%J Archives of Disease in Childhood
%A S Syed
%A R Ashwick
%A M Schlosser
%A A Gonzalez-Izquierdo
%A L Li
%A R Gilbert
%O This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
%L discovery10107886
%X Objective: Electronic health records (EHRs) are routinely
used to identify family violence, yet reliable evidence of
their validity remains limited. We conducted a systematic
review and meta-analysis to evaluate the positive
predictive values (PPVs) of coded indicators in EHRs
for identifying intimate partner violence (IPV) and child
maltreatment (CM), including prenatal neglect.
Methods: We searched 18 electronic databases
between January 1980 and May 2020 for studies
comparing any coded indicator of IPV or CM including
prenatal neglect defined as neonatal abstinence
syndrome (NAS) or fetal alcohol syndrome (FAS), against
an independent reference standard. We pooled PPVs for
each indicator using random effects meta-analyses.
Results: We included 88 studies (3 875 183 individuals)
involving 15 indicators for identifying CM in the
prenatal period and childhood (0–18 years) and five
indicators for IPV among women of reproductive age
(12–50 years). Based on the International Classification
of Disease system, the pooled PPV was over 80% for
NAS (16 studies) but lower for FAS (<40%; seven
studies). For young children, primary diagnoses of CM,
specific injury presentations (eg, rib fractures and retinal
haemorrhages) and assaults showed a high PPV for
CM (pooled PPVs: 55.9%–87.8%). Indicators of IPV in
women had a high PPV, with primary diagnoses correctly
identifying IPV in >85% of cases.
Conclusions: Coded indicators in EHRs have a high
likelihood of correctly classifying types of CM and
IPV across the life course, providing a useful tool for
assessment, support and monitoring of high-risk groups
in health services and research.
%C England
%D 2020
%T Predictive value of indicators for identifying child maltreatment and intimate partner violence in coded electronic health records: a systematic review and meta-analysis