African Emergency Medicine Journal | 16 January 2012
A Systematic Review of the HITS Tool's Diagnostic Yield for Intimate Partner Violence in Female Emergency Department Patients in the Western Cape, 2012
N, a, l, e, d, i, B, o, t, h, a, ,, L, i, n, d, i, w, e, v, a, n, d, e, r, M, e, r, w, e
Abstract
Intimate partner violence is a critical public health concern. Emergency departments are a key point of access for affected individuals. Systematic screening with validated tools like HITS (Hurt, Insult, Threaten, Scream) may improve detection, but its performance in local clinical contexts needs assessment. This systematic review aimed to synthesise evidence on the diagnostic yield of the HITS tool for systematic intimate partner violence screening among female patients aged 18–49 in a regional hospital emergency department in the Western Cape, South Africa. A systematic review was performed. Multiple electronic databases were searched for studies reporting on HITS tool screening within the specified population and setting. Data on screening yield and tool performance were extracted and synthesised narratively. The search identified a limited number of eligible studies. The available evidence suggests that systematic administration of the HITS tool identifies a substantial proportion of female emergency department patients at risk of intimate partner violence. One primary study reported a positive screen rate of approximately 22% in this cohort. The HITS tool shows a notable diagnostic yield for intimate partner violence in this emergency department setting, indicating its potential utility as a screening instrument. The current evidence base, however, remains sparse. Further rigorous research is required to confirm these findings and to evaluate the tool’s feasibility, acceptability, and impact on clinical referral pathways. Any implementation of routine screening should be supported by comprehensive staff training and clear management protocols. Intimate partner violence, domestic violence, emergency service, hospital, mass screening, diagnostic techniques and procedures, South Africa This review consolidates the specific evidence for using the HITS screening tool in a South African emergency department context, highlighting both its potential yield and the need for more extensive local research.