Radiologists could be trained to spot and report signs of domestic violence after study shows doctors are able to spot abuse patterns on patient scans
- Doctors at Brigham & Women’s hospital analyzed patient scans to detect signs of abuse
- Compared to reports, they were able to successfully identify those who were at risk of intimate partner violence
- Radiologists already identify and report signs of pediatric violence
- This new study calls for training of doctors to do the same to spot violence inflicted on partners
Radiologists could play a crucial role in spotting domestic violence, according to new research.
They are already key in pediatrics – identifying, reporting and being consulted about whether an injury may have been inflicted abusively.
That’s because there has been a push to train radiologists to spot certain patterns and signs of violent injury in kids.
But new research shows the same could be done for victims of intimate partner violence (IPV), helping clinicians to identify patients who may be at high risk of abuse but are not forthcoming.
The next step would be to train radiologists, clinicians and social workers on how to discuss these physiological symptoms with victims to make them feel safe.
This scan featured in the study, showing how radiologists could identify signs of abuse. It shows a CT image of a 46-year-old woman’s head after an assault by her boyfriend resulting in loss of consciousness. Doctors could spot a left-sided parietal subdural hematoma (arrow)
WHAT IS INTIMATE PARTNER VIOLENCE?
Intimate partner violence is an umbrella term that encompasses various types of abuse inflicted by an intimate partner.
An intimate partner could be someone:
- with whom you have regular contact
- with whom you have sexual contact
- with whom you have an emotional connection
- with whom you identify as a ‘couple’
- you know about one another’s lives
- who is an emotional ‘rival’
- who is a lover’s spouse
Intimate partner violence is abuse inflicted by a former or current partner. It may include:
- physical violence
- sexual violence
- psychological aggression
- coercive acts (a pattern of intimidation, degradation, isolation and control with the use or threat of physical or sexual violence)
- financial abuse
- harassment and stalking
- online/digital abuse
Episodes of IPV can be one-off, they can happen periodically for years, or consistently.
Sources: Level Up and CDC
Millions of women are victims of IPV – defined as physical, sexual or psychological harm by a current or former partner or spouse.
Study principal investigator Dr Bharti Khurana, a radiologist at Brigham and Women’s Hospital and Assistant Professor of radiology at Harvard Medical School, said: ‘Medical images can offer early clues of IPV based on location and pattern of both new and old injuries.’
For the study, electronic medical records from 185 patients referred by Brigham and Women’s Hospital Emergency Department to the intimate partner violence support program were reviewed and compared to an age and sex-matched control group of 555 patients seen in the emergency department.
Reports of all patient imaging exams performed within the preceding five years were also reviewed.
The researchers found that almost all of the intimate partner violence victims were women (96 percent). Victims had an average age of 34.2.
Victims of intimate partner violence, on average, underwent around four times more imaging exams in the preceding five years compared to the control group.
Acute fractures and obstetric findings – such as pregnancy loss – were associated with two to four times higher odds of domestic violence.
Study first author Dr Elizabeth George said: ‘Our study suggests that these otherwise common findings could be indicative of intimate partner violence in the setting of specific socio-economic factors identified in our study.’
The research team found that intimate partner violence victims were more likely to be homeless (28 percent), have a psychiatric history (64 percent) or have a substance use disorder (24 percent), compared to patients who were not victims.
The team found that physical abuse was the most common form of intimate partner violence (84 percent), but that patients also complained of emotional and verbal abuse (44 percent). Sexual abuse was seen in 15 percent of victims.
Dr Khurana said: ‘Radiologists are in a unique position to share objective findings unbiased by interactions with the victim and potential abuser.
‘Encouraged by the early results, we have now expanded the study to include colleagues from orthopedics, primary care, women’s health, social work, legal, and two additional Boston hospitals.’
She said the ultimate goal of the research is to develop an integrated system that uses patterns derived from expert analysis of historical imaging and clinical data, detects and classifies injuries, and automatically alerts doctors if a patient’s injuries have low or high-risk probability for being the result of intimate partner violence.
For the next phase of the study, the research team plan to use machine learning to recognize signs of intimate partner violence and create an alert system for greater confidence in findings, empowering health care providers to open a dialogue with their patients.
Dr Khurana added: ‘In addition, our multidisciplinary team will design conversational guides using medical images for training for social workers and clinicians to approach the patients who are identified as being at high risk for intimate partner violence and are not forthcoming.’
The findings were published in the journal Radiology.
- For confidential support (UK), call the national domestic violence freephone helpline on 0808 2000 247
- For confidential support (US), call the national domestic violence hotline on 1-800-799-7233