Garcia-Esteve Lluïsa, Torres Anna, Navarro Purificación, Ascaso Carlos, Imaz Maria Luisa, Herreras Zoe, Valdés Manuel
Servicio de Psiquiatría, Institut Clínic de Neurociències, Barcelona, España.
Med Clin (Barc). 2011 Oct 8;137(9):390-7. doi: 10.1016/j.medcli.2010.11.038. Epub 2011 Jul 14.
To validate four instruments to detect domestic violence in health-care settings against external criteria -Index of Spouse Abuse (ISA), Psychological Maltreatment of Women Inventory short form (PMWI-SF), Woman Abuse Screening Tool (WAST), Partner Violence Screen (PVS)- and to assess the concordance and compare the diagnostic accuracy.
This was a case-control study. The study sample was recruited from primary care and domestic violence centers. The ISA, PMWI-SF, WAST and PVS were administered to 223 controls and 182 intimate partner violence cases. Received Operating Characteristic (ROC) curve analysis was carried out. Measures were compared in terms of ROC curves and overall agreement.
The areas under the curve (AUC) were: ISA 0.99 (IC 95%, 0.98-0.99), PMWI-SF 0.98 (IC 95% 0.97-0.99), WAST 0.95 (IC 95% 0.93-0.97), PVS 0.91 (IC 95% 0.87-0.94). The overall agreement between the four tools was excellent (Fleiss Kappa=0.82). The ISA and the PMWI-SF performed slightly better than WAST, and these three instruments performed better than PVS for detecting domestic violence. The PVS had lower concordance values with the other instruments.
The four instruments demonstrated adequate diagnostic accuracy and overall agreement for detect domestic violence. Some overestimation of sensitivity may occur due to different source of cases.
验证四种在医疗机构中检测家庭暴力的工具，以对照外部标准——配偶虐待指数（ISA）、妇女心理虐待量表简版（PMWI-SF）、妇女虐待筛查工具（WAST）、伴侣暴力筛查量表（PVS）——并评估一致性，比较诊断准确性。
这是一项病例对照研究。研究样本从初级保健机构和家庭暴力中心招募。对223名对照者和182名亲密伴侣暴力案件受害者施测ISA、PMWI-SF、WAST和PVS。进行了受试者工作特征（ROC）曲线分析。根据ROC曲线和总体一致性对各项测量指标进行比较。
曲线下面积（AUC）分别为：ISA为0.99（95%置信区间，0.98 - 0.99），PMWI-SF为0.98（95%置信区间0.97 - 0.99），WAST为0.95（95%置信区间0.93 - 0.97），PVS为0.91（95%置信区间0.87 - 0.94）。这四种工具之间的总体一致性极佳（Fleiss卡帕系数 = 0.82）。ISA和PMWI-SF在检测家庭暴力方面的表现略优于WAST，这三种工具的表现均优于PVS。PVS与其他工具的一致性值较低。
这四种工具在检测家庭暴力方面显示出足够的诊断准确性和总体一致性。由于病例来源不同，可能会出现对敏感性的一些高估。
