Accuracy of 3 brief screening questions for detecting partner violence in the emergency department

K. M. Feldhaus, J. Koziol-McLain, H. L. Amsbury, I. M. Norton, S. R. Lowenstein and J. T. Abbott
Department of Emergency Medicine, Denver Health Medical Center, CO 80204, USA.

OBJECTIVE: To devise a brief screening instrument to detect partner violence and to partially validate this screen against established instruments. DESIGN: Prospective survey. SETTING: Two urban, hospital-based emergency departments. PARTICIPANTS: Of 491 women presenting during 48 randomly selected 4-hour time blocks, 322 (76% of eligible patients) participated. Respondents had a median age of 36 years; 19% were black, 45% white, and 30% Hispanic, while 6% were of other racial or ethnic groups; 54% were insured. INTERVENTIONS: We developed a partner violence screen (PVS), consisting of 3 questions about past physical violence and perceived personal safety. We administered the PVS and 2 standardized measures of partner violence, the Index of Spouse Abuse (ISA) and the Conflict Tactics Scale (CTS). MAIN OUTCOME MEASURES: Sensitivity, specificity, and predictive values of the PVS were compared with the ISA and the CTS as criterion standards. RESULTS: The prevalence rate of partner violence using the PVS was 29.5% (95% confidence interval [CI], 24.6%-34.8%). For the ISA and CTS, the prevalence rates were 24.3% (95% CI, 19.2%-30.1 %) and 27.4% (95% CI, 21.7%-33.6%), respectively. Compared with the ISA, the sensitivity of the PVS in detecting partner abuse was 64.5%; the specificity was 80.3%. When compared with the CTS, sensitivity of the PVS was 71.4%; the specificity was 84.4%. Positive predictive values ranged from 51.3% to 63.4%, and negative predictive values ranged from 87.6% to 88.7%. Overall, 13.7% of visits were the result of acute episodes of partner violence. CONCLUSION: Three brief directed questions can detect a large number of women who have a history of partner violence.

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