At the 1997 annual meeting of the American Academy of Family Physicians Dr. K. Sherin of the UIC-Christ Hospital, Department of Family Medicine introduced a brief domestic violence screening tool called HITS. He and his colleagues developed this tool to easily and more effectively screen for domestic violence. Dr. Sherin pointed out that HITS is model after the widely use screening tool for alcoholism called "CAGE"

The four questions in HITS stand for;

1. How often dose your partner physically Hurt you?
1. How often dose your partner Insult or talk down to you?
1. How often dose your partner Threaten you with physical harm?
1. How often dose your partner Scream or curse at you?

Each question is answered on a five point scale ranging from 1 to 5 for never, rarely, sometimes, fairly often, and frequently, respectively. The Score Ranges from a minimum of 4 to a maximum of 20. The patients who fall in the 11 to 20 range score are the ones who should be offered information regarding battered women's services including emergency shelter places and mental health services.

In phase I of the study the validity of HITS was established to assess the tool in clinical settings. Dr. Sherin and colleagues compared this four item screening tool with the verbal and physical aggression items of the Conflict Tactics Scale (CTS), a 19 item screening tool for domestic violence in use since the 1970's. In this study 160 adult female family practice office patients living with a partner for at least 12 months completed two questionnaires. In phase II, 99 women who were self-identified victims of domestic violence completed the HITS. Then a comparison of Study 1 was made with Study 2.

For study 1, Cronbach's alpha was 0.80 for the HITS scale. The correlation of HITS and CTS scores was 0.85. For study 2, the mean HITS scores for office patients and abuse victims were 6.13 and 15.15, respectively (p <.0005). Optimal data analysis revealed that a cut score of 10.5 on the HITS reliably differentiated respondents in the two groups (p < .05). Using this cut score, 91% of patients and 96% of abuse victims were accurately classified.

The HITS scale showed good internal consistency and concurrent validity with the CTS verbal and physical aggression items. The HITS also showed good construct validity in its ability to differentiate family practice patients from abuse victims. The HITS scale is promising as a domestic violence screening mnemonic for family practice physicians and residents.