Using Radiology as a Screening Tool to Identify Intimate Partner Violence

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2025.01.003

Patrick J. Lenehan MD, PhD , Anji Tang MD , Gaurav V. Watane MD , Rahul Gujrathi MD , Hyesun Park MD , Babina Gosangi MD , Richard Thomas MD , Felipe Boschini Franco MD , Krishna Patel MPH , Ilana Warsofsky MD , Bernard Rosner PhD , Bharti Khurana MD, MBA

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引用次数: 0

Abstract

Objective

To identify imaging utilization patterns and radiologically evident injuries suggestive of intimate partner violence (IPV).

Methods

This retrospective case-control study analyzed historical imaging reports from women reporting physical IPV between 2013 and 2018 (“cases”; n = 265; 6,401 imaging studies) and age- and race-matched controls not reporting IPV (n = 875; 13,462 imaging studies). Adjusted incidence rate ratios (aIRRs) were calculated using Poisson regression to compare imaging utilization by organ system or modality. Logistic regression calculated adjusted odds ratios (aORs) for canceled studies and studies conducted in the emergency department (ED), overnight, or on weekends. Injury patterns were assessed by calculating aIRRs of injury by anatomic site and comparing synchronous and asynchronous injury detection. A time-to-event analysis using Cox proportional hazards regression compared the cumulative incidence of asynchronous injury in patients with at least one injury.

Results

Patients experiencing IPV underwent imaging at a higher rate than controls (aIRR: 1.5, 95 confidence interval [CI]: 1.5-1.6). They were more likely to cancel screening mammograms (aOR: 3.2, 95% CI: 1.8-5.7) and undergo imaging in the ED (aOR: 3.8, 95% CI: 2.9-5.0), overnight (aOR: 1.6, 95% CI: 1.3-1.9) and on weekends (aOR: 1.3, 95% CI: 1.1-1.5). The injury rate was higher in cases (aIRR: 15.1, 95% CI: 12.5-18.1), particularly for cranial (aIRR: 104.5, 95% CI: 14.2-770.1), facial (aIRR: 47.0, 95% CI: 18.9-117.0), and thoracic (aIRR: 32.6, 95% CI: 11.5-92.2) injuries. Cases were more likely to have multiple injuries in a single encounter (aOR: 4.7, 95% CI: 1.5-14.1) or multiple encounters with unique injuries (hazard ratio: 4.9, 95% CI: 2.6-9.3).

Conclusion

Patients experiencing IPV had higher rates of imaging studies, imaging utilization in the ED, weekend, and overnight settings, screening examination cancellation, and radiologically evident injuries than controls.

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使用放射学作为识别亲密伴侣暴力的筛查工具

目的探讨亲密伴侣暴力（IPV）的影像学应用模式和影像学表现。方法本回顾性病例对照研究分析了2013年至2018年报告身体IPV的女性的历史影像学报告(“病例”；N = 265；6401个影像学研究)和年龄和种族匹配的对照组未报告IPV (n = 875；13462个影像学研究)。使用泊松回归计算校正发病率比（airr），比较不同器官系统或模式的成像利用率。Logistic回归计算了取消研究和在急诊科（ED）、夜间或周末进行的研究的调整优势比（aORs）。通过计算各解剖部位损伤的airr并比较同步和异步损伤检测来评估损伤模式。使用Cox比例风险回归的时间-事件分析比较了至少有一次损伤的患者的非同步损伤的累积发生率。结果IPV患者接受影像学检查的比例高于对照组（aIRR: 1.5, 95可信区间[CI]: 1.5-1.6）。他们更有可能取消乳房x光筛查（aOR: 3.2, 95% CI: 1.8-5.7），并在急诊科（aOR: 3.8, 95% CI: 2.9-5.0）、夜间（aOR: 1.6, 95% CI: 1.3-1.9）和周末（aOR: 1.3, 95% CI: 1.1-1.5）接受影像学检查。损伤率在病例中较高（aIRR: 15.1, 95% CI: 12.5-18.1），特别是颅脑损伤（aIRR: 104.5, 95% CI: 14.2-770.1）、面部损伤（aIRR: 47.0, 95% CI: 18.9-117.0）和胸部损伤（aIRR: 32.6, 95% CI: 11.5-92.2）。病例更有可能在一次接触中出现多处损伤（aOR: 4.7, 95% CI: 1.5-14.1）或多次接触中出现独特损伤（风险比：4.9,95% CI: 2.6-9.3）。结论与对照组相比，IPV患者有更高的影像学检查率、在急诊科、周末和过夜的影像学使用率、筛查检查取消率和影像学上明显的损伤率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.