Multisite External Validation of a Clinical Screening Tool for Interpersonal Firearm Violence Risk.

Area of Science:

• Public Health
• Emergency Medicine
• Criminology

Background:

• Interpersonal firearm violence (FV) poses a significant public health concern, necessitating effective screening tools for prevention.
• Existing screening methods for FV risk among young adults in emergency settings are limited.

Purpose of the Study:

• To validate the 4-item, 10-point SaFETy (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) score for predicting 12-month FV risk.
• To assess the SaFETy score's predictive performance in a diverse population of young adults presenting to emergency departments.

Main Methods:

• A prospective longitudinal study was conducted in 4 level 1 emergency departments across 3 cities.
• 1506 adults aged 18-24 years were enrolled, with 12-month FV outcomes ascertained through self-report and medical record review.
• The SaFETy score was evaluated alongside demographic data, baseline injury, violence history, and mental health screening to predict FV.

Main Results:

• The SaFETy score demonstrated good predictive ability for 12-month FV, with an area under the receiver-operating characteristic curve (AUC) of 0.78.
• Individuals with higher SaFETy scores exhibited significantly increased rates of FV (e.g., 25.0% for scores ≥6 vs. 1.8% for scores of 0).
• Adding the SaFETy score to existing triage data improved prediction models, indicating its distinct predictive value.

Conclusions:

• The SaFETy score is a validated tool for predicting firearm violence risk in young adults within emergency department settings.
• The score provides valuable, distinct predictive information beyond commonly collected triage data.
• Implementation of the SaFETy score can enhance targeted prevention strategies for firearm violence.