STaT: A Three-Question Screen for Intimate Partner Violence

Abstract

Objective:

To develop a simple, sensitive screening tool for lifetime intimate partner violence (IPV) in women.

Methods:

In the emergency department (ED) of an urban teaching hospital, 75 English-speaking women between 18 and 64 years old were tested. The sensitivity and specificity of 43 dichotomous response-option, IPV screening questions were compared. The reference standard was lifetime IPV, determined by a semistructured interview, using preset criteria of specific violence acts or emotional control or both by an intimate partner. Questions with high sensitivity (>70%) were tested together against the reference standard. Answering yes to any question scored 1 point. Content area and the area under receiver-operator curve (AUROC) of the screening questions determined the final tool.

Results:

Sixty-three percent of women reported lifetime IPV. Eight of the 43 screening questions had a sensitivity of >70%. After testing possible combinations, the final three-question screen, STaT had the highest AUROC. The STaT questions are: "Have you ever been in a relationship where your partner has pushed or Slapped you?" "Have you ever been in a relationship where your partner Threatened you with violence?" and "Have you ever been in a relationship where your partner has thrown, broken or punched Things?" The sensitivity (95% confidence intervals [95% CI]) of STaT for lifetime IPV is 96%(90%, 100%), 89% (81%, 98%), and 64% (50%, 78%) for a score of ≥1, ≥2, and 3, respectively. The corresponding specificity is 75% (59%-91%), 100%, and 100%.

Conclusions:

Three simple questions when used together can effectively identify lifetime IPV and will aid clinicians' efforts to identify abuse in women.