%). Respon...