WEDNESDAY, April 8, 2026 (HealthDay News) -- For young adults presenting to the emergency department (ED), the Serious fighting, Friend weapon carrying, community Environment, and firearm Threats (SaFETy) score predicts firearm violence (FV) risk, according to a study published in online April 7 in the Annals of Internal Medicine.
Jason E. Goldstick, Ph.D., from the University of Michigan in Ann Arbor, and colleagues conducted a prospective longitudinal study involving adults aged 18 to 24 years seen for any reason at four level 1 EDs to validate the four-item, 10-point SaFETy score.
Twelve-month FV could be ascertained in 1,122 of 1,506 participants; of those, 73 (6.5 percent) had 12-month FV. The researchers found that 12-month FV rates were 1.8, 12.1, and 25.0 percent for baseline SaFETy scores of 0, 1 to 5, and 6 or greater, respectively. For the score, the area under the receiver-operating characteristic (ROC) curve (AUC) was 0.78. A SaFETy score greater than 0 was the optimal ROC cut point, with a sensitivity and specificity of 83.1 and 62.4 percent; the positive predictive value was optimized with a SaFETy score greater than 4 (31.6 percent). Model-based predictions underestimated risk among those with SaFETy scores of 0 and overestimated risk among those with SaFETy scores of 1 to 5 or 6 or greater in logistic regression of 12-month FV, including the full covariate set. Predictions' AUC were improved by adding the SaFETy score to the full covariate set (0.84 versus 0.81). A larger added contribution of the SaFETy score was seen for predictions based only on variables typically available at triage (demographic data, ED visit reason, and recent ED use).
"Reversing current interpersonal FV 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 write.