title: Radiologists' Training, Experience, and Attitudes About Elder Abuse Detection.
abstract: OBJECTIVE
  Elder abuse is underrecognized, and identification of subtle cases requires a high index of suspicion among all health care providers. Because many geriatric injury victims undergo radiographic imaging, diagnostic radiologists may be well positioned to identify injury patterns suggestive of abuse. Little is known about radiologists' experience with elder abuse. Our goal was to describe knowledge, attitudes, training, and practice experience in elder abuse detection among diagnostic radiologists.
  
  
  METHODS
  We conducted 19 interviews with diagnostic radiologists at a large urban academic medical center using a semistructured format. Data from these sessions were coded and analyzed to identify themes.
  
  
  RESULTS
  Only two radiologists reported any formal or informal training in elder abuse detection. All subjects believed they had missed cases of elder abuse. Even experienced radiologists reported never having received a request from a referring physician to assess images for evidence suggestive of elder abuse. All subjects reported a desire for additional elder abuse training. Also, subjects identified radiographic findings or patterns potentially suggestive of elder abuse, including high-energy injuries such as upper rib fractures, injuries in multiple stages of healing, and injuries inconsistent with reported mechanism.
  
  
  CONCLUSIONS
  Radiologists are uniquely positioned to identify elder abuse. Though training in detection is currently lacking, providers expressed a desire for increased knowledge. In addition, radiologists were able to identify radiographic findings suggestive of elder abuse. On the basis of these findings, we plan to conduct additional studies to define pathognomonic injury patterns and to explore how to empower radiologists to incorporate detection into their practice.
authors.affiliation: 1 Division of Emergency Medicine, Weill Cornell Medical College, 525 E 68th St, Rm M130, New York, NY 10065.
authors.forename: Tony
authors.initials: T
authors.lastname: Rosen
authors.affiliation: 2 University of Colorado Medical School, Aurora, CO.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Bloemen
authors.affiliation: 1 Division of Emergency Medicine, Weill Cornell Medical College, 525 E 68th St, Rm M130, New York, NY 10065.|3 Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, NY.
authors.forename: Jasmin
authors.initials: J
authors.lastname: Harpe
authors.affiliation: 4 Department of Radiology, Weill Cornell Medical College, New York, NY.
authors.forename: Allen M
authors.initials: AM
authors.lastname: Sanchez
authors.affiliation: 4 Department of Radiology, Weill Cornell Medical College, New York, NY.
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Mennitt
authors.affiliation: 1 Division of Emergency Medicine, Weill Cornell Medical College, 525 E 68th St, Rm M130, New York, NY 10065.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: McCarthy
authors.affiliation: 5 Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY.
authors.forename: Refky
authors.initials: R
authors.lastname: Nicola
authors.affiliation: 6 Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
authors.forename: Kieran
authors.initials: K
authors.lastname: Murphy
authors.affiliation: 2 University of Colorado Medical School, Aurora, CO.
authors.forename: Veronica M
authors.initials: VM
authors.lastname: LoFaso
authors.affiliation: 1 Division of Emergency Medicine, Weill Cornell Medical College, 525 E 68th St, Rm M130, New York, NY 10065.
authors.forename: Neal
authors.initials: N
authors.lastname: Flomenbaum
authors.affiliation: 3 Division of Geriatric and Palliative Medicine, Weill Cornell Medical College, New York, NY.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
mesh_terms: D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000706:statistics & numerical data*; D004521:Educational Measurement; D004552:Elder Abuse / Q000175:diagnosis* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D000072177:Radiologists / Q000193:education* / Q000706:statistics & numerical data; D011871:Radiology / Q000193:education*; D014481:United States
keywords: elder abuse; elder abuse radiology findings; geriatric injury; intentional injury