FiGHTS: a preliminary screening tool for adolescent firearms-carrying

Ann Emerg Med. 2003 Dec;42(6):798-807. doi: 10.1016/S0196064403007224.


Study objective: Adolescent firearms-carrying is a risk factor for serious injury and death. Clinical screening tools for firearms-carrying have not yet been developed. We present the development of a preliminary screening test for adolescent firearms-carrying based on the growing body of knowledge of firearms-related risk factors.

Methods: A convenience sample of 15,000 high school students from the 1999 National Youth Risk Behavior Survey was analyzed for the purpose of model building. Known risk factors for firearms-carrying were candidates for 2 models predicting recent firearms-carrying. The "brief FiGHTS score" screening tool excluded terms related to sexual behavior, significant substance abuse, or criminal behavior (Fi=fighting, G=gender, H=hurt while fighting, T=threatened, S=smoker). An "extended FiGHTS score," which included 13 items, was developed for more precise estimates.

Results: The brief FiGHTS score had a sensitivity of 82%, a specificity of 71%, and an area under the receiver operating characteristic (ROC) curve of 0.84. The extended FiGHTS score had an area under the ROC curve of 0.90. Both models performed well in a validation data set of 55,000 students.

Conclusion: The brief and extended FiGHTS scores have high sensitivity and specificity for predicting firearms-carrying and may be appropriate for clinical testing.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Female
  • Firearms / statistics & numerical data*
  • Humans
  • Male
  • Mass Screening / instrumentation*
  • Risk Factors
  • Risk-Taking*
  • Sensitivity and Specificity
  • Sex Factors
  • Smoking / epidemiology
  • United States / epidemiology
  • Violence / statistics & numerical data