Predictive Validity of the Brøset Violence Checklist in a Secured Institution for Offenders With Intellectual Disabilities.
Jacob Hvidhjelm, Søren Holst
PMID 40114337WHAT IT FOUND
The Brøset Violence Checklist missed most violent incidents in offenders with intellectual disabilities, identifying only 26.3% of cases.
It reliably ruled out violence, with a negative predictive value of 99.3%, but failed to predict high-risk situations effectively.
Key findings
01The checklist had an area under the curve of 0.610, indicating modest discriminative ability for predicting violence within 24 hours.
02Sensitivity was low across all thresholds, ranging from 26.3% at a score of 1 or more down to 4.7% at a score of 6.
03Predictive performance varied by time of day, with the highest sensitivity during the evening shift and the weakest during the night shift.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was conducted in a single institution, limiting generalizability to other settings. The sample included only 10 female residents, making sex-specific findings less reliable. 18% of potential BVC assessments were missing from the dataset. The observational design prevents causal inferences about why the tool performs differently across shifts or sexes. Staff-reported outcome data may introduce reporting bias, particularly during night shifts with lower staffing levels.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not interpret the high negative predictive value as proof that the tool is safe to use for all risk decisions. While it effectively rules out violence for most people, its low sensitivity means it misses the majority of actual violent incidents, particularly during night shifts and for female residents.