Risk stratification using data from electronic medical records better predicts suicide risks than clinician assessments
MetadataShow full item record
To date, our ability to accurately identify patients at high risk from suicidal behaviour, and thus to target interventions, has been fairly limited. This study examined a large pool of factors that are potentially associated with suicide risk from the comprehensive electronic medical record (EMR) and to derive a predictive model for 1–6 month risk. Methods: 7,399 patients undergoing suicide risk assessment were followed up for 180 days. The dataset was divided into a derivation and validation cohorts of 4,911 and 2,488 respectively. Clinicians used an 18-point checklist of known risk factors to divide patients into low, medium, or high risk. Their predictive ability was compared with a risk stratification model derived from the EMR data. The model was based on the continuation-ratio ordinal regression method coupled with lasso (which stands for least absolute shrinkage and selection operator).Results: In the year prior to suicide assessment, 66.8% of patients attended the emergency department (ED) and 41.8% had at least one hospital admission. Administrative and demographic data, along with information on prior self-harm episodes, as well as mental and physical health diagnoses were predictive of high-risk suicidal behaviour. Clinicians using the 18-point checklist were relatively poor in predicting patients at high-risk in 3 months (AUC 0.58, 95% CIs: 0.50 – 0.66). The model derived EMR was superior (AUC 0.79, 95% CIs: 0.72 – 0.84). At specificity of 0.72 (95% CIs: 0.70-0.73) the EMR model had sensitivity of 0.70 (95% CIs: 0.56-0.83). Conclusion: Predictive models applied to data from the EMR could improve risk stratification of patients presenting with potential suicidal behaviour. The predictive factors include known risks for suicide, but also other information relating to general health and health service utilisation.
Showing items related by title, author, creator and subject.
Risk stratification using data from electronic medical records better predicts suicide risks than clinician assessmentsTran, The Truyen; Luo, W.; Phung, D.; Harvey, R.; Berk, M.; Kennedy, R.; Venkatesh, S. (2014)Background: To date, our ability to accurately identify patients at high risk from suicidal behaviour, and thus to target interventions, has been fairly limited. This study examined a large pool of factors that are ...
Predicting unplanned readmission after myocardial infarction from routinely collected administrative hospital dataRana, S.; Tran, The Truyen; Luo, W.; Phung, D.; Kennedy, R.; Venkatesh, S. (2014)Objective Readmission rates are high following acute myocardial infarction (AMI), but risk stratification has proved difficult because known risk factors are only weakly predictive. In the present study, we applied hospital ...
Fairnie, Helen Margaret (2005)Scant attention has been given to occupational health hazards of Australian veterinarians. This study aimed to identify the major risk factors for occupational injury and disease, emotional health and suicide rates of ...