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December 9, 2009

Screening for Intimate Partner Violence—Reply

JAMA. 2009;302(22):2434-2435. doi:10.1001/jama.2009.1797

In Reply: Dr Jayatilleke and colleagues raise some important questions to consider in interpreting the findings of our trial. In response to the issue of participant discussions with clinicians, we performed a post hoc analysis within the screened group, comparing the recurrence of IPV among those who reported having a discussion with their clinician vs those who did not, and found no statistically significant difference. At 18 months' follow-up, the observed recurrence of IPV in the last 6 months was 51.4% (95% confidence interval [CI], 39.8%-62.9%) vs 42.5% (95% CI, 33.0%-51.9%), respectively. Reported violence at 6 months (64.1% [95% CI, 53.5%-74.7%] vs 54.3% [95% CI, 44.2%-64.5%], respectively) and at 12 months (51.9% [95% CI, 40.8%-63.1%] vs 48.5% [95% CI, 38.8%-58.3%], respectively) of follow-up showed a similar pattern: having a discussion with a clinician was not associated with a reduction in violence. Although we do not know what cues motivated the clinicians to discuss IPV with women, there is the opportunity to examine other factors such as IPV severity and specific risk indicators, such as marital status, and we plan to do so in future analyses.