title: Screening women for intimate partner violence: a systematic review to update the U.S. Preventive Services Task Force recommendation.
abstract: BACKGROUND
  In 2004, the U.S. Preventive Services Task Force determined that evidence was insufficient to support screening women for intimate partner violence (IPV).
  
  
  OBJECTIVE
  To review new evidence on the effectiveness of screening and interventions for women in health care settings in reducing IPV and related health outcomes, the diagnostic accuracy of screening instruments, and adverse effects of screening and interventions.
  
  
  METHODS
  MEDLINE and PsycINFO (January 2002 to January 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through fourth quarter 2011), Scopus, and reference lists.
  
  
  METHODS
  English-language trials of the effectiveness of screening and interventions, diagnostic accuracy studies of screening instruments, and studies of any design about adverse effects.
  
  
  METHODS
  Investigators extracted data about study populations, designs, and outcomes and rated study quality by using established criteria.
  
  
  RESULTS
  A large fair-quality trial of screening versus usual care indicated reduced IPV and improved health outcomes for both groups, but no statistically significant differences between groups. Fifteen fair- and good-quality studies evaluated 13 screening instruments, and six instruments were highly accurate. Four fair- and good-quality trials of counseling reported reduced IPV and improved birth outcomes for pregnant women, reduced IPV for new mothers, and reduced pregnancy coercion and unsafe relationships for women in family-planning clinics. Fourteen studies indicated minimal adverse effects with screening, but some women experienced discomfort, loss of privacy, emotional distress, and concerns about further abuse.
  
  
  CONCLUSIONS
  Trials were limited by heterogeneity, lack of true control groups, high loss to follow-up, self-reported measures, and lack of accepted reference standards.
  
  
  CONCLUSIONS
  Screening instruments accurately identify women experiencing IPV. Screening women for IPV can provide benefits that vary by population, while potential adverse effects have minimal effect on most women.
  
  
  BACKGROUND
  Agency for Healthcare Research and Quality.
authors.affiliation: Oregon Evidence-based Practice Center, Oregon Health & Science University, Portland, OR 97239, USA. nelsonh@ohsu.edu
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Nelson
authors.forename: Christina
authors.initials: C
authors.lastname: Bougatsos
authors.forename: Ian
authors.initials: I
authors.lastname: Blazina
mesh_terms: D017579:Domestic Violence / Q000517:prevention & control; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008403:Mass Screening; D016032:Randomized Controlled Trials as Topic; D012747:Sexual Partners