Reliability and validity of the "extended - hurt, insult,threaten, scream" (e-hits) screening tool in detecting intimate partner violence in hospital emergency departments in Hong Kong

C. C. Chan, Y. C. Chan, May Lan Alma Mary Gerardina Au, G. O.C. Cheung

Research output: Journal article publicationJournal articleAcademic researchpeer-review

39 Citations (Scopus)


Objectives: To assess the reliability and validity of a brief screening instrument, "E-HITS" (Extended - Hurt, Insult, Threaten, Scream), for detecting female intimate partner violence (IPV) in Hong Kong emergency departments (EDs). Method: Quantitative data were collected from a victim group (n=110) and a control group (n=116). Statistical properties of the instruments were analysed to ascertain its internal consistency, test/re-test reliability, concurrent validity and discriminant validity. Results: Cronbach's alpha was 0.90 for the E-HITS. Two-week test/re-test reliability was 0.71 (p<0.001). Respondents' scores on the E-HITS positively correlated with those on psychological aggression, physical assault, sexual coercion and injury scales, and negatively correlated with the negotiation scale of the revised Conflict Tactics Scale at a statistically significant level. Subsequent Receiver Operating Characteristic (ROC) curve analysis revealed that E-HITS reached a sensitivity of 98.2% and a specificity of 94.8% at a cut-off of 8.5. The overall accuracy of the E-HITS indicated by the area under curve (AUC) in the ROC is 0.991. Conclusion:These results show that the E-HITS has good internal consistency, test/re-test reliability, as well as concurrent and discriminant validity. The E-HITS is a valid and reliable tool for screening intimate partner violence in Hong Kong EDs.
Original languageEnglish
Pages (from-to)109-117
Number of pages9
JournalHong Kong Journal of Emergency Medicine
Issue number2
Publication statusPublished - 1 Jan 2010


  • Battered women
  • Domestic violence
  • Hospital emergency services
  • Mass screening
  • Spouse abuse

ASJC Scopus subject areas

  • Emergency Medicine

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