Ann Intern Med
ER screening tool predicts firearm violence risk in young adults
Clinical takeaway: A simple ED-based screening tool may help identify young adults at elevated risk for firearm violence and guide targeted prevention efforts.
Emergency department visits offer a key opportunity to identify patients at risk for future firearm violence, even when they present for unrelated reasons. Current clinical guidance emphasizes firearm safety counseling, but not formal risk screening tools.
The SaFETy score (Serious fighting, Friend weapon carrying, community Environment, and firearm Threats) uses four self-reported items: fighting frequency, exposure to neighborhood gun violence, friends carrying weapons, and recent firearm threats.
In this prospective study of 1,506 adults aged 18 to 24 across four level 1 trauma centers, 6.5% experienced firearm violence within 12 months. Risk increased sharply with higher SaFETy scores, from 1.8% at a score of 0 to 25% at scores of 6 or higher.
The score showed good discrimination and improved risk prediction even when added to demographic, behavioral, and clinical factors.
“Reversing current interpersonal firearm violence trends requires utilizing all available tools to focus primary prevention, and this research supports a valuable role of the SaFETy score in those efforts,” the authors conclude.
Source: Goldstick JE, et al. Ann Intern Med. April 7, 2026. Multisite External Validation of a Clinical Screening Tool for Interpersonal Firearm Violence Risk