Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 7 , Pages 1453-1459, July 2009

A Comparison of 2 Protocols to Detect Intimate Partner Violence

  • Leslie R. Halpern, DDS, MD, PhD, MPH

      Affiliations

    • Assistant Surgeon, Faculty, Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Assistant Professor, Harvard School of Dental Medicine, Boston, MA
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Halpern: Massachusetts General Hospital, 55 Fruit St, Warren Bldg, Suite 1201, Boston, MA 02114
  • ,
  • Blair A. Parry, CCRC, BA

      Affiliations

    • Research Coordinator, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Gregory Hayward, BA

      Affiliations

    • Research Assistant, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • David Peak, MD

      Affiliations

    • Instructor, Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
  • ,
  • Thomas B. Dodson, DMD, MPH

      Affiliations

    • Visiting Oral and Maxillofacial Surgeon and Director, Center for Applied Clinical Investigation, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, and Associate Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA

Purpose

Intimate partner violence (IPV) frequently results in maxillofacial injuries. The purpose of this study is to compare 2 protocols to identify women who self-report IPV-related injuries.

Materials and Methods

Using a cross-sectional study design, we enrolled a sample of injured women who presented to the emergency department (ED) for evaluation and treatment. The predictor variable was the protocol used to identify injury etiology, that is, an innovative diagnostic protocol (DP) or the ED's standard operating procedure (SOP). The outcome variable was self-reported injury etiology categorized as IPV or other. Descriptive and bivariate statistics were computed. Sensitivity, specificity, positive predictive value, negative predictive value, and odds ratios were computed (with P ≤ .05 being considered statistically significant).

Results

The sample was composed of 286 women with a mean age of 45.8 years. The self-reported prevalence of IPV-related injuries was 11.5% and 5% for the DP and SOP, respectively (P = .03). The diagnostic statistics for the DP and SOP, respectively, were as follows: sensitivities, 94% and 50%; specificities, 76% and 95%; positive predictive values, 34% and 50%; and negative predictive values, 98% and 95%. In the adjusted model the women evaluated with the DP had a 38-fold increased likelihood of reporting IPV (P < .01) when compared with the SOP.

Conclusions

These results suggest that the proposed DP is associated with an increased frequency of self-reported IPV-related injuries when compared with the ED's SOP.

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 This study was supported in part by the Department of Oral and Maxillofacial Surgery's Education and Research Fund and the Center for Applied Clinical Investigation, as well as the Massachusetts General Physicians Organization (L.R.H., T.B.D.).

PII: S0278-2391(09)00278-X

doi:10.1016/j.joms.2009.03.003

Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 7 , Pages 1453-1459, July 2009