Study designs of evaluations included in the review
The intervention studies had to have a comparison group. No inclusion criteria relating to the study design were stated for studies of screening.
Specific interventions included in the review
Studies that evaluated the performance of verbal or written questionnaires, or other assessment procedures such as brief physical examinations in the primary care setting, and studies that assessed the effectiveness of an intervention to reduce harm from family and intimate partner violence, were eligible for inclusion in the review.
The studies had to be conducted in or linked to primary care, obstetrics or gynaecology or emergency department settings, and include a physician or other health provider in the process of assessment or intervention, to be eligible for inclusion. The studies also had to be applicable to United States clinical practice.
Studies that assessed the effectiveness of interventions to educate health care professionals about family violence or to increase screening rates were excluded, as were studies about mandatory reporting laws, descriptions of programmes, the accuracy of physician diagnosis and reporting of abuse, and physician factors relating to reporting.
The included studies of screening for child abuse used self-administered questionnaires, sometimes in conjunction with interviews and review of medical records, clinical staff interviews and clinical observation. None used specific physical examination protocols. The included studies of interventions for child abuse assessed support services, home visitation programmes and comprehensive services, including care by a multidisciplinary team for prenatal, postnatal and paediatric care.
The included studies of screening for intimate partner violence against women compared brief screening instruments against previously validated instruments, compared instruments against directed interview, measured inter-rater reliability and/or internal consistency, or compared methods of administration. The included studies of interventions for intimate partner violence against women assessed a wallet-sized card listing community resources, counselling, and counselling plus a 'mentor mother' in the community.
The included studies of screening for elder abuse assessed a caregiver abuse screening instrument and elder abuse screening instruments.
Reference standard test against which the new test was compared
The review did not include any diagnostic accuracy studies that compared the performance of the index test with a reference standard of diagnosis.
Participants included in the review
Studies of women, children and elderly adults were eligible for inclusion in the review. Studies of patients presenting with trauma were excluded.
The included studies of screening for child abuse primarily assessed parents, particularly pregnant women, rather than children directly. The included studies of interventions for child abuse were for pregnant and postpartum women and their infants, who were considered at high risk because of sociodemographic characteristics and/or additional risk factors.
The included studies of screening for intimate partner violence against women included women attending family practice clinics, prenatal clinics, a parenthood clinic, or emergency departments. The included studies of interventions for intimate partner violence against women included women attending prenatal clinics.
The included studies of screening for elder abuse included abusive and non-abusive caregivers, elderly victims of abuse, elderly adults referred to Adult Protective Services but found not to be abused, elderly adults from a family practice clinic, or a convenience sample of white minority elderly adults living in public housing.
Outcomes assessed in the review
Studies that assessed indicators of physical abuse, neglect, emotional abuse and/or sexual abuse, and related health outcomes were eligible for inclusion in the review.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.