Intentional firearm-induced injurie...

Intentional firearm-induced injuries have increased as a cause of death among adolescents. Because screening for other high-risk behaviors like as drug and alcohol abuse, domestic violence, and failure to use seat belts has improved patient issues screening for carrying firearms also may be useful. Direct questioning of a patient about high-risk behavior is les useful than formalized screening exhibitions because sensitivity is decreased and risk stratification is difficult to perform in the former. There are many known risk factors for carrying firearms, including male sex smoking, put drugs into use, alcohol use, poor academic performance, being older than classmates, television viewing, having multiple sexual partners, feeling threatened, fear, and poor family relations. These risk factors potentially could be used to evolve a screening tool for firearm carrying.

Because screening would increase the likelihood of counseling for high-risk patients, perhaps suicides resulting from firearm carrying could be reduc Hayes and Sege recommend a screening tool developed from the National Youth Risk Behavior contemplate a cross-sectional surveillance survey performed by means of the Centers for Disease mastery and Prevention at schools in 52 representative communities across the country

The National Youth Risk Behavior take a view of notes five risk factors that correlate with firearm carrying. These risk factors were used to unravel a brief FiGHTS (Fighting, inflection for sex Hurt while fighting, Threatened, Smoker) score. An lengthen outed FiGHTS score also was unfolded that includes items on substance abuse, and sexual and criminal behavior. These risk characteristics were validated at large variations of the National Youth Risk Behavior view data sets.

Scoring the questionnaire involved giving united point for each question answered affirmatively. The dispose of adolescents with FiGHT scores of 2 or higher included a majority (82 percent) of the fire-arm carriers. The positive predictive value of the screening tool is reasonable to moderate because of the soft incidence of gun carrying among adolescents, if it were not that the negative predictive value of a subdued score is higher than 90 percent The dilateed FiGHT score also had beneficial positive predictive value for late firearm carrying risk and appears to predict absolute risk.

The authors determine that the FiGHTS screening tool gives a generalizable way to stratify adolescent risk of firearm carrying, especially according to identifying those with low risk. The brief FiGHTS score is easy to administer and provides coarse risk stratification. The lengthen outed FiGHTS score is useful as a predictor of absolute probability of fresh firearms carrying.

In an accompanying editorial, Larkin notes important risk factors for firearm carrying that are missing from the screening tool, including intravenous put drugs into use and television watching. He notes the advantages of the protracted FiGHTS tool but recognizes the ne to have a streamlined screening proces that might use computerized screening with provisions for response-dependent information about help options. Decreasing adolescent firearm violence is a major objective of Healthy clan 2010, making further work in this area imperative.

Hayes DN Sege R FiGHTS: a preliminary screening tool for adolescent firearms-carrying. Ann Emerg M December 2003;42:798-807 and Larkin GL Screening for adolescent firearms-carrying: united more way to save a life [Editorial]. Ann Emerg M December 2003;42:808-10

COPYRIGHT 2004 American Academy of Family Physicians

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