Identification of Child Survivors of Sex Trafficking From Electronic Health Records: An Artificial Intelligence Guided Approach.

Survivors of child sex trafficking (SCST) experience high rates of adverse health outcomes. Amidst the duration of their victimization, survivors regularly seek healthcare yet fail to be identified. This study sought to utilize artificial intelligence (AI) to identify SCST and describe the elements of their healthcare presentation. An AI-supported keyword search was conducted to identify SCST within the electronic medical records (EMR) of ∼1.5 million patients at a large midwestern pediatric hospital. Descriptive analyses were used to evaluate associated diagnoses and clinical presentation. A sex trafficking-related keyword was identified in .18% of patient charts. Among this cohort, the most common associated diagnostic codes were for Confirmed Sexual/Physical Assault; Trauma and Stress-Related Disorders; Depressive Disorders; Anxiety Disorders; and Suicidal Ideation. Our findings are consistent with the myriad of known adverse physical and psychological outcomes among SCST and illuminate the future potential of AI technology to improve screening and research efforts surrounding all aspects of this vulnerable population.

Recognition and Management of Nonaccidental Esophageal Perforation.

Nonaccidental trauma is a common pediatric concern that often goes unrecognized. Although most patients present with bruising, burns, fractures, and head trauma, it is critical that physicians be able to diagnose and treat atypical presentations such as pharyngeal and esophageal trauma. In this report, we describe the presentation and management of a 5-week-old girl with an inflicted esophageal perforation.

Teen Knowledge of Commercial Sexual Exploitation of Children.

INTRODUCTION: The commercial sexual exploitation of children (CSEC) is a pediatric health care problem with significant physical and mental health consequences for victims, even death. Although there exists community-wide collaborations in the United States to address professional response to CSEC, these efforts often have a limited capacity to reach adolescents and involve them in CSEC prevention. As part of a prevention strategy, the National Institute of Justice recommends educating youth about CSEC and exploiters' recruitment tactics. Despite this recommendation, little is known regarding American youth knowledge of CSEC. METHODS: A descriptive research design was used for this study. All adolescents, male and female, presenting to a high-volume urban pediatric hospital-based Midwestern Child Advocacy Center (CAC) due to concerns for alleged sexual abuse were invited to participate in the study by answering a self- administered electronic questionnaire. This questionnaire explores the participants' knowledge, awareness, and attitudes about CSEC, in addition to collecting demographic data, such as participant age, gender identity, grade, school district, and school. RESULTS: During the six-month study period, 286 CAC patients were eligible to participate in the study. Nearly all participants (n = 217; 97%) agreed that pimping is wrong. While the majority of participants indicated an awareness of human trafficking (n = 198; 94%) and sex trafficking (n = 193; 87%); just (n = 91; 41%) had heard of labor trafficking. Fewer participants (n = 55; 25%) identified that a doctor, nurse, or other health care provider had ever spoken with them about sex trafficking. DISCUSSION: Study participants overwhelmingly conveyed negative attitudes toward CSEC. Participating adolescents indicated a significantly higher awareness of sex trafficking (87%) versus labor trafficking (10%). Sex trafficking receives more attention in the media than labor trafficking. Given that study participants indicated hearing about trafficking primarily from the media (74%) and family/friends, this may explain the deficit in labor trafficking awareness. Although study participants demonstrated mostly accurate baseline knowledge of CSEC, that knowledge was not universal.