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

JAMA. 1997 May 7;277(17):1357-61.


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.

MeSH terms

  • Adult
  • Colorado
  • Emergency Service, Hospital*
  • Female
  • Humans
  • Mass Screening
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prospective Studies
  • Sensitivity and Specificity
  • Socioeconomic Factors
  • Spouse Abuse / diagnosis*
  • Spouse Abuse / ethnology
  • Spouse Abuse / prevention & control
  • Urban Population