Trust, (Dis)Belief, and Love

Population vs Individual Prediction of Poor Health From Results of Adverse Childhood Experiences Screening

“…Fourth, because ACE screening is being recommended in both children and adults, we tested the predictive ability of ACE scores measured both prospectively in childhood and retrospectively in adulthood. Findings were consistent regardless of the ACE measure used, which suggests that screening both children and adults for ACEs has limited ability to inform individual prediction of poor health outcomes.…”

“…To prevent health problems, ACE screening has been proposed to identify at-risk individuals who may benefit from health interventions . ACE screening in children has already been implemented in primary care clinics in the US, while adults are being screened for ACEs through population-based telephone health surveys in the US and through health care assessments in the UK . Such screening commonly involves administering a questionnaire assessing exposure to 10 ACEs: physical, sexual, and emotional abuse; emotional and physical neglect; domestic violence; and parental substance abuse, mental illness, separation, and incarceration .…”

“…Such screening commonly involves administering a questionnaire assessing exposure to 10 ACEs: physical, sexual, and emotional abuse; emotional and physical neglect; domestic violence; and parental substance abuse, mental illness, separation, and incarceration . Individuals with high ACE scores are then referred for health interventions (eg, medical and mental health services) or provided with information about support services . However, concerns have been raised about the utility of ACE screening in preventing poor health outcomes because of unanswered questions about forecasting, incremental prediction, discrimination, and measurement.…”