Single Question vs Ongoing Violence Assessment Tool for Intimate Partner Violence Screening

Area of Science:

• Public Health
• Emergency Medicine
• Sociology

Background:

• Intimate partner violence (IPV) is a significant public health concern, with many victims seeking care in emergency departments (EDs).
• Effective IPV screening in busy ED settings remains a challenge, leading to underdetection of cases.
• This study evaluated brief IPV screening tools for improved ED implementation.

Purpose of the Study:

• To assess the efficacy of a single-question IPV screening tool and the 4-item Ongoing Violence Assessment Tool (OVAT).
• To compare these brief tools against the Index of Spouse Abuse (ISA), considered the gold standard for IPV assessment.
• To identify optimal strategies for IPV screening in emergency departments.

Main Methods:

• A prospective study enrolled 400 English-speaking female patients aged 18-55 in the ED.
• Participants were randomized to complete either the single-question tool or the OVAT, followed by the ISA and feedback surveys.
• Sensitivity, specificity, positive predictive value, and negative predictive value were calculated and compared using chi-square and Fisher exact tests.

Main Results:

• The single-question tool screened significantly faster (median 6 seconds) than the OVAT (median 13 seconds).
• The OVAT demonstrated higher sensitivity (75.0%) than the single-question tool (53.3%) when compared to the ISA.
• Specificity was high for both tools (94.1% for single-question, 92.8% for OVAT), with the OVAT having a higher negative predictive value (98.2%).

Conclusions:

• The time saved by the single-question tool offers minimal clinical benefit due to its lower sensitivity.
• The OVAT shows better performance in detecting IPV compared to the single question, despite a slightly longer screening time.
• Further research is essential to determine the most effective IPV screening tool for emergency department settings.