• Timothy F Platts-Mills, Karen Hurka-Richardson, Rayad B Shams, Aileen Aylward, Joseph A Dayaa, Melinda Manning, Laura Mosqueda, Jason S Haukoos, Mark A Weaver, Philip D Sloane, Debbie Travers, Phyllis L Hendry, Ashley Norse, Christopher W Jones, Samuel A McLean, Bryce B Reeve, Sheryl Zimmerman, Investigators for the ED Senior AID Research Group, Katie Davenport, Debra Bynum, Emilia Frederick, Kim Lassiter-Fisher, Amy Stuckey, Racquel Daley-Placide, Mark Hoppens, Judy Betterton, Samantha Owusu, Cynthia Flemming, and Andrew Colligan.
• Department of Emergency Medicine, University of North Carolina School of Medicine, Chapel Hill, NC. Electronic address: tplattsm@med.unc.edu.
• Ann Emerg Med. 2020 Sep 1; 76 (3): 280-290.

Study ObjectiveEmergency department (ED) visits provide an important opportunity for elder abuse identification. Our objective was to assess the accuracy of the ED Senior Abuse Identification (ED Senior AID) tool for the identification of elder abuse.MethodsWe conducted a study of the ED Senior AID tool in 3 US EDs. Participants were English-speaking patients 65 years old and older who provided consent or for whom a legally authorized representative provided consent. Research nurses administered the screening tool, which includes a brief mental status assessment, questions about elder abuse, and a physical examination for patients who lack the ability to report abuse or for whom the presence or absence of abuse was uncertain. The reference standard was based on the majority opinion of a longitudinal, expert, all data (LEAD) panel following review and discussion of medical records, clinical social worker notes, and a structured social and behavioral evaluation. For the reference standard, LEAD panel members were blinded to the results of the screening tool.ResultsOf 916 enrolled patients, 33 (3.6%) screened positive for elder abuse. The LEAD panel reviewed 125 cases: all 33 with positive screen results and a 10% random sample of negative screen results. Of these, the panel identified 17 cases as positive for elder abuse, including 16 of the 33 cases that screened positive. The ED Senior AID tool had a sensitivity of 94.1% (95% confidence interval [CI] 71.3% to 99.9%) and specificity of 84.3% (95% CI 76.0% to 90.6%).ConclusionThis multicenter study found the ED Senior AID tool to have a high sensitivity and specificity as a screening tool for elder abuse, albeit with wide CIs.Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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