Accuracy of an Intimate Partner Violence Screening Tool for Female VHA Patients: A Replication and Extension

The 4‐item Hurt/Insult/Threaten/Scream (HITS) tool accurately detects past‐year intimate partner violence (IPV) among female Veterans Health Administration (VHA) patients; however, it lacks a sexual IPV item. This study evaluated the accuracy of an extended HITS (E‐HITS), which adds a sexual IPV item, in female VHA patients. A sample of 80 female U.S. veteran VHA patients in New England completed a mail survey (50.0% response rate) that included the 5‐item E‐HITS and the Revised Conflict Tactics Scales (CTS‐2). Women were included if they were in an intimate relationship in the past year. The women averaged 49 years of age and 86.0% of the sample was White. Accuracy of the 4‐item HITS was compared to the 5‐item E‐HITS, using the CTS‐2 as the reference. There were 20 women (25.0%) who reported past‐year IPV on the CTS‐2. The receiver operator characteristic curves demonstrated that the HITS and E‐HITS performed nearly identically at their optimal cutoff scores of 6 and 7, respectively. At these cutoff scores, the sensitivity of both tools was .75, 95% CI [.55, .95]. The specificities were similar; .83 for the HITS, 95% CI [.73, .92], and .82 for the E‐HITS, 95% CI [.72, .90]. Including a sexual IPV item may be clinically beneficial; it also attains the same accuracy of case identification as the HITS. Resumen El instrumento de 4 ítems HITS (Hurt/Insult/Threaten/Scream) detecta en forma precisa la violencia en la pareja (IPV) en el último año entre pacientes mujeres de la Administración de Salud de Veteranos (VHA); sin embargo, carece de un ítem de IPV de tipo sexual. Este estudio evaluó la precisión de un HITS extendido (E‐HITS), que agrega un ítem de IPV sexual, en pacientes de sexo femenino de VHA. Una muestra de 80 mujeres veteranas de EUA, pacientes de VHA en New England, completaron una encuesta (Tasa de respuesta de 50%) que incluyó el E‐HITS de 5 ítems y el Revised Confict Tactics Scales (CTS‐2). Fueron incluidas las mujeres que estuvieron en una relación el último año. El promedio de edad fue de 49 años y el 86% de la muestra era de raza blanca. La precisión del HITS de 4 ítems fue comparada a la del E‐HITS de 5 ítems usando la CTS‐2 como referencia. Hubo 20 mujeres (25%) que reportaron IPV del último año en el CTS‐2. Las curvas de Características Operativas del Receptor (ROC) demostraron que el HITS y el E‐HITS rindieron de forma prácticamente idéntica en sus puntajes de corte óptimos de 6 y 7, respectivamente. En esos puntajes de corte, la sensibi