Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Avenue (116B-3), Boston, MA, 02130, USA,
J Gen Intern Med. 2013 Oct;28(10):1288-93. doi: 10.1007/s11606-013-2534-x. Epub 2013 Jul 4.
Female Veterans are at high risk for physical, sexual, and psychological forms of intimate partner violence (IPV) victimization. This study evaluated the accuracy of a brief IPV victimization screening tool for use with female Veterans Health Administration (VHA) patients.
Participants completed a paper-and-pencil mail survey that included the four-item Hurt/Insult/Threaten/Scream (HITS) and the 39-item Revised Conflict Tactics Scales (CTS-2). Operating characteristics, including sensitivity and specificity, were calculated using the CTS-2 as the reference standard for past-year IPV.
Female veterans from a roster of randomly selected female patients of the New England VA Healthcare System. Women must have reported being in an intimate relationship in the past year to be included.
Primary measures included the HITS (index test) and the CTS-2 (reference standard).
This study included 160 women. The percentage of women who reported past-year IPV, as measured by any physical assault, sexual coercion, and/or severe psychological aggression on the CTS-2, was 28.8 %. The receiver-operator characteristic curve demonstrated that the HITS cutoff score of 6 maximizes the true positives while minimizing the false positives in this sample. The sensitivity of the optimal HITS cutoff score of 6 was 78 % (95 % CI 64 % to 88 %), specificity 80 % (95 % CI 71 % to 87 %), positive likelihood ratio 3.9 (95 % CI 2.61 to 5.76), negative likelihood ratio 0.27 (95 % CI 0.16 to 0.47), positive predictive value 0.61 (95 % CI 0.47, 0.73), and negative predictive value 0.90 (95 % CI 0.82, 0.95).
For a low-burden screen, the HITS demonstrated good accuracy in detecting past-year IPV relative to the CTS-2 in a sample of female VHA patients with an optimal cutpoint of 6. The HITS may help VHA and other health-care providers detect past-year IPV and deliver appropriate care for female Veterans.
女性退伍军人面临身体、性和心理形式的亲密伴侣暴力（IPV）受害的高风险。本研究评估了一种简短的 IPV 受害筛查工具在女性退伍军人事务部（VA）患者中的准确性。
参与者完成了一份纸质邮件调查，其中包括四项伤害/侮辱/威胁/尖叫（HITS）和 39 项修订冲突策略量表（CTS-2）。使用 CTS-2 作为过去一年 IPV 的参考标准，计算了操作特征，包括敏感性和特异性。
来自新英格兰 VA 医疗保健系统随机选择的女性患者名单中的女性退伍军人。女性必须报告在过去一年中处于亲密关系才能被包括在内。
主要措施包括 HITS（指标测试）和 CTS-2（参考标准）。
本研究包括 160 名女性。根据 CTS-2 测量，报告过去一年 IPV 的女性比例为任何身体攻击、性胁迫和/或严重心理攻击的比例为 28.8%。接收者操作特征曲线表明，在该样本中，HITS 得分 6 的最佳截断分数最大化了真阳性，同时最小化了假阳性。最佳 HITS 截断分数 6 的敏感性为 78%（95%CI 64%至 88%），特异性为 80%（95%CI 71%至 87%），阳性似然比为 3.9（95%CI 2.61 至 5.76），阴性似然比为 0.27（95%CI 0.16 至 0.47），阳性预测值为 0.61（95%CI 0.47，0.73），阴性预测值为 0.90（95%CI 0.82，0.95）。
对于低负担的筛查，HITS 在检测女性 VA 患者样本中过去一年的 IPV 方面表现出与 CTS-2 相当的准确性，最佳切点为 6。HITS 可能有助于 VA 和其他医疗保健提供者检测过去一年的 IPV 并为女性退伍军人提供适当的护理。
