Anuradha Paranjape1, Jane Liebschutz. 1. Ambulatory Service, Edith Nourse Rogers Veterans Administration Hospital and Boston University School of Medicine, Boston, Massachusetts, USA. aparanj@emory.edu
Abstract
OBJECTIVE: To develop a simple, sensitive screening tool for lifetime intimate partner violence (IPV) in women. METHODS: In the emergency department (ED) of an urban teaching hospital, 75 English-speaking women between 18 and 64 years old were tested. The sensitivity and specificity of 43 dichotomous response-option, IPV screening questions were compared. The reference standard was lifetime IPV, determined by a semistructured interview, using preset criteria of specific violence acts or emotional control or both by an intimate partner. Questions with high sensitivity (>70%) were tested together against the reference standard. Answering yes to any question scored 1 point. Content area and the area under receiver-operator curve (AUROC) of the screening questions determined the final tool. RESULTS: Sixty-three percent of women reported lifetime IPV. Eight of the 43 screening questions had a sensitivity of >70%. After testing possible combinations, the final three-question screen, STaT had the highest AUROC. The STaT questions are: "Have you ever been in a relationship where your partner has pushed or Slapped you?" "Have you ever been in a relationship where your partner Threatened you with violence?" and "Have you ever been in a relationship where your partner has thrown, broken or punched Things?" The sensitivity (95% confidence intervals [95% CI]) of STaT for lifetime IPV is 96% (90%, 100%), 89% (81%, 98%), and 64% (50%, 78%) for a score of >/=1, >/=2, and 3, respectively. The corresponding specificity is 75% (59%-91%), 100%, and 100%. CONCLUSIONS: Three simple questions when used together can effectively identify lifetime IPV and will aid clinicians' efforts to identify abuse in women.
OBJECTIVE: To develop a simple, sensitive screening tool for lifetime intimate partner violence (IPV) in women. METHODS: In the emergency department (ED) of an urban teaching hospital, 75 English-speaking women between 18 and 64 years old were tested. The sensitivity and specificity of 43 dichotomous response-option, IPV screening questions were compared. The reference standard was lifetime IPV, determined by a semistructured interview, using preset criteria of specific violence acts or emotional control or both by an intimate partner. Questions with high sensitivity (>70%) were tested together against the reference standard. Answering yes to any question scored 1 point. Content area and the area under receiver-operator curve (AUROC) of the screening questions determined the final tool. RESULTS: Sixty-three percent of women reported lifetime IPV. Eight of the 43 screening questions had a sensitivity of >70%. After testing possible combinations, the final three-question screen, STaT had the highest AUROC. The STaT questions are: "Have you ever been in a relationship where your partner has pushed or Slapped you?" "Have you ever been in a relationship where your partner Threatened you with violence?" and "Have you ever been in a relationship where your partner has thrown, broken or punched Things?" The sensitivity (95% confidence intervals [95% CI]) of STaT for lifetime IPV is 96% (90%, 100%), 89% (81%, 98%), and 64% (50%, 78%) for a score of >/=1, >/=2, and 3, respectively. The corresponding specificity is 75% (59%-91%), 100%, and 100%. CONCLUSIONS: Three simple questions when used together can effectively identify lifetime IPV and will aid clinicians' efforts to identify abuse in women.
Authors: Ameeta S Kalokhe; Anuradha Paranjape; Christine E Bell; Gabriel A Cardenas; Tamy Kuper; Lisa R Metsch; Carlos del Rio Journal: AIDS Patient Care STDS Date: 2012-02-24 Impact factor: 5.078
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