Heterogeneity of existing research relating to sexual violence, sexual assault and rape precludes meta-analysis of injury data

Significant progress has recently occurred in the provision of forensic medical care to Irish patients reporting sexual violence. This includes a network of Sexual Assault Treatment Units and the development of the Clinical... [ view full abstract ]

Significant progress has recently occurred in the provision of forensic medical care to Irish patients reporting sexual violence. This includes a network of Sexual Assault Treatment Units and the development of the Clinical Nurse Specialist in Sexual Assault Forensic Examination. One aim of forensic examination is to identify the nature and extend of injury so that this may be used as evidence in criminal proceedings. In order for practitioners to adequately explain to the court the findings of their examinations of victims of sexual violence, they must have access to research data which will place their findings in to context. Unfortunately, existing research has reported a very wide range of injury prevalence data. This papers aims to provide an explanation for this wide variation in results and, furthermore, this paper aims to establish if it is possible to carry out a meta-analysis of existing research data, pertaining to the prevalence of injury after sexual assault. It was anticipated that pooling of individual study results may allow statistically robust determination of the true prevalence of injury in victims of sexual violence. A systematic search of the international literature was performed with a view to identifying injury prevalence data. In addition to numerical data relating to injury prevalence, information pertaining to the study setting, the grade of examining clinician and the examination technique that was employed in each study was also recorded. It is demonstrated that heterogeneity in research methodology, between existing research studies, is responsible for the broad range of reported injury prevalence rates. This heterogeneity is seen to preclude robust meta-analysis. Thus, it is concluded that the existing literature pertaining to the prevalence of injury after sexual violence is insufficiently homogenous to allow pooling of results. A number of potential solutions and implications for future research are outlined.