Screening for partner violence does work

Article

Currently available screening instruments are effective in identifying incidents of domestic violence, a systemic review by the US Preventive Services Task Force reports.

Currently available tools used to identify women in violent relationships have high specificity and sensitivity.

Counseling interventions are effective in reducing the incidence of intimate partner violence.

Existing screening instruments are extremely accurate in their ability to identify women in abusive relationships, according to a systematic review performed to update the United States Preventive Services Task Force’s (USPSTF) 2004 recommendation on the subject.

In 2004, the USPSTF was unsure of the value of such screening instruments, reporting that the evidence was insufficient to recommend screening for intimate partner violence (IPV) in a healthcare setting.

But this latest review of English-language trials published between January 2002 and January 2012 found that available instruments, such as the 4-item Hurt, Insult, Threaten, and Scream instrument; the Humiliation, Afraid, Rape, Kick instrument; and the Woman Abuse Screening Tool, among others, have high sensitivity and specificity for current or recent IPV.

Published online May 7 in the Annals of Internal Medicine, the review also found that more women in the screened groups talked with their doctors about IPV.

The investigators also evaluated interventions for reducing IPV. Among the benefits of counseling were improved birth outcomes for pregnant women, fewer incidents of IPV for new mothers, and lower rates of pregnancy coercion and unsafe relationships for women in family planning clinics.

No real adverse effects of screening were found, except for reports by some women of feeling uncomfortable, distressed, or that their privacy was being invaded. Others were concerned about future abuse.

Limitations of the trials include that they lacked population diversity, true control groups, and acceptable reference standards; had high losses to follow-up; and relied on self-reporting measures. The authors caution that the benefits of screening can vary by population.

Read other articles in this issue of Special Delivery

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