How radiologists can help identify victims of domestic violence
Radiologists are not typically involved in the treatment of patients who have experienced domestic violence, but there are several signs providers can be on the lookout for to spot potential victims.
A team of experts detailed some of those findings in a new analysis published in the Journal of the American College of Radiology.
“Intimate partner violence (IPV) often remains undetected due to both patient and provider factors including reluctance to disclose abuse, limited training of health care workers to recognize IPV warning signs, and time constraints on clinical encounters,” explained Bharti Khurana, MD, from Brigham and Women’s Hospital Trauma Imaging Research and Innovation Center, and colleagues. “These issues are exaggerated in emergency or urgent care settings due to the rapid pace of care delivery and lack of longitudinal relationships between patients and providers. Objective and systematic analysis of radiologic studies provides an opportunity for earlier IPV detection in patients who are not yet ready to disclose.”
Prior to the COVID-19 pandemic, it was estimated that up to 47% of women in the United States had experienced some type of IPV during their lives. Numerous reports have indicated that COVID lockdowns exacerbated the issue, likely resulting in significantly more instances than in the years prior.
Unfortunately, it isn't always obvious that a patient has been subjected to IPV. Given their limited patient interaction, it can be especially difficult for radiologists to determine whether injuries stem from IPV. This latest analysis was done to help radiologists detect patterns that could signal a patient is experiencing domestic violence.
For their work, the team retrospectively analyzed hundreds of cases of women who reported IPV in medical settings. They assessed all imaging exams completed on the cohort, both at the time of their reporting and in other general imaging settings (routine mammograms, for example). The group took note of imaging frequency, time, location of service and injury patterns and compared their findings to a group of age- and race-matched controls not reporting IPV.
Through this, the team made these observations:
Women reporting IPV undergo imaging more often than those who do not.
IPV victims are more likely to cancel routine mammograms.
IPV victims are most often seen in emergency departments, during overnight shifts and on weekends.
Injuries are more common among women who report IPV, particularly cranial, facial and thoracic injuries.
These women more often present with multiple injuries during a single visit or have numerous encounters with unique injuries at each visit.
“Early detection is critical but challenging, and imaging can play an important role in this task,” the authors noted. “This analysis expands our understanding by considering all available imaging data rather than only imaging studies performed in a particular time window around the initial reporting of IPV and by assessing new features such as temporal patterns, ED imaging utilization, and cancellation and completion rates of screening examinations.”
The team suggested that radiologists should take a moment to take note of a patient’s imaging history if they have any suspicion they may be experiencing domestic violence. In doing so, they could help patients’ care teams to investigate further and potentially intervene.
Learn more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.