Smith Child Health Outcomes, Research and Evaluation Center

Lurie Children's Child Injury Plausibility Assessment Support Tool (LCAST) - A new, free app available for download

How to Access the App

The Lurie Children’s Child Injury Plausibility Assessment Support Tool (LCAST) app is accessible via Apple and Google app stores and can be found by searching any of the following keywords: "LCAST", "abuse", "bruising", "child injury", "clinical decision rule", or "TEN-4-FACESp".

The LCAST app designed to support recognition of abuse in babies and young children who have bruises. It was developed by researchers Mary Clyde Pierce, MD, and Kim Kaczor, from Ann & Robert H. Lurie Children’s Hospital of Chicago in partnership with Slingshot and BioDigital.

App Output and Results

The app is strictly a screening tool to help improve recognition of abuse and cannot be used to diagnose abuse. It helps inform decision-making regarding the likelihood of abusive or accidental bruising. The app can also be used as an educational tool for learning about bruising characteristics that commonly result from abusive and accidental injury.

Intended Users

The app is intended for clinical use by licensed healthcare professionals and providers, including physicians, nurses, paramedics, and social service professionals.

Relevant Pediatric Population

The app can only be used in children with bruising who are YOUNGER than 4.0 years of age. If the child does not have bruising, this app cannot be applied.

The Science Behind the App

The app is based on evidence resulting from a National Institutes of Health-funded multi-center study lead by Lurie Children's researcher Mary Clyde Pierce, MD, published in the journal JAMA Network Open that derived, refined, and validated a bruising clinical decision rule called TEN-4-FACESp. TEN-4-FACESp has three components based on specific body regions with bruising, patterned bruising, and bruising anywhere on non-mobile infants. An affirmative finding for any one of the three TEN-4-FACESp components without a clear and reasonable explanation indicates a potential risk for abuse. The child may warrant further evaluation, and consultation with an expert in child abuse should be considered. Learn more about TEN-4-FACESp.

Why Focus on Bruising?

Bruising is the most common injury resulting from physical abuse and is the most overlooked or misdiagnosed antecedent injury prior to an abuse-related fatality or near-fatality in a young child. Bruising occurs from both accidental and abusive trauma, but differences identified by the TEN-4-FACESp bruising clinical decision rule may allow improved and earlier recognition of the abused child.