Rachel Berger, M.D., M.P.H.

  • Division Chief, Child Advocacy
  • Professor of Pediatrics and Clinical and Translational Science
  • Director, Child Abuse Research, Safar Center for Resuscitation Research

Rachel Berger became the chief of the Division of Child Advocacy in 2013. She joined the division in 2001 after completing a fellowship in general academic pediatrics and earning an MPH degree from the University of Pittsburgh Graduate School of Public Health. She is primarily a clinical researcher, and her predominant research focus is improving the diagnosis of physical abuse injury in young children by using electronic health records and novel types of clinical decision support.

Major Lectureships

  • “Protecting Our Children: Improving Detection of Child Abuse in our EDs,” Northwell Health/Long Island Jewish Medical Center, Department of Medicine, Grand Rounds, New Hyde Park, NY, February 2018
  • “The Biomarkers for Infant Brain Injury Score (BIBIS): Improving Identification of Intracranial Hemorrhage in Infants and Young Children Using Serum Biomarkers,” McGowan Annual Scientific Retreat, Pediatric Session, University of Pittsburgh, Pittsburgh, Pa., March 2018
  • “Using an Electronic Health Record (EHR)-Based Child Abuse Clinical Decision Support to Improve Outcomes in our Most Vulnerable Children,” Primary Children’s Hospital, The Karen K. Hansen Honorary Lecture Series, Pediatric Grand Rounds, Salt Lake City, Utah, April 2018
  • “Use of the Electronic Health Record to Improve Identification, Evaluation, and Reporting of Abuse,” Grand Rounds, Penn State College of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pa., April 2018
  • “Medical Child Abuse in the Age of Facebook, GoFundMe and Press Ganey,” A Special Lecture of Pediatric Grand Rounds and Reception in Honor of Basil Zitelli, MD, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pa., May 2018.

Education & Training

  • Master’s of Public Health
  • Children’s Hospital of Pittsburgh Fellowship
  • Children’s Hospital of Pittsburgh Internship/Residency - Pediatrics
  • Doctor of Medicine
  • Bachelor of Arts

Representative Publications

Refereed articles

  1. Berger RP, Wadowsky RM. Rhabdomyolysis associated with Mycoplasma pneumoniae infection: A case report. Pediatrics. 2000 Feb;105(2):433-6. PubMed PMID: 10654971.
  2. Berger RP, Pierce MC, Wisniewski S, Adelson PD, Clark RSB, Ruppel R, Kochanek P. Neuron-specific enolase and S100B in cerebrospinal fluid after severe traumatic brain injury in infants and children. Pediatrics. 2002 Feb;109(2):e31. PubMed PMID: 11826241.
  3. Berger RP, Bogen B, Dulani T, Broussard E. Implementation of a program to teach pediatric residents and faculty about domestic violence. Arch Pediatr Adolesc Med. 2002 Aug;156(8):804-10. PubMed PMID: 12144372.
  4. Pitetti R, Maffei F, Chang K, Hickey R, Berger R, Pierce MC. Prevalence of retinal hemorrhages and child abuse in children presenting with an apparent life-threatening event. Pediatrics. 2002 Sep;110:557-62. PubMed PMID: 12205260.
  5. Berger RP, Pierce MC, Wisniewski S, Adelson PD, Kochanek PM. Serum S100B concentrations are increased after closed head injury in children: A preliminary study. J Neurotrauma. 2002 Nov;19(11):1405-9. PubMed PMID: 12490005.
  6. Pierce MC, Bertocci G, Berger R, Vogeley E. Injury biomechanics for aiding in the diagnosis of non-accidental head trauma. Neurosurg Clin N Am. 2002 Apr;13(2):155-68. PubMed PMID: 12391701.
  7. Herr S, Pierce MC, Berger RP, Ford H, Pitetti RD. Does valsalva retinopathy occur in infants? An initial investigation in infants with vomiting due to pyloric stenosis. Pediatrics. 2004 Jun;113(6):1658-61. PubMed PMID: 15173487.
  8. Berger RP, Kochanek PM, Pierce, MC. Biochemical markers of brain injury: Could they be used as diagnostic adjuncts in cases of inflicted traumatic brain injury? Child Abuse Negl. 2004 Jul;28(7):739-54. PubMed PMID: 15261469.
  9. Berger RP, Heyes M, Wisniewski S, Adelson D, Thomas N, Kochanek P. Assessment of the macrophage marker quinolinic acid in cerebrospinal fluid after pediatric traumatic brain injury: Insight into the timing and severity of injury in child abuse. J Neurotrauma. 2004 Sep;21(9):1123-30. PubMed PMID: 15453983.
  10. Ettaro L, Berger RP, Songer T. Abusive head trauma in young children: characteristics and medical charges in a hospitalized population. Child Abuse Negl. 2004 Oct;28(10):1099-111. PubMed PMID: 15519438.
  11. Morad Y, Avni I, Benton S, Berger RP, Byerley JS, Coffman K, Greeley CS, Gustavson EE, Levitt CJ, Lenane A, Topley J, Levin AV. Normal computerized tomography of brain in children with shaken baby syndrome. J AAPOS. 2004 Oct;8:445-50. PubMed PMID: 15492737.
  12. Berger RP, Adelson PD, Dulani T, Pierce M, Cassidy L, Kochanek PM. Serum neuron-specific enolase, S100B and myelin basic protein concentrations after inflicted and non-inflicted traumatic brain injury in children. J Neurosurg. 2005 Jul;103(1 Suppl):61-8. PubMed PMID: 16122007.
  13. Satchell M, Lai Y, Kochanek P, Wisniewski S, Fink E, Berger RP, DeKosky S, Adelson PD, Clark R. Cytochrome c, a biomarker of apoptosis, is increased in cerebrospinal fluid from infants with inflicted brain injury from child abuse. J Cereb Blood Flow Metab. 2005 Jul;25(7):919-27. PubMed PMID: 15744250.
  14. Berger RP, Dulani T, Adelson PD, Leventhal JM, Richichi R, Kochanek PM. Identification of inflicted traumatic brain injury in well-appearing infants using serum and cerebrospinal markers: A possible screening tool. Pediatrics. 2006 Feb;117(2):325-32. PubMed PMID: 16452350.
  15. Berger RP. The use of serum biomarkers to predict outcome after traumatic brain injury in adults and children. J Head Trauma Rehabil. 2006 Jul-Aug;21(4):315-33. PubMed PMID: 16915008.
  16. Berger RP, Adelson PD, Richichi R, Kochanek P. Serum biomarkers after traumatic and hypoxemic brain injuries: Insight into the biochemical response of the pediatric brain to inflicted brain injury. Devt Neurosci. 2006;28:327-35. PubMed PMID: 16943655.
  17. Berger RP, Kochanek P. Urinary S100B concentrations are increased after brain injury in children: A preliminary study. Pediatr Crit Care Med. 2006 Nov;7:557-61. PubMed PMID: 17006387.
  18. Campbell KA, Bogen DL, Berger RP. The other children: A survey of child abuse physicians on the medical evaluation of children living with a physically abused child. Arch Pediatr Adolesc Med. 2006 Dec;160:1241-6. PubMed PMID: 17146021.
  19. Beers S, Berger RP, Adelson PD. Neurocognitive outcome and serum biomarkers in inflicted vs. non-inflicted traumatic brain injury in young children. J Neurotrauma. 2007 Jan;24(1):97-105. PubMed PMID: 17263673.
  20. Shore P, Berger RP, Varma S, Janesko K, Wisniewski S, Clark R, et al. Cerebrospinal fluid biomarkers versus Glasgow Coma Scale and Glasgow Outcome Scale in pediatric traumatic brain injury: The role of young age and inflicted injury. J Neurotrauma. 2007 Jan;24(1):75-86. PubMed PMID: 17263671.
  21. Gao W, Mandeep CS, Berger RP, Gilbert OS, Allen DL, Pisano M, Adelson PD, Clark RSB, Jenkins L, Kochanek P. A gel-based proteomic comparison of human cerebrospinal fluid between inflicted and non-inflicted pediatric traumatic brain injury. J Neurotrauma. 2007 Jan;24(1):43-53. PubMed PMID: 17263669.
  22. Campbell KA, Berger RP, Ettaro L, Roberts MS. Cost-effectiveness of head computed tomography in infants with possible inflicted traumatic brain injury. Pediatrics. 2007 Aug;120:295-304. PubMed PMID: 17671055.
  23. Buttram SDW, Wisniewski SR, Jackson EK, Adelson PD, Feldman K, Bayir H, Berger RP, Clark RSB, Kochanek PM. Multiplex assessment of cytokine and chemokine levels in cerebrospinal fluid following severe pediatric traumatic brain injury: Effects of moderate hypothermia. J Neurotrauma. 2007 Nov;24(11):1707-17. PubMed PMID: 18001201.
  24. Berger RP, Beers SR, Richichi R, Wiesman D. Serum biomarker concentrations and outcome after pediatric traumatic brain injury. J Neurotrauma. 2007 Dec;24(12):1793-801. PubMed PMID: 18159990.
  25. Kochanek PM, Berger RP, Bayir H, Wagner A, Jenkins LW, Clark RSB. Biomarkers of primary and evolving damage in traumatic and ischemic brain injury: Diagnosis, prognosis, probing mechanisms, and therapeutic decision making. Curr Opin Crit Care. 2008 Apr;14:135-41. PubMed PMID: 18388674.
  26. Runyan DK, Berger RP, Barr RG. Defining an ideal system to establish the incidence of inflicted traumatic brain injury: Summary of the consensus conference. Am J Prev Med. 2008 Apr;34(4S):S163-8. PubMed PMID: 18374269.
  27. Fink EL, Lai Y, Zhang X, Janesko-Feldman K, Adelson PD, Szabó C, Berger RP, Sarnaik AA, Kochanek PM, Clark RSB. Quantification of poly(ADP-ribose)-modified proteins in cerebrospinal fluid from infants and children after traumatic brain injury. J Cereb Blood Flow Metab. 2008 Sep;28(9):1523-9. PubMed PMID: 18506195.
  28. Berger RP, Ta’asan S, Rand A, Lokshin A, Kochanek P. Multiplex assessment of serum biomarker concentrations in well-appearing children with inflicted traumatic brain injury. Pediatr Res. 2009 Jan;65(1):97-102. PubMed PMID: 18787505.
  29. Berger R, Richichi R. Derivation and validation of an equation for adjustment of neuron-specific enolase concentrations in hemolyzed serum. Pediatr Crit Care Med. 2009 Mar;10(2):260-3. PubMed PMID: 19188872.
  30. Campbell KA, Squires J, Cook L, Berger RP. Disparities in the medical examination of children in the home of a child with suspected physical abuse. Child Abuse Negl. 2009 Sep;33(9):612-7. PubMed PMID: 19811828.
  31. Vitale MA, Squires, J, Zuckerbraun NS, Berger RP. Evaluation of the siblings of physically abused children: A comparison of child protective services caseworkers and child abuse physicians. Child Maltreat. 2010 May;15(2):144-51. PubMed PMID: 20147344.
  32. Berger RP, Bazaco MC, Wagner AK, Kochanek PM, Fabio A. Trajectory analysis of serum biomarker concentrations facilitates outcome prediction after pediatric traumatic and hypoxemic brain injury. Dev Neurosci. 2010;32(5-6):396-405. PubMed PMID: 20847541.
  33. Mehta A, Kochanek PM, Tyler-Kabara E, Adelson PD, Wisniewski SR, Berger RP, Sidoni MD, Bell RL, Clark RSB, Bell MJ. Relationship of intracranial pressure and cerebral perfusion pressure with outcome in young children after severe traumatic brain injury. Dev Neurosci. 2010;32(5-6):413-9. PubMed PMID: 20847542.
  34. D’Onofrio G, Jauch E, Jagoda A, Allen MH, Anglin D, Barsan WG, Berger RP, Bobrow BJ, Boudreaux ED, Bushnell C, ChanY-F, Currier G, Eggly S, Ichord R, Larkin GL, Laskowitz D, Neumar RW, Newman-Toker DE, Quinn J, Shear K, Todd KH, Zatzick D. Contributing author: NIH Roundtable on opportunities to advance research on neurological and psychiatric emergencies. Ann Emerg Med. 2010 Nov;56(5):551-64. PubMed PMID: 21036295.
  35. Duffy S, Squires J, Fromkin JB, Berger RP. Use of skeletal surveys to evaluate for physical abuse: Analysis of 703 consecutive skeletal surveys. Pediatrics. 2011 Jan;127(1):e47-52. PubMed PMID: 21149429.
  36. Berger RP. Predicting outcome after severe pediatric TBI: Making progress one baby step at a time. Pediatr Crit Care Med. 2011 May;12(3):362-4. PubMed PMID: 21637150.
  37. Berger RP, Houle JF, Hayes RL, Wang KK, Mondello S, Bell MJ. Translating biomarkers research to clinical care: Applications and issues for rehabilomics. PM R. 2011 Jun;3(6 Suppl 1):S31-8. PubMed PMID: 21703578.
  38. Li S, Mitchell E, Fromkin J, Berger RP. Retinal hemorrhages in low-risk children evaluated for physical abuse. Arch Pediatr Adolesc Med. 2011 Oct;165(10):913-7. PubMed PMID: 21969393.
  39. Berger RP, Fromkin J, Stutz H, Makoroff K, Scribano PV, Feldman K, Tu LC, Fabio A. Abusive head trauma during a time of increased unemployment: A multicenter analysis. Pediatrics. 2011 Oct;128(4):637-43. PubMed PMID: 21930535.
  40. Berger RP, Hayes RL, Richichi R, Beers SR, Wang KK. Serum concentrations of ubiquitin C-terminal hydrolase-L1 and αII-spectrin breakdown product 145 kDa correlate with outcome after pediatric TBI. J Neurotrauma. 2012 Jan 1;29(1):162-7. PubMed PMID: 22022780.
  41. Adelson PD, Pineda J, Bell MJ, Abend NS, Berger RP, Giza CC, Hotz G, Wainwright MS. Common data elements for pediatric traumatic brain injury: Recommendations from the working group on demographics and clinical assessment. J Neurotrauma. 2012 Mar 1;29(4):639-53. PubMed PMID: 21939389.
  42. Berger RP, Beers S, Papa L, Bell M. Common data elements for pediatric traumatic brain injury: Recommendations from the biospecimens and biomarkers workgroup. J Neurotrauma. 2012 Mar 1;29(4):672-7. PubMed PMID: 22106839.
  43. Salonia R, Bell MJ, Kochanek PM, Berger RP. The utility of near infrared spectroscopy in detecting intracranial hemorrhage in children. J Neurotrauma. 2012 Apr 10;29(6):1047-53. PubMed PMID: 22098538.
  44. Beers SR, Wisniewski SR, Garcia-Filion P, Tian Y, Hahner T, Berger RP, Bell MJ, Adelson PD. Validity of a pediatric version of the Glasgow outcome scale-extended. J Neurotrauma. 2012 Apr 10;29(6):1126-39. PubMed PMID: 22220819.
  45. Lindberg DM, Shapiro RA, Laskey AL, Pallin DJ, Blood EA, Berger RP; ExSTRA Investigators. Prevalence of abusive injuries in siblings and household contacts of physically abused children. Pediatrics. 2012 Aug;130(2):193-201. PubMed PMID: 22778300.
  46. Shein SL, Bell MJ, Kochanek PM, Tyler-Kabara EC, Wisniewski SR, Feldman K, Makoroff K, Scribano PV, Berger RP. Risk factors for mortality in children with abusive head trauma. J Pediatr. 2012 Oct;161(4):716-22.e1. PubMed PMID: 22578583.
  47. Singh R, Squires J, Fromkin JB, Berger RP. Assessing the use of follow-up skeletal surveys in children with suspected physical abuse. J Trauma Acute Care Surg. 2012 Oct;73(4):972-6. PubMed PMID: 22902733.
  48. Sussman S, Squires J, Stitt R, Zuckerbraun J, Berger RP. Increased serum creatine phosphokinase in a child with bruising due to physical abuse. Pediatr Emerg Care. 2012 Dec;28(12):1366-8. PubMed PMID: 23222104.
  49. Su E, Bell MJ, Kochanek PM, Wisniewski SR, Bayir H, Clark RSB, Adelson PD, Tyler-Kabara EC, Janesko-Feldman KL, Berger RP. Increased CSF concentrations of myelin basic protein after TBI in infants and children: Absence of significant effect of therapeutic hypothermia. Neurocrit Care. 2012 Dec;17(3):401-7. PubMed PMID: 22890910.
  50. Lindberg DM, Harper NS, Laskey AL, Berger RP. Prevalence of abusive fractures of the hands, feet, spine or pelvis on skeletal survey: Perhaps “uncommon” is more common than suggested. Pediatr Emerg Care. 2013 Jan;29(1):26-9. PubMed PMID: 23283258.
  51. Lindberg DM, Shapiro RA, Blood EA, Steiner RD, Berger RP; ExSTRA Investigators. Utility of hepatic transaminases in children with concern for abuse. Pediatrics. 2013 Feb;131(2):268-75. PubMed PMID: 23319537.
  52. Papa L, Ramia MM, Kelly JM, Burks SS, Pawlowicz A, Berger RP. Systematic review of clinical research on biomarkers for pediatric traumatic brain injury. J Neurotrauma. 2013 Mar 1;30(5):324-38. PubMed PMID: 23078348.
  53. Kochanek PM, Berger RP, Fink EL, Au AK, Bayir H, Bell MJ, Dixon CE, Clark RSB. The potential for bio-mediators and biomarkers in pediatric traumatic brain injury and neurocritical care. Front Neurol. 2013 Apr;4:40. PubMed PMID: 23637695.
  54. Goyal A, Failla MD, Niyonkuru C, Amin K, Fabio A, Berger RP, Wagner AK. S100b as a prognostic biomarker in outcome prediction for patients with severe traumatic brain injury. J Neurotrauma. 2013 Jun 1; 30(11):946-57. PubMed PMID: 23190274.
  55. Deye KP, Berger RP, Lindberg DM, ExSTRA Investigators. Occult abusive injuries in infants with apparently isolated skull fractures. J Trauma Acute Care Surg. 2013 Jun; 74(6):1553-8. PubMed PMID: 23694887.
  56. Zuccoli G, Panigrahy A, Haldipur A, Willaman D, Squires J, Wolford J, Sylvester C, Mitchell E, Lope LA, Nischal KK, Berger RP. Susceptibility-weighted imaging depicts retinal hemorrhages in abusive head trauma. Neuroradiology. 2013 Jul;55(7):889-93. PubMed PMID: 23568702.
  57. Greiner MV, Berger RP, Thackeray JD, Lindberg DM. Examining Siblings to Recognize Abuse (ExSTRA) Investigators. Dedicated retinal examination in children evaluated for physical abuse without radiographically identified traumatic brain injury. J Pediatr. 2013 Aug; 163(2):527-31. PubMed PMID: 23498157.
  58. Lindberg DM, Blood EA, Campbell KA, Laskey AL, Berger RP. Examining Siblings to Recognize Abuse (ExSTRA) Study Group. Predictors of screening and injury in contacts of physically abused children. J Pediatr. 2013 Sep;163(3):730-5.e1-3. PubMed PMID: 23566385.
  59. Putnam-Hornstein E, Wood JN, Fluke J, Yoshioka-Maxwell A, Berger RP. Preventing severe and fatal child maltreatment: Making the case for the expanded use and integration of data. Child Welfare. 2013;92(2):59-75. PubMed PMID: 24199323.
  60. Scribano PV, Makoroff KL, Feldman KW, Berger RP. Association of perpetrator relationship to abusive head trauma clinical outcomes. Child Abuse Negl. 2013 Oct; 37(10):771-7. PubMed PMID: 23735871.
  61. Fink EL, Berger RP, Clark RSB, Watson RS, Angus DC, Richichi R, Panigrahy A, Callaway CW, Bell MJ, Kochanek PM. Serum biomarkers of brain injury to classify outcome after pediatric cardiac arrest. Crit Care Med. 2014 Mar;42(3):664-74. PubMed PMID: 24164954.
  62. Mondello S, Schmid K, Berger RP, Kobeissy F, Italiano D, Jeromin A, Hayes RL, Tortella FC, Buki A. The challenge of mild traumatic brain injury: Role of biochemical markers in diagnosis of brain injury. Med Res Rev. 2014 May;34(3):503-31. PubMed PMID: 23813922.
  63. Lindberg DM, Berger RP, Reynolds MS, Alwan RM, Harper NS; Examining Siblings To Recognize Abuse Investigators. Yield of skeletal survey by age in children referred to abuse specialists. J Pediatr. 2014 Jun;164(6):1268-73.e1. PubMed PMID: 24630357.
  64. Gao W, Lu C, Kochanek PM, Berger RP. Serum amyloid A is increased in children with abusive head trauma: A gel-based proteomic analysis. Pediatr Res. 2014 Sep;76(3):280-6. PubMed PMID: 24941216.
  65. Thorpe EL, Zuckerbraun NS, Wolford JE, Berger RP. Missed opportunities to diagnose child physical abuse. Pediatr Emerg Care. 2014 Nov;30(11):771-6. PubMed PMID: 25343739.
  66. Buki A, Kovacs N, Czeiter E, Schmid K, Berger RP, Kobeissy F, Italiano D, Hayes RL, Tortella FC, Mezosi E, Schwarcz A, Toth A, Nemes O, Mondello S. Minor and repetitive head injury. Adv Tech Stand Neurosurg. 2015;42:147-92. PubMed PMID: 25411149.
  67. Berger RP, Fromkin J, Rubin P, Snyder J, Richichi R, Kochanek PM. Serum D-dimer concentrations are increased after pediatric traumatic brain injury. J Pediatr. 2015 Feb;166(2):383-8. PubMed PMID: 25454315.
  68. Kumar RG, Diamond ML, Boles JA, Berger RP, Tisherman SA, Kochanek PM, Wagner AK. Acute CSF interleukin-6 trajectories after TBI: Associations with neuroinflammation, polytrauma, and outcome. Brain Behav Immun. 2015 Mar;45:253-62. PubMed PMID: 25555531.
  69. Berger RP, Parks S, Fromkin J, Rubin P, Pecora PJ. Assessing the accuracy of the International Classification of Disease codes to identify abusive head trauma: A feasibility study. Inj Prev. 2015 Apr;21(e1):e133-7. PubMed PMID: 24167034.
  70. Berger RP, Sanders D, Rubin D. Commission to Eliminate Abuse and Neglect Fatalities. Pediatricians’ role in preventing child maltreatment fatalities: a call to action. Pediatrics. 2015 Nov;136(5):825-7. PubMed PMID: 26438700.
  71. Kumar RG, Rubin JE, Berger RP, Kochanek PM, Wagner AK. Principal components derived from CSF inflammatory profiles predict outcome in survivors after severe traumatic brain injury. Brain Behav Immun. 2016 Mar;53:183-93. PMID: 26705843.
  72. Wood JN, French B, Fromkin J, Fakeye O, Scribano PV, Letson MM, Makoroff KL, Feldman KW, Fabio A, Berger R. Association of pediatric abusive head trauma rates with macroeconomic indicators. Acad Pediatri. 2016 Apr;16(3):224-32. PubMed PMID: 26183000.
  73. Flom L, Fromkin J, Panigrahy A, Tyler-Kabara E, Berger RP. Development of a screening MRI for infants at risk for abusive head trauma. Pediatr Radiol. 2016 Apr;46(4):519-26. PMID: 26589303.
  74. Berger RP, Panigrahy A, Gottschalk S, Sheetz M. Effective radiation dose in a skeletal survey performed for suspected child abuse. J Pediatr. 2016 Apr;171:310-2. PMID: 26831745.
  75. Fink EL, Berger RP, Clark RS, Watson RS, Angus DC, Panigrahy A, Richichi R, Callaway CW, Bell MJ, Mondello S, Hayes RL, Kochanek PM. Exploratory study of serum ubiquitin carboxyl-terminal esterase L1 and glial fibrillary acidic protein for outcome prognostication after pediatric cardiac arrest. Resuscitation. 2016 Apr;101:65-70. PMID: 26855294.
  76. Leeper CM, Nasr I, McKenna C, Berger RP, Gaines BA. Elevated admission international normalized ratio strongly predicts mortality in victims of abusive head trauma. J Trauma Acute Care Surg. 2016 May;80(5):711-6. PMID: 27100929.
  77. Mondello S, Kobeissy F, Vestri A, Hayes RL, Kochanek PM, Berger RP. Serum concentrations of ubiquitin C-terminal hydrolase-L1 and glial fibrillary acidic protein after pediatric traumatic brain injury. Sci Rep. 2016 Jun 20:6:28203. PMID: 27319802.
  78. Berger RP, Fromkin J, Herman B, Pierce MC, Saladino RA, Flom L, Tyler-Kabara EC, McGinn T, Richichi R, Kochanek PM. Validation of the Pittsburgh Infant Brain Injury Score for abusive head trauma. Pediatrics. 2016 Jul;138(1):e20153756. PMID: 27338699.
  79. Letson MM, Cooper JN, Deans KJ, Scribano PV, Makoroff KL, Feldman KW, Berger RP. Prior opportunities to identify abuse in children with abusive head trauma. Child Abuse Negl. 2016 Oct;60:36-45. PMID 27680755.
  80. Dias MS, Rottmund CM, Cappos KM, Reed ME, Wang M, Stetter C, Shaffer ML, Hollenbeak CS, Paul IM, Christian CW, Berger RP, Klevens J. Association of a postnatal parent education program for abusive head trauma with subsequent pediatric abusive head trauma hospitalization rates. JAMA Pediatr. 2017 Mar 1;171(3):223-29. PMID 28135348.
  81. Berger RP, Pak BJ, Kolesnikova MD, Fromkin J, Saladino R, Herman BE, Pierce MC, Englert D, Smith PT, Kochanek PM. Derivation and validation of a serum biomarker panel to identify infants with acute intracranial hemorrhage. JAMA Pediatr. 2017 Jun 5;171(6):e170429. Epub 2017 Jun 5. PMID 28395008.
  82. Berger RP, Saladino RA, Fromkin J, Heineman E, Suresh S, McGinn T. Development of an electronic medical record-based child physical abuse alert system. J American Medical Informatics Association. 2018 Feb 1;25(2):142-49. PMID 28641385.
  83. Henry MK, French B, Feudtner C, Zonfrillo MR, Lindberg DM, Anderst JD, Berger RP, Wood JN. Cervical spine imaging and injuries in young children with non-motor vehicle crash-associated traumatic brain injury. Pediatr Emerg Care. 2018 Feb 15 [Epub ahead of print]. PMID 29461428.
  84. Tiyyagura G, Christian C, Berger R, Lindberg D; ExSTRA Investigators. Occult abusive injuries in children brought for care after intimate partner violence: an exploratory study. Child Abuse Negl. 2018 Feb 20;79:136-43. PMID 29452932.
  85. Fink EL, Clark RSB, Berger RP, Fabio A, Angus DC, Watson RS, Gianakas JJ, Panigrahy A, Callaway CW, Bell MJ, Kochanek PM. 24 vs 72 hours of hypothermia for pediatric cardiac arrest: a pilot, randomized controlled trial. Resuscitation. 2018 May;126:14-20. Epub 2018 Feb 14. PMID 29454009.
  86. Berger RP, Dalton E, Campbell K. Understanding the intergenerational cycle of child protective service involvement. Pediatrics. 2018 Jun;141(6):e20180577. PMID: 29844138.
  87. Suresh S, Saladino RA, Fromkin J, Heineman E, McGinn T, Richichi R, Berger RP. Integration of physical abuse clinical decision support into the electronic health record at a tertiary care children’s hospital. J American Medical Informatics Association. 2018 Jul 1;25(7):833-40. PMID 29659856.
  88. Lorenz DJ, Pierce MC, Kaczor K, Berger RP, Bertocci G, Herman BE, Herr S, Hymel KP, Jenny C, Leventhal JM, Sheehan K, Zuckerbraun N. Classifying injuries in young children as abusive or accidental: reliability and accuracy of an expert panel approach. J Pediatr. 2018 Jul;198:144-50.e4. Epub 2018 Mar 15. PMID 29550228.
  89. Wood JN, Henry MK, Berger RP, Lindberg DM, Anderst JD, Song L, Localio R, Feudtner C. Use and utility of skeletal surveys to evaluate for occult fractures in young injured children. Academic Pediatrics. 2018 Aug 16 [Epub ahead of print]. PMID: 30121318.
  90. Rumball-Smith J, Fromkin J, Rosenthal B, Shane D, Skrbin J, Bimber T, Berger RP. Implementation of routine electronic health record-based child abuse screening in general emergency departments. Child Abuse Negl. 2018 Aug 28 [Epub ahead of print]. PMID: 30170921.
  91. Berger R, Lindberg D. Early recognition of physical abuse: bridging the gap between knowledge and practice. J Peds. In press.
  92. Krawiec C, Berger RP, Levi B. What we can learn from failure: an EHR-based child protection alert system. Child Maltreatment. In revision.
  93. Fingarson A, Pierce MC, Lorenz D, Kaczor K, Bennett B, Berger R, Currie M, Herr S, Hickey S, Magana J, Makoroff K, Williams, M, Young A, Zuckerbraun N, Thompson R. Caregiver features associated with increased risk of child physical abuse in young children. Pediatrics. In submission.

Reviews, invited published papers, proceedings of conference and symposia, monographs, books, and book chapters

  1. Kochanek PM, Berger RP, Jenkins LW. Biochemical and molecular mechanisms after severe traumatic brain injury in children: Contemporary studies from child abuse to proteomics. In: Vincent JL, editor. Yearbook of Intensive Care and Emergency Medicine 2002. Berlin & Heidelberg, Springer-Verlag: 2002:688-98.
  2. Berger RP. Biochemical, metabolic and molecular responses in the brain after inflicted childhood neurotrauma – Response. In: Reece R and Nicholson C, editors. Inflicted Childhood Neurotrauma. Proceedings of a conference sponsored by Department of Health and Human Services, National Institutes of Health, National Institute of Child Health and Human Development, Office of Rare Diseases, National Center for Medical Rehabilitation Research; 2002 Oct 10-11; Bethesda (MD):203-5.
  3. Berger RP. Biomarkers or neuroimaging in central nervous system injury: Will the real "gold standard" please stand up? Pediatr Crit Care Med. 2003;4(3):391.
  4. Berger RP, Adelson PD. Evaluation and management of pediatric head trauma in the emergency department: Current concepts and state-of-the-art research. Clin Pediatr Emerg Med. 2005;6(1):8-15.
  5. Berger RP, Adelson PD, Kochanek P. Response to a Letter to the Editor. J Neurosurg. 2006;104(6 Suppl Pediatrics):436.
  6. Kochanek PM, Bayir H, Berger RP, Dixon CE, Jenkins L, Kline AE, Tisherman S, Wagner AK, Clark RSB. The Safar Center for Resuscitation Research: Searching for breakthroughs in the new millennium. Gen Reanimatol. 2006;11(5-6):15-25.
  7. Berger RP, Hymel K, Gao W. The use of biomarkers after inflicted traumatic brain injury: Insight into etiology, pathophysiology and biochemistry. Clin Pediatr Emerg Med. 2006;7(3):186-93.
  8. Bechtel K, Berger RP. Inflicted traumatic brain injury: Making the diagnosis in the emergency department. Clin Pediatr Emerg Med. 2006;7(3):138-42.
  9. Kochanek PM, Berger RP, Margulies SS, Jenkins LW. Inflicted childhood neurotrauma: new insight into the detection, pathobiology, prevention, and treatment of our youngest patients with traumatic brain injury. J Neurotrauma. 2007;24(1):1-4.
  10. Berger RP. Diagnosing abusive head trauma: A primer for health care providers. Brain Inj Prof. 2008;5(1):18-20.
  11. Berger RP, Bell M. Serum biomarkers of traumatic brain injury. In: Rowin ME, Spinella P, editors. Current Concepts in Pediatric Critical Care. Society of Critical Care Medicine, January 2010:21-30.
  12. Berger RP, Hayes RL, Wang KKW, Kochanek P. Using serum biomarkers to diagnose, assess, treat and predict outcome after pediatric TBI. In: Anderson V, Yeates KO, editors. Pediatric Traumatic Brain Injury - New Frontiers in Clinical and Translational Research. New York: Cambridge University Press, 2010:36-53.
  13. Berger RP. Biochemical markers of head trauma in children. In: Jenny C, editor. Child Abuse and Neglect: Diagnosis, Treatment, and Evidence. St. Louis, MO: Elsevier Saunders, 2011:429-40.
  14. Berger RP, Zuckerbraun N. Biochemical markers. In: Kirkwood MW and Yeates KO, editors. Mild Traumatic Brain Injury in Children and Adolescents: From Basic Science to Clinical Management. New York, NY: Guilford Press, 2012:145-61.
  15. Berger RP, McGinn T. Deciding whether to screen for abusive head trauma: Do we need a clinical decision rule? Pediatr Crit Care Med. 2013;14:230-1.
  16. Lindberg DM, Berger RP, Lane WG. PECARN abdominal injury rule should exclude potentially abused children [letter to the editor]. Ann Emerg Med. 2013 Sep;62(3):276-7. PubMed PMID: 23969129.
  17. Berger RP, Bell MJ. Abusive head trauma. In: Wheeler DS, Wong HR, Shanley TP, editors. Pediatric Critical Care Medicine, Volume 2: Respiratory, Cardiovascular and Central Nervous Systems, 2nd ed. London: Springer, 2014:617-26.
  18. Zuckerbraun NS, King CC, Berger RP. Emergency department evaluation of mild traumatic brain injury. In: Vos P, Diaz-Arrastia R, editors. Traumatic Brain Injury. Wiley-Blackwell, March 2015:55-70.
  19. Berger RP, Simon D, Wolford JE, Bell MJ. Abusive head trauma. In: Nichols DG, Shaffner DH, editors. Rogers’ Textbook of Pediatric Intensive Care, 5th ed. Philadelphia: Wolters Kluwer Health, 2016: Chapter 62.
  20. Kochanek PM, Berger RP. Brain injury biomarkers in the critically ill. In: Webb A, Angus D, Finfer S, Gattinoni L, Singer M, editors. Oxford Textbook of Critical Care, 2nd ed. Oxford University Press, May 2016:1432-36.
  21. Berger RP. Abusive Head Trauma (Part I, Chapter 5). In: Wang, K, editor. Neurotrauma. A Comprehensive Book on Traumatic Brain Injury and Spinal Cord Injury. New York: Oxford University Press. In press: Publication Date 11/7/18.
  22. Berger RP. Animal Research (Chapter 2) and Berger RP, Thorpe E. Consent and Deception (Chapter 3). In: Guttman K, Shouldice M, Levin AV, editors. Clinical and Ethical Issues in Child Abuse Research: An Evidence-Based Guide. New York: Springer. In press.

Published abstracts (since 2010)

  1. Singh R, Duffy S, Squires J, Fromkin J, Berger RP. Assessing the use of follow-up skeletal surveys in children with suspected physical abuse. PAS 2010 63:2830.17.
  2. Berger RP, Fromkin J, Stutz H, Makoroff K, Feldman K, Scribano PV, Songer T. An increase in abuse head trauma during the current recession: A multi-center analysis. PAS 2010 63: 1140.4.
  3. Makoroff K, Eby M, Scribano PV, Feldman K, Songer T, Berger RP. Age-related mortality and injury characteristics of abusive head trauma in children: Implications for prevention programs. PAS 2010 63:1140.5.
  4. Scribano PV, Curran S, Makoroff K, Feldman K, Berger RP. The importance of non-biologic caretakers as perpetrators of abusive head trauma in children >1 yr of age. PAS 2010 63: 2830.10.
  5. Zuccoli G, Panigrahy A, Berger RP. Neuroimaging findings in abusive head trauma. XIX Symposium Neuroradiologicum, The World Congress of Diagnostic and Therapeutic Neuroradiology. October 4-9, 2010. Bologna, Italy. NJR 2010;23(Suppl 1):156-61.
  6. Su E, Kochanek PM, Bell MJ, Adelson PD, Bayir H, Janesko-Feldman KL, Berger RP. Myelin basic protein level increases in the cerebrospinal fluid of children and infants following traumatic brain injury: The effect of therapeutic hypothermia. Presented at Society of Critical Care Medicine 40th Critical Care Congress. January 15-19, 2011. San Diego, CA . Crit Care Med 2011;38(Suppl):A21.
  7. Stein S, Bell MJ, Kochanek PM, Tyler-Kabara E, Wisniewski S, Feldman K, Makoroff K, Scribano P, Berger RP. Glasgow coma scale (GCS) score is associated with mortality in abusive head trauma in children. Presented at Society of Critical Care Medicine 40th Critical Care Congress. January 15-19, 2011. San Diego, CA. J Neurotrauma 2010;26:A55.
  8. Fink EL, Berger RP, Clark RSB, Watson RS, Angus DC, Panigrahy A, Callaway CW, Bell MJ, Kochanek PM. Serum biomarkers of brain injury predict outcome after pediatric cardiac arrest. American Heart Association Annual Meeting 2011. Resuscitation Science Symposium. November 13-15, 2011. Orlando, FL. Circulation 2011;124:A154.
  9. Goyal A, Niyonkuru C, Carter MD, Amin KB, Fabio A, Berger RP, Wagner AK. S100b as a prognostic biomarker in outcome prediction for patients with severe TBI. National Neurotrauma Association Annual Meeting. July 22-25, 2012. Phoenix, AZ. J Neurotrauma 29:A193 D36.
  10. Boles J, Amin K, Niyonkuru K, Berger R, Kochanek RM, Tisherman S, Wagner AK. The Influence of Isolated Head Injury Status on Inflammation Cytokine Levels Post Traumatic Brain Injury. National Neurotrauma Association Annual Meeting. July 22-25, 2012. Phoenix, AZ. J Neurotrauma 29:A-44 A35.
  11. Letson MM, Cooper JN, Deans KJ, Scribano PV, Makoroff KL, Feldman K, Berger RP. Prior opportunities to diagnose abuse in children with abusive head trauma. PAS. May 5, 2013. Washington, DC. 2013 4145.2.
  12. Margulies S, Kilbaugh TJ, Sullivan S, Costine BA, Janesko-Feldman K, Berger RP, Duhaime A-C. Time-dependent changes in biomarker levels following both diffuse and focal TBI in immature swine. 31st Annual National Neurotrauma Symposium. August 4-7, 2013. Nashville, TN. J Neurotrauma 30:A-67 B114.
  13. Bokshan S, Leonard JR, Mondello S, Hayes RL, Limbrick D, Bruce CT, Berger RP, Pineda JA. Biomarkers of primary injury and secondary injury due to increased intracranial pressure in pediatric head trauma. 31st Annual National Neurotrauma Symposium. August 4-7, 2013. Nashville, TN. J Neurotrauma 30:A-70 B118.
  14. Fromkin JB, Flom LL, Tyler-Kabara E, Panigrahy A, Berger RP. Optimizing a fast MR protocol for abusive head trauma screening. (Platform Presentation). 2014 Pediatric Academic Societies & Asian Society for Pediatric Research Joint Meeting. May 3-6, 2014. Vancouver, Canada E-PAS 2014:1415.7.
  15. Fromkin JB, Herman B, Pierce MC, Rubin P, Berger RP. Using a clinical decision rule to identify brain injury in infants. (Platform Presentation). 2014 Pediatric Academic Societies & Asian Society for Pediatric Research Joint Meeting. May 3-6, 2014. Vancouver, Canada. E-PAS 2014:1415.1.
  16. Saladino RA, Fromkin J, Heineman E, Suresh S, McGinn T, Berger RP. Using the electronic medical record to improve screening practices in children at risk for physical abuse. Pediatric Academic Societies Meeting. April 30-May 3, 2016. Baltimore, MD. E-PAS 2016:4140:316.

Other publications

  1. Berger RP, Lindberg DM. Please do not stop performing skeletal surveys or making referrals to Child Protective Services [E-letter], Pediatrics (March 13, 2009). http://pediatrics.aappublications.org/cgi/eletters/123/2/e247.
  2. Berger RP, Christian C, DeJong A. Child abuse is also an important serious cause of crying in infants [E-letter], Pediatrics (March 16, 2009). http://pediatrics.aappublications.org/cgi/eletters/123/3/841.
  3. Berger RP. “Child abuse in Pennsylvania is worse than you think” (opinion piece, Pittsburgh Post -Gazette Forum, June 2011). http://www.post-gazette.com/stories/opinion/perspectives/child-abuse-in-pennsylvania-is-worse-than-you-think-301748/
  4. Berger RP, Carrasco M. “A post-Sandusky letdown” (opinion piece, Pittsburgh Post-Gazette Forum, October 2012) http://www.post-gazette.com/stories/opinion/perspectives/a-post-sandusky-letdown-658430/?print=1\
  5. Berger RP, Zolotor AJ. Is there an association between physical punishment in chidhood & physical health in adulthood? [invited commentary]. Pediatrics. 2013 Aug; 132(2):e500-1. PubMed PMID: 23858421.
  6. Berger RP Changing the Way we see Child abuse https://saveinjuredkids.org/blog/changing-the-way-we-see-child-abuse-by-dr-rachel-berger/ (Posted April 1, 2014)
  7. Berger RP. The Child Advocacy Center at Children’s: Protecting Our Most Vulnerable Children. http://childrenspgh.org/the-child-advocacy-center-at-childrens-hospital-protecting-our-most-vulnerable-children/ (Posted April 1, 2014)
  8. Berger RP. Adults need no training to do what’s right (letter to the editor, Pittsburgh Post-Gazette, February 17, 2015). http://www.post-gazette.com/opinion/letters/2015/02/17/Adults-need-no-training-to-do-what-s-right/stories/201502170013.
  9. Berger RP. Raising awareness for child abuse. http://childrenspgh.org/raising-awareness-for-child-abuse/ (Posted April 21, 2015).
  10. Berger RP. “Who is the Next Larry Nassar?” (opinion piece, Pittsburgh Post-Gazette, February 25, 2018. http://www.post-gazette.com/opinion/Op-Ed/2018/02/25/Who-is-the-next-Larry-Nassar/stories/201802250032.
  11. Berger R, Dalton E, Campbell K. Understanding the intergenerational cycle of child protective service involvement [invited commentary]. Pediatrics. 2018 Jun; 141(6):e20180577.

Podcasts

Children’s Hospital of Pittsburgh’s Pediatric Hospital Medicine Podcast
Title: Child Abuse – Review from the PHM Core Competencies
Course Directors: Tony R. Tarchichi MD and Rachel Berger, MD
http://pedhospmed.libsyn.com/
12/9/17

Research Interests

Berger is the director for division research activities.

Decreasing Unsafe Sleep in Allegheny County: A Multi-disciplinary, Multi-pronged Approach. The goal of this project is to better understand unsafe sleep injuries and deaths and to develop a multi-disciplinary approach to decrease them. The study, sponsored by the Henry L. Hillman Foundation Opportunity Fund, began in April 2016 and ended in June 2018.

Evaluating an Intervention to Decrease Unsafe Sleep in Infants. This two-prong project aims to decrease the top cause of post-neonatal death in our country: sudden unexpected infant death related to unsafe sleep. A randomized controlled trial will assess if a previously evaluated intervention with parents can be replicated locally and enhanced to reduce unsafe infant sleep. Continuation of the multi-disciplinary rapid root cause analysis program, created in 2015-17 with Hillman Foundation funds, will drive community-based interventions to reduce unsafe sleep. This study, sponsored by the Henry L. Hillman Foundation, began in July 2018 and will end in June 2020.

Development and Dissemination of an Electronic Health Record based Child Abuse Clinical Decision Support System Toolkit. The goal of this project is to expand the use of a validated EHR-based child abuse-related clinical decision support system to other children’s hospitals which use Cerner. The study, sponsored by the Beckwith Foundation, began in July 2017 and will end December 2018.

Improved Identification of Intracranial Hemorrhage in Infants and Young Children Using Serum Biomarkers. The goal of this project is to further develop and bring closer to clinical use a patent protected biomarker panel on a patented device which can identify acute intracranial hemorrhage in infants at risk for abusive head trauma. The study, sponsored by the Coulter Translational Research Partners Program, began in September 2017 and will end in December 2018.

Disseminating Child Abuse Clinical Decision Support to Improve Detection, Evaluation and Reporting. The goal of this project is the dissemination of child abuse clinical decision support system which was developed as part of a separate PCORI-funded grant to two other electronic health records, EPIC and All-Scripts. The study, sponsored by Patient Centered Outcome Research Institute (PCORI), began in March 2018 and will end February 2020.

Research Grants

  • Disseminating Child Abuse Clinical Decision Support to Improve Detection, Evaluation and Reporting
  • Evaluating an Intervention to Decrease Unsafe Sleep in Infants
  • Improved Identification of Intracranial Hemorrhage in Infants and Young Children Using Serum Biomarkers
  • Decision Making in Child Protection: Improving the Safety Net for Young Children with Suspected Physical Abuse to Prevent Child Maltreatment, Injuries and Fatalities
  • Development and Dissemination of an Electronic Health Record-based Child Abuse Clinical Decision Support System Toolkit
  • Decreasing Unsafe Sleep in Allegheny County: A Multi-disciplinary, Multi-pronged Approach
  • Validation of Serum Biomarkers to Classify Outcome after Pediatric Cardiac Arrest
  • The PA Child Welfare Training Program IV-E Budget/IV-E

CV

Division