Intimate partner violence: development of a brief risk assessment for the emergency department.
OBJECTIVE
Women assaulted by intimate partners are frequently patients in emergency departments (EDs). Many victims and health care providers fail to take into account the potential risks of repeat partner violence. The objective of this study was to use data from a larger study of domestic violence risk assessment methods to develop a brief assessment for acute care settings to identify victims at highest risk for suffering severe injury or potentially lethal assault by an intimate partner or former partner.


METHODS
Victims of intimate partner violence (IPV) were interviewed twice between 2002 and 2004. The baseline interview included the 20 items of Campbell's Danger Assessment (DA; predictor). The follow-up interview, conducted 9 months later on average, assessed abuse inflicted since the baseline interview (outcome). Multiple logistic regression was used to identify questions on the DA most predictive of severe abuse and potentially lethal assaults. Female IPV victims were recruited from New York City family courts, Los Angeles County Sheriff's Department 9-1-1 calls, New York City and Los Angeles shelters, and New York City hospitals; 666 women responded to the DA at baseline, and 60% participated in follow-up interviews.


RESULTS
Severe injuries or potentially lethal assaults were experienced by 14.9% of retained study participants between the baseline and follow-up interviews. The best brief prediction instrument has five questions. A positive answer to any three questions has a sensitivity of 83% (95% confidence interval = 70.6% to 91.4%).


CONCLUSIONS
This instrument can help predict which victims may be at increased risk for severe injury or potentially lethal assault and can aid clinicians in differentiating which patients require comprehensive safety interventions.
Snider
Carolyn
C
Emergency Department, St. Michael's Hospital, and the Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. sniderc@smh.toronto.on.ca
Webster
Daniel
D
O'Sullivan
Chris S
CS
Campbell
Jacquelyn
J
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D015141:Los Angeles; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D009518:New York; D012372:ROC Curve; D018570:Risk Assessment / Q000379:methods; D013179:Spouse Abuse / Q000208:ethnology / Q000517:prevention & control / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data