Multisite External Validation of a Clinical Screening Tool for Interpersonal Firearm Violence Risk

BACKGROUND: Screening tools for interpersonal firearm violence (FV) are needed to facilitate prevention. OBJECTIVE: To validate the 4-item, 10-point SaFETy (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) score. DESIGN: Prospective longitudinal study. SETTING: 4 level 1 emergency departments (EDs) in 3 cities. PARTICIPANTS: Adults aged 18 to 24 years seen in an ED for any reason. MEASUREMENTS: FV (shooting someone or being shot) 12 months after baseline from self-report and medical record review, SaFETy score, and self-reported baseline covariates (demographic characteristics; baseline assault injury; violence-related ED use in the past 6 months; drug misuse; anxiety, depression, and posttraumatic stress screening; and FV in the past 6 months). RESULTS: = 0.025). The added contribution of the SaFETy score to predictions based only on variables typically available at triage (demographic data, ED visit reason, and recent ED use) was larger. LIMITATION: Outcomes were primarily self-reported, and the highest-risk subsamples were more likely to have missing data. CONCLUSION: The SaFETy score predicts FV risk in general samples of young adults in the ED. A comprehensive covariate set, involving factors that are difficult or intrusive to measure, did not reproduce the SaFETy score's risk gradient or explain its discriminatory power, suggesting that the score provides distinct predictive information. PRIMARY FUNDING SOURCE: Centers for Disease Control and Prevention.