Hymel KP, Armijo-Garcia V, Musick M, et al. - In this cluster randomized trial, researchers estimated the influence of the PediBIRN (Pediatric Brain Injury Research Network) 4-variable clinical decision rule (CDR) on abuse evaluations and missed abusive head trauma in pediatric intensive care settings. Candidates were 8 pediatric intensive care units (PICUs) in US academic medical centers; PICU and child abuse physicians; and consecutive acutely head-injured patients < 3 years (n = 183 and n = 237, intervention vs control). In PICU settings, the PediBIRN-4 CDR application encouraged improvements in assessments that reduced the risk of missed abusive head trauma.