Dr. Bharti Khurana: Bringing Intimate Partner Violence Into Focus

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Bharti Khurana

BOSTON—Dr. Bharti Khurana, MD, is a radiologist at Brigham and Women’s Hospital in Boston, but she is known more for her pioneering work in the area of intimate partner violence, or IPV.

What is IPV? It is defined as physical, sexual or emotional violence between partners or former partners, and now has become a critical public health issue and widely prevalent. One in four women and one in seven men have reported experiencing severe physical violence from an intimate partner in their lifetime in the U.S.

Dr. Khurana is currently one of three finalists at the hospital in a competition that welcomes project ideas geared toward solving vexing medical problems. This year’s finalists are pursuing forward-thinking and inventive research to improve patient care. Each of the three finalists hopes to receive the $100,000 BRIght Futures Prize, which will be awarded at Discover Brigham on Wednesday, Nov. 7. If you want to vote in this challenge, please click on the voting site:https://goo.gl/6AG3MZ

Dr. Khurana’s project is called “Making the Invisible Visible: Bringing Intimate Partner Violence into Focus.” She is creating tools for clinicians to use to identify patients who are experiencing IPV.

Dr. Bharti Khurana, MD

Dr. Khurana told INDIA New England News that while reading the X-Rays, she can detect a clear patterns of intimate partner violence because of injuries in the body, most on nose, central face and on hand.

“We are completely unbiased. We are not basing our decision on anything else such as culture or race,” said Dr. Khurana. “The concern is based on the patterns the radiologist is seeing.”

Dr. Khurana said her attention to intimate partner violence was drawn by a social worker at a conference in 2016 and then she began her pioneering work in this area.

Dr. Khurana is doing this through machine learning – teaching a computer program to recognize signs of IPV based on radiological and clinical findings from known IPV cases. She has already presented findings from studies of this – studies that have found years-past evidence of fractures of patients in the ER, exposing signs of past violence.

In addition, her team is preparing guidelines with which social workers and clinicians can approach those affected patients who are at risk, but who are not forthcoming.

Here is a Q/A on the topic with Dr. Khurana that was recently published in BWH Bulletin:

Question: What problem are you trying to solve?

Dr. Khurana: Intimate partner violence (IPV), defined as physical, sexual or emotional violence between partners or former partners, is a critical public health issue and widely prevalent. One in four women and one in seven men have reported experiencing severe physical violence from an intimate partner in their lifetime in the U.S. IPV has both short- and long-term negative health consequences, and even childhood exposure to IPV has been linked to adverse mental and physical health effects in adults. Half of female homicides between 2003 and 2014 have been linked to IPV. Despite how often IPV occurs, many victims think they are alone, and cases can go unreported for decades.

The medical community could play a vital role in detecting IPV early and preventing its perpetuation. But IPV can be a very difficult subject to raise with a patient. Also, IPV happens mostly within the confines of the home and evidence is mostly elusive. Although questionnaires about safety have helped, the proportion of identifiable IPV cases to date only represents the tip of the iceberg. There is more that we as radiologists can do by looking specifically for early signs of IPV and providing opportunity to offer preventive services.

Question: What is your solution?

Dr. Khurana: We are creating new tools to empower clinicians to identify patients who are experiencing IPV. Our goal is to develop an integrated system that uses patterns derived from expert analysis of historical imaging and clinical data, detects and classifies injuries for their likelihood of being as a result of IPV, and automatically alerts clinicians if a patient’s injuries have low or high-risk probability for IPV.

To do so, we plan to use machine learning – that is, teach a computer program to recognize signs of IPV based on radiological and clinical findings from known IPV cases. This will give us a comprehensive picture and help generate a checklist to identify those most at risk. In addition, our multidisciplinary team will design conversational guides and training for social workers and clinicians to approach the patients who are identified as being at high risk for IPV but are not forthcoming.

Question: How will your research project benefit people?

Dr. Khurana: Intervening early means preventing adverse physical and mental consequences that result from IPV. With funding from the BRIght Futures Prize, we will be able to take the next step toward identifying radiological findings and clinical risk factors in patients with documented IPV.

Our goal is to give clinicians the tools, classification models, statistical evidence and alert systems for greater confidence and robustness in findings, empowering them to open a dialogue with their patients about IPV. We hope that this will have a ripple effect, changing the lives of patients and their families; strengthening the role of the medical community in identifying IPV; and breaking the silence around IPV in our society.

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