TY  - JOUR
T1  - Screening for intimate partner violence in health care settings: A randomized trial
AU  - MacMillan HL, Wathen C, Jamieson E, et al
Y1  - 2009/08/05
N1  - 10.1001/jama.2009.1089
JO  - JAMA
SP  - 493
EP  - 501
VL  - 302
IS  - 5
N2  - Context 
                  Whether intimate partner violence (IPV) screening reduces violence or improves health outcomes for women is unknown.Objective 
                  To determine the effectiveness of IPV screening and communication of positive results to clinicians.Design, Setting, and Participants 
                  Randomized controlled trial conducted in 11 emergency departments, 12 family practices, and 3 obstetrics/gynecology clinics in Ontario, Canada, among 6743 English-speaking female patients aged 18 to 64 years who presented between July 2005 and December 2006, could be seen individually, and were well enough to participate.Intervention 
                  Women in the screened group (n=3271) self-completed the Woman Abuse Screening Tool (WAST); if a woman screened positive, this information was given to her clinician before the health care visit. Subsequent discussions and/or referrals were at the discretion of the treating clinician. The nonscreened group (n=3472) self-completed the WAST and other measures after their visit.Main Outcome Measures 
                  Women disclosing past-year IPV were interviewed at baseline and every 6 months until 18 months regarding IPV reexposure and quality of life (primary outcomes), as well as several health outcomes and potential harms of screening.Results 
                  Participant loss to follow-up was high: 43% (148/347) of screened women and 41% (148/360) of nonscreened women. At 18 months (n = 411), observed recurrence of IPV among screened vs nonscreened women was 46% vs 53% (modeled odds ratio, 0.82; 95% confidence interval, 0.32-2.12). Screened vs nonscreened women exhibited about a 0.2-SD greater improvement in quality-of-life scores (modeled score difference at 18 months, 3.74; 95% confidence interval, 0.47-7.00). When multiple imputation was used to account for sample loss, differences between groups were reduced and quality-of-life differences were no longer significant. Screened women reported no harms of screening.Conclusions 
                  Although sample attrition urges cautious interpretation, the results of this trial do not provide sufficient evidence to support IPV screening in health care settings. Evaluation of services for women after identification of IPV remains a priority.Trial Registration 
                  clinicaltrials.gov Identifier: NCT00182468
SN  - 0098-7484
M3  - doi: 10.1001/jama.2009.1089
UR  - http://dx.doi.org/10.1001/jama.2009.1089
ER  -