RESEARCH

Intimate partner violence (IPV) is a pervasive and critical public health problem, defined as physical, sexual, and emotional violence between partners or former partners. Despite its widespread occurrence, IPV remains significantly underdiagnosed due to victims’ fear, societal stigma, and barriers faced by healthcare providers. Early detection is vital to prevent the escalation of IPV into life-threatening situations. However, the current screening tools capture only a fraction of cases, highlighting the urgency for improved early detection to address this critical unmet medical and social need.

Scope of the problem

• According to the National Intimate Partner and Sexual Violence Survey (NISVIS), a third of women (37.3%) and men (30.9%) experience IPV in their lifetime and 23.2% of women and 13.9% of men have experienced severe physical violence by an intimate partner.
  – Smith SG, Zhang X, Basile KC, Merrick MT, Wang J, Kresnow M, Chen J. The National Intimate Partner and Sexual Violence Survey: 2015 Data Brief – Updated Release 2018.
• The consequences of IPV extend far beyond the immediate abuse, leading to adverse health outcomes that persist long after the abuse ends. The frequency and severity of abusive behavior can escalate over time, with the level of severity acting as a critical predictor of potential homicides.
  Miller E, McCaw B. Intimate Partner Violence. N Engl J Med. 2019 Feb 28;380(9):850-7.
• A staggering 55-58% of female homicides in the United States are committed by their intimate partner or family members. More than 70% of all murder suicides involve an intimate partner, with women representing 94% of victims.
  – Data Source
• The financial toll of IPV is substantial, surpassing $8.3 billion annually. Based on an estimated 43 million IPV victims, the lifetime economic burden amounts to a staggering $3.6 trillion, with government sources shouldering approximately $1.3 trillion of this burden.
  – Peterson C, Kearns MC, McIntosh WL, Estefan LF, Nicolaidis C, McCollister KE, Gordon A, Florence C. Lifetime Economic Burden of Intimate Partner Violence Among U.S. Adults. Am J Prev Med. 2018 Oct;55(4):433-44.

We are creating new tools to empower healthcare providers to effectively identify and aid patients who may be experiencing IPV. Our goal is to create an integrated system that harnesses the power of expert analysis, historical imaging, and clinical data to detect and classify injuries based on their likelihood of being caused by IPV. By implementing this system, we aim to streamline the process and automatically notify clinicians when a patient’s injuries indicate a low or high-risk probability of IPV.

Technology

Automated clinical decision support tool for Intimate Partner Violence Risk and Severity Prediction – AIRS 

 Distinguishing features of AIRS

• The AIRS tool is based on the integrated Holistic Artificial Intelligence for Medicine (HAIM) framework and uses both structured and unstructured data extracted from Electronic Medical Records (EMR). Our innovative AI algorithms, meticulously developed through interdisciplinary research and expert input, offer profound insights into the nature and potential ramifications of IPV for both patients and providers.
• By leveraging the power of technology, AIRS automatically analyzes patient data, generates a probability score for IPV, and assesses the potential severity of injuries. This automated alert is delivered at the point of care, enabling healthcare providers to address IPV concerns with their patients promptly.
• The AIRS tool represents a significant advancement in objectively identifying IPV by eliminating unconscious human bias. It incorporates a range of strategies to mitigate bias and enhance its objectivity, interpretability, and transparency.
• Our integrated system emphasizes privacy, security, and ethical considerations. We adhere to strict protocols to protect patient data confidentiality while ensuring healthcare providers have access to the necessary information for making informed decisions in an unbiased, objective manner.
• Furthermore, AIRS surpasses mere detection by offering “caring conversations” guides specifically designed for healthcare and social workers. By incorporating trauma-informed care principles, these guides provide invaluable support in engaging with patients identified by the AIRS tool, offering a wealth of resources, and aiding in creating safety plans.

• Our primary objective is to equip clinicians with comprehensive tools, classification models, statistical evidence, and alert systems, instilling greater confidence and robustness in their findings. This empowerment enables clinicians to initiate crucial conversations with their patients about IPV.
• Unlike existing approaches reliant on online or paper screening forms and healthcare provider interviews, which have demonstrated low detection rates, our solution, AIRS, ensures consistent and reliable screening for IPV in healthcare settings.
• By intervening at an early stage, we can prevent adverse physical, mental, and social consequences associated with IPV. This proactive approach has the potential to create a ripple effect, positively transforming the lives of patients and their families. Furthermore, it strengthens the medical community’s role in identifying IPV and takes a significant step toward breaking the silence surrounding IPV within our society.
• Our ultimate vision is to create a healthcare landscape where IPV is promptly identified and effectively addressed, supporting survivors to break free from the cycle of violence. Equipping clinicians with powerful tools and raising awareness, we aim for a lasting impact on individuals, families, and communities affected by IPV.