Characteristics of child physical abuse cases that are referred by the police for a clinical forensic medical examination.

In child physical abuse cases, a clinical forensic medical examination (CFME) is performed to document medical evidence, such as lesions and scars. In Denmark, however, not all cases are referred by the police to a CFME, and we aimed to study the key characteristics of police reported cases of child physical abuse (N = 136, ages 4-17 years) - case context, the child's disclosure and sociodemographic factors - that could influence the police's selection process. Associations between case characteristics and CFME referrals were studied using univariate and multivariate logistic regression models, which were supported by age- and sex-matched conditional logistic regression models. CFME referrals were found to be less common for cases with children from a low socioeconomic status family or with previously reported concerns (such as a report to the social services), and more common when the violence endured by children involved punching/striking of limbs or left visible marks. Moreover, the number of victims in a sibship seemed to be associated with CFME referrals. Referrals were not influenced by parents' origin or the suspect-child relationship. A biased referral process may lead to unequal case handling and undermine the rule of law. By identifying the characteristics relevant to this process, we aimed to contribute to a systematic and consistent approach to case management. Future qualitative interview studies with police officers and prosecutors and studies focused on larger populations can offer further valuable insights into the selection process.