How far does screening women for domestic (partner) - NIHR Health ...

DOI: 10.3310/hta13160 Health Technology Assessment 2009; Vol. 13: No. 16
Inclusion and
exclusion criteria
The generic criteria that applied to all seven
questions are listed in Tables 1 and 2.
Further question-specific criteria are listed below.
All criteria were applied independently by two
reviewers and disagreements were adjudicated by a
third reviewer.
Question I: What is the prevalence of partner violence
and its health consequences?
• Primary studies of prevalence restricted to UK
populations from 1995 onwards.
• Review of health consequences restricted to
systematic reviews from 1990 onwards.
Question II: Are screening tools valid and reliable?
• Included study designs had to be validation
studies, i.e. they evaluated a screening tool
against a standard criterion/comparator.
• The comparator had to have high sensitivity
and specificity.
• The comparator could have any number of
items, but the index screening tool had to
comprise 12 items or fewer. The rationale
behind this postprotocol decision was the
requirement for screening tools to be used in
a clinical, not research setting. Long screening
tools would be unsuitable due to the time
needed to complete them, and we chose 12
items as an arbitrary cut-off. This reduced
the number of screening tools reviewed but
improved the clinical applicability of our
findings.
• Studies were excluded if non-standardised
clinical interviews were used as the comparator.
Question III: Is screening for partner violence
acceptable to women?
• Studies only reporting women’s perceived
barriers to disclosure but not their views about
the acceptability of screening were excluded.
Question IV: Are interventions effective once partner
violence is disclosed in a health-care setting?
• Intervention studies on co-morbid populations
were included if all the participants had
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Chapter 3
Review methods
experienced partner violence or if the outcome
data for those who had experienced partner
violence were reported separately.
• Studies of interventions with children
were included if the mothers were also
involved; either the mothers received their
own interventions or they played a role in
interventions targeted at their children.
Question V: Can mortality or morbidity be reduced
following screening?
• Studies that measured mortality, morbidity
or quality of life outcomes for women were
included.
• Studies of screening intervention studies
that measured proxy measures that were
potentially associated with decreased morbidity
and mortality were included, particularly
documentation of abuse or referral to expert
partner violence services.
• Studies where documentation was limited to
recording the disclosure of abuse, without
recording more detailed information (about,
e.g., context, safety and, perhaps, the
perpetrator), were excluded.
• Studies reporting changes in identification
rates with no other outcomes were excluded.
• Studies that only reported one proxy outcome
were excluded, unless this was referral to
expert partner violence services.
Question VI: Is a partner violence screening
programme acceptable to health professionals and
the public?
• In addition to survey studies, intervention
studies reporting attitude change were
included and the before and after data
reported separately.
• We did not include studies addressing the issue
of whether screening is acceptable to male
members of the public.
• Papers that only reported on the perceived
barriers to screening were excluded.
• Studies were excluded if they only measured
screening behaviour without reporting attitudes
towards screening for partner violence.
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