Halpern Leslie R, Perciaccante Vincent J, Hayes Catherine, Susarla Seenu, Dodson Thomas B
Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA 02114, USA.
J Trauma. 2006 May;60(5):1101-5. doi: 10.1097/01.ta.0000218247.58465.db.
To better identify women at risk for intimate partner violence (IPV), we developed a diagnostic protocol composed of injury location and response to a verbal questionnaire to identify women at high risk for reporting an IPV-related injury etiology. The purpose of this study was to test the external validity of the protocol when applied at two institutions that differ considerably in terms of geography and socioeconomic measures.
A cross-sectional design was used at two demographically and geographically different hospitals, designated H1 and H2. The sample was composed of adult females age >or=18 years presenting to the emergency department (ED) for evaluation and management of nonverifiable traumatic injuries. The predictor variable was risk for reporting an IPV-related injury. Risk was categorized per the protocol as high or low. High-risk subjects had visible head, neck, or face (HNF) injuries and positive responses to the questionnaires. Low-risk subject had non-HNF injuries or negative responses to the screening questionnaires. The outcome variable was self-reported injury etiology classified as IPV-related or other. Descriptive and bivariate statistics and standard measurements for a diagnostic test were computed.
The sample was composed of 400 subjects, with 200 subjects enrolled at each institution. Self-reported IPV was 34% and 9.5% at H1 and H2, respectively. The protocol classified 33% (H1) and 18% (H2) of subjects as high risk. Sensitivities were 90% (H1) and 74% (H2). Specificities were 96% (H1) and 88% (H2). Subjects classified per protocol as high-risk had an 18-fold (p < 0.01, H1) and 13-fold (p < 0.01, H2) increased risk for reporting IPV-related injuries.
Despite significant geographic and socioeconomic differences between the two hospitals, the results suggest that our protocol may be applicable in disparate clinical settings.
为了更好地识别亲密伴侣暴力（IPV）风险较高的女性，我们制定了一种诊断方案，该方案由损伤部位及对一份口头调查问卷的回答组成，用于识别报告与IPV相关损伤病因风险较高的女性。本研究的目的是在地理和社会经济指标差异很大的两家机构应用该方案时，检验其外部有效性。
在两家人口统计学和地理特征不同的医院（分别指定为H1和H2）采用横断面设计。样本由年龄≥18岁、因不可核实的创伤性损伤到急诊科（ED）进行评估和治疗的成年女性组成。预测变量是报告与IPV相关损伤的风险。根据该方案，风险分为高风险或低风险。高风险受试者有可见的头部、颈部或面部（HNF）损伤且对问卷回答为阳性。低风险受试者有非HNF损伤或对筛查问卷回答为阴性。结果变量是自我报告的损伤病因，分为与IPV相关或其他。计算了诊断试验的描述性和双变量统计量以及标准测量值。
样本由400名受试者组成，每家机构招募200名受试者。H1和H2自我报告的IPV分别为34%和9.5%。该方案将33%（H1）和18%（H2）的受试者分类为高风险。敏感性分别为90%（H1）和74%（H2）。特异性分别为96%（H1）和88%（H2）。根据方案分类为高风险的受试者报告与IPV相关损伤的风险增加了18倍（p<0.01，H1）和13倍（p<0.01，H2）。
尽管两家医院在地理和社会经济方面存在显著差异，但结果表明我们的方案可能适用于不同的临床环境。
