Oregon Evidence-based Practice Center, Oregon Health & Science University, Portland, OR 97239, USA.
Ann Intern Med. 2012 Jun 5;156(11):796-808, W-279, W-280, W-281, W-282. doi: 10.7326/0003-4819-156-11-201206050-00447. Epub 2012 May 7.
In 2004, the U.S. Preventive Services Task Force determined that evidence was insufficient to support screening women for intimate partner violence (IPV).
To review new evidence on the effectiveness of screening and interventions for women in health care settings in reducing IPV and related health outcomes, the diagnostic accuracy of screening instruments, and adverse effects of screening and interventions.
MEDLINE and PsycINFO (January 2002 to January 2012), Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews (through fourth quarter 2011), Scopus, and reference lists.
English-language trials of the effectiveness of screening and interventions, diagnostic accuracy studies of screening instruments, and studies of any design about adverse effects.
Investigators extracted data about study populations, designs, and outcomes and rated study quality by using established criteria.
A large fair-quality trial of screening versus usual care indicated reduced IPV and improved health outcomes for both groups, but no statistically significant differences between groups. Fifteen fair- and good-quality studies evaluated 13 screening instruments, and six instruments were highly accurate. Four fair- and good-quality trials of counseling reported reduced IPV and improved birth outcomes for pregnant women, reduced IPV for new mothers, and reduced pregnancy coercion and unsafe relationships for women in family-planning clinics. Fourteen studies indicated minimal adverse effects with screening, but some women experienced discomfort, loss of privacy, emotional distress, and concerns about further abuse.
Trials were limited by heterogeneity, lack of true control groups, high loss to follow-up, self-reported measures, and lack of accepted reference standards.
Screening instruments accurately identify women experiencing IPV. Screening women for IPV can provide benefits that vary by population, while potential adverse effects have minimal effect on most women.
Agency for Healthcare Research and Quality.
2004 年，美国预防服务工作组确定，没有足够的证据支持对女性进行亲密伴侣暴力（IPV）筛查。
综述有关在医疗保健环境中对女性进行 IPV 筛查和干预以减少 IPV 及相关健康结局、筛查工具的诊断准确性以及筛查和干预的不良影响的新证据。
MEDLINE 和 PsycINFO（2002 年 1 月至 2012 年 1 月）、Cochrane 对照试验中心注册库和 Cochrane 系统评价数据库（截至 2011 年第四季度）、Scopus 和参考文献列表。
英文语言的筛查和干预效果试验、筛查工具的诊断准确性研究以及任何设计的不良影响研究。
调查人员提取有关研究人群、设计和结局的数据，并使用既定标准对研究质量进行评分。
一项大型、高质量的筛查与常规护理比较试验表明，两组的 IPV 均减少，健康结局改善，但两组间无统计学差异。15 项公平和高质量的研究评估了 13 种筛查工具，其中 6 种工具具有高度准确性。4 项公平和高质量的咨询试验报告称，妊娠妇女的 IPV 减少，生育结局改善，新妈妈的 IPV 减少，计划生育诊所的妇女妊娠胁迫和不安全关系减少。14 项研究表明，筛查的不良影响最小，但有些妇女感到不适、隐私受损、情绪困扰以及对进一步受虐的担忧。
试验受到异质性、缺乏真正的对照组、高失访率、自我报告的测量方法以及缺乏公认的参考标准的限制。
筛查工具能准确识别经历 IPV 的女性。对女性进行 IPV 筛查可以为不同人群带来益处，而潜在的不良影响对大多数女性的影响最小。
医疗保健研究与质量署。
