Results indicate that routine screening IPV has been introduced in many health settings to improve identification and responsiveness to IPV, yet the debate about the level of evidence required to warrant routine screening continues. The article presents three assumptions which are indicated to have impeded progress in measuring the impact of screening: the first being that routine screening is a test only which does not of itself have an impact on patients; second, that it can be assessed by evaluating interventions provided to women after abuse is identified through screening; and lastly that there can be an agreed appropriate intervention for IPV. Noted is that each of these assumptions is problematic, and in addition, there are significant impediments to evaluating screening as an intervention through a randomized control trial. These include identification of the study group, isolating the control group from the intervention, ethics, lack of baseline data, and recall bias. The paper concludes with a recommendation that a range of study designs is required and a rethink of assumptions is needed in researching this area. Table, figures, and references