Making the Invisible Visible: Bringing Intimate Partner Violence into Focus

This year’s BRIght Futures Prize finalists are pursuing forward-thinking and inventive research to improve patient care. Each of the three finalists hopes to receive the $100,000 BRIght Futures Prize, which will be awarded at Discover Brigham on Wednesday, Nov. 7. Read about their work below, and vote for your choice.

Bharti Khurana, MD
Director, Emergency Radiology Fellowship, Department of Radiology


What problem are you trying to solve?

Intimate partner violence (IPV), defined as physical, sexual or emotional violence between partners or former partners, is a critical public health issue and widely prevalent. One in four women and one in seven men have reported experiencing severe physical violence from an intimate partner in their lifetime in the U.S. IPV has both short- and long-term negative health consequences, and even childhood exposure to IPV has been linked to adverse mental and physical health effects in adults. Half of female homicides between 2003 and 2014 have been linked to IPV. Despite how often IPV occurs, many victims think they are alone, and cases can go unreported for decades.

The medical community could play a vital role in detecting IPV early and preventing its perpetuation. But IPV can be a very difficult subject to raise with a patient. Also, IPV happens mostly within the confines of the home and evidence is mostly elusive. Although questionnaires about safety have helped, the proportion of identifiable IPV cases to date only represents the tip of the iceberg. There is more that we as radiologists can do by looking specifically for early signs of IPV and providing opportunity to offer preventive services.

What is your solution?

We are creating new tools to empower clinicians to identify patients who are experiencing IPV. Our goal is to develop an integrated system that uses patterns derived from expert analysis of historical imaging and clinical data, detects and classifies injuries for their likelihood of being as a result of IPV, and automatically alerts clinicians if a patient’s injuries have low or high-risk probability for IPV.

To do so, we plan to use machine learning – that is, teach a computer program to recognize signs of IPV based on radiological and clinical findings from known IPV cases. This will give us a comprehensive picture and help generate a checklist to identify those most at risk. In addition, our multidisciplinary team will design conversational guides and training for social workers and clinicians to approach the patients who are identified as being at high risk for IPV but are not forthcoming.

How will your research project benefit people?

Intervening early means preventing adverse physical and mental consequences that result from IPV. With funding from the BRIght Futures Prize, we will be able to take the next step toward identifying radiological findings and clinical risk factors in patients with documented IPV.

Our goal is to give clinicians the tools, classification models, statistical evidence and alert systems for greater confidence and robustness in findings, empowering them to open a dialogue with their patients about IPV. We hope that this will have a ripple effect, changing the lives of patients and their families; strengthening the role of the medical community in identifying IPV; and breaking the silence around IPV in our society.

Collaborators and Affiliations:

George Dyer, MD, program director, Harvard Combined Orthopaedic Residency Program, Department of Orthopaedic Surgery

Annie Lewis-O’Connor, NP, PhD, founder and director of the Coordinated Approach to Recovery and Empowerment (C.A.R.E.) Clinic

Kathryn Rexrode, MD, MPH, chief, Division of Women’s Health

Steven Seltzer, MD, FACR, chair emeritus, Radiology

Giles Boland, MD, FACR, chair, Radiology

Marta Chadwick Balcom, JD, director, Violence Intervention and Prevention Programs, Center for Community Health and Health Equity

Hanni Stoklosa, MD, MPH, Department of Emergency Medicine

Mark Michalski, MD, executive director, MGH & BWH Center for Clinical Data Sciences (CCDS)

Katherine Andriole, PhD, director, Research and Operations, CCDS

William Berry, MD, associate director, Ariadne Labs

Mitchel Harris, MD, chief, Department of Orthopedics, Massachusetts General Hospital

Paul Tornetta, MD, chief, Department of Orthopedic Surgery, Boston Medical Center

 

CAST YOUR VOTE
or read more about the other BRIght Futures finalists:

The Open Anatomy Project

Time to Heal Chronic Wounds

13 Responses to “Making the Invisible Visible: Bringing Intimate Partner Violence into Focus”

  1. Renu Joshi

    This is a very important topic and statistics are alarming so far. Needs more research.

    Reply
  2. Tracey

    This is wonderful and meaningful work. I wholeheartedly support this initiative! I believe this research will ultimately support and provide a voice to women who may otherwise be afraid to speak up — Women from all walks of life that live in silence. You have my vote, Dr. Khurana. To me you have already won! Good luck.

    Reply
  3. Alexandra Spalding

    Yes, yes, yes! The issue is hard for many women to talk about, so bedside manner is key. Also need to get around the issue of Scope of Practice. As a bodyworker in the US I am constrained to handle only physical pain, and to listen but not advise about emotional and mental pain.Unfortunately they are intertwined.

    Reply
  4. Andrew Dienstfrey

    Congratulations to all finalists for their commitment to working on our most challenging problems. Dr. Khurana and collaborators, good luck in your work! We need your solutions!

    Reply
  5. Fainess Lipenga

    This is very important issue, I am glad professionals are taking first step from the bottom of this. It’s true it’s hard to talk about it it’s unfortable topics yet there is no education or awareness for this , this will be a good move.

    Reply

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