Intimate partner violence

1 Overview

Domain / Phenotype

Sex

Both (Note: Female-specific codes apply; see implementation)

Age Range

Child (0-18y) Adult (Any age)

Individual

Parent Child Any Adult (General IPV)

Coding System

READ SNOMED CT ICD-10 ICD-9 HES-APC speciality field HES-AE speciality field

Data Sources

CPRD Aurum CPRD GOLD HES-APC HES-AE

2 Definition

The WHO defines IPV as any behaviour within an intimate relationship that causes physical, psychological or sexual harm to adults who are, or have been, intimate partners or family members.

We restricted IPV indicators to parents aged ≥16 and their corresponding children to prevent misclassification of child maltreatment by the parents of younger parents.

Suspected IPV: Includes suspected indicators with coding terms mentioning historic IPV or maltreatment by an unspecified person. For instance, the "suspected IPV, NOS" indicator contains codes mentioning "[X]Maltreatment, by acquaintance or friend", "Risk of non-accidental injury", and "Assault in the home".

3 Clinical Codelist

Download IPV Codelist (2044 codes - excluding algo) Download IPV Codelist (3281 codes - incl. algo)

See the ACEsinEHRs Control documentation for code processing rules and release information.

Indicator Structure & Taxonomy

Domain	Indicator Code	Indicator Name	No. Codes
IPV	IPV1	IPV, NOS (incl. physical/sexual abuse)	67
IPV	IPV2	Mother assaulted + child protection recording or pregnant incident†	554
IPV	IPV3	Suspected IPV NOS	33
IPV	IPV4	Suspected IPV, physical or sexual abuse	45
IPV	IPV5	Mother assaulted NOS (hospital admission only)	119
IPV	IPV6	Mother assaulted + high-risk presentations (algorithm)†	236

4 Implementation

Certain specific indicators within this domain require rule-based algorithms to prevent misclassification.

Algorithm 1 Susp. IPV: Assault NOS & High-Risk (30/100 days)

Include as IPV if assault recording co-occurs with any "high-risk presentation recording" 30 days before the assault or in 100-days post the assault recording. High-risk recordings are a composite variable of recordings related to parental conflicts, health visitors being sent to the home, nurse partnership referrals, superficial head injuries and bruises. We developed the composite variable using results from our systematic review. In the current study, the algorithm showed PPVs ranging from 18%-30% of definitive IPV (derivation cohort).

R Script / Logic

# Logic flag for IPV high-risk presentation algorithm
ipv_algo_high_risk <- merged_data %>%
 filter(indicator == "Assault NOS") %>%
 mutate(
  is_ipv = ifelse(
   (days_to_high_risk >= -30 & days_to_high_risk <= 100), 
   TRUE, FALSE
  )
 )

Algorithm 2 Definitive IPV: Assault & Safeguarding/Pregnancy (45 days)

Include as IPV if assault recording co-occurs with any recordings of a safeguarding referral, child protection recording, definitive CM indicator, or "pregnant state, incidental" (marked in codelist) within 45 days of the assault. UK guidelines state 45 days is the maximum timeframe for an initial outcome following a children’s social care assessment from the date of received safeguarding referral (see point 82, working together to safeguard children).

R Script / Logic

# Logic flag for IPV 45-day safeguarding/pregnancy algorithm
ipv_algo_45_days <- merged_data %>%
 filter(indicator == "Assault NOS") %>%
 mutate(
  is_ipv = ifelse(
   (safeguarding_or_preg == TRUE & abs(days_between) <= 45), 
   TRUE, FALSE
  )
 )