Patrick Lenehan, MD, PhD and Anji Tang, MD are co-first authors, and Bharti Khurana, MD, MBA, in the Department of Radiology Trauma Imaging Research and Innovation Center (TIRIC) at Brigham and Women's Hospital, is the corresponding author of a paper published in the Journal of the American College of Radiology (JACR), " Utilizing Radiology as a Screening Tool to Identify Intimate Partner Violence."
How would you summarize your study for a lay audience?
Intimate partner violence (IPV) is very common, with over 40% of women in the United States experiencing IPV throughout their lifetime. Alarmingly, it is estimated that about half of female homicides in the United States and internationally are related to IPV. Reporting IPV to clinicians or other members of the healthcare system is often not possible, deferred, or delayed, leading to repeated cycles of abuse or aggression. However, patients experiencing IPV do frequently seek help from healthcare providers for physical and psychological injuries associated with IPV, even if they have not yet reported it.
We performed this study to inform radiologists about the imaging and injury patterns associated with IPV so they can be better equipped to help identify these patients earlier.
What question were you investigating?
We wanted to understand how radiological imaging and evident injury patterns differ between women who have reported IPV and women who have not.
What approach did you use?
In this study, we compared the amount, types, and timing of imaging studies and injury patterns between patients experiencing IPV (the "case" cohort) and patients who have not reported IPV (the "control" cohort). We gathered all patients' prior imaging studies and asked radiologists to analyze them retrospectively. They reviewed the radiology reports and recorded the type and anatomical location of any injuries. We also recorded the day of the week, time of day, and clinical setting (e.g., Emergency Department) where each image was taken, allowing us to compare these features between the case and control cohorts.
What did you find?
We determined that patients experiencing IPV:
- Underwent more imaging studies than controls and tended to have a disproportionate amount of their imaging performed during overnight and weekend periods
- Had a higher rate of radiologically evident injuries across most anatomic sites and had distinctive injury patterns, with particularly high rates of injuries to the head, face, and thorax
- Were more likely to experience synchronous injuries (at least two unique injuries identified during a single clinical encounter) and asynchronous injuries (at least two unique injuries identified during separate clinical encounters)
What are the implications?
This work has the potential to help patients by enabling radiologists to detect IPV earlier. It is well known that the experience of IPV often goes unrecognized across repeated clinical encounters. We hope this work can help shorten the time between the initial clinical presentation and the time of IPV recognition.
What are the next steps?
The Journal of American Radiology will disseminate our findings through continuing medical education (CME) credit to radiologists so that they can more accurately raise suspicion for IPV and effectively communicate this with patient-facing clinicians. We also aim to develop artificial intelligence (AI)-enabled clinical decision support tools that leverage imaging and other data to quantify real-time IPV risk for individual patients.
Authorship: In addition to Lenehan, Tang, and Khurana, Mass General Brigham authors include Gaurav V Watane, Rahul Gujrathi, Hyesun Park, Babina Gosangi, Richard Thomas, Felipe Boschini Franco, Ilana Warsofsky, and Bernard Rosner. Additional authors include Krishna Patel.
Paper cited: Lenehan P, Tang A, et al., "Utilizing Radiology as a Screening Tool to Identify Intimate Partner Violence," Journal of the American College of Radiology (JACR) DOI: 10.1016/j.jacr.2025.01.00
Funding: This work was supported by the American College of Radiology Innovation Fund.
Disclosures: Patrick J. Lenehan reports a relationship with nference, Inc. that includes employment and equity or stocks.
