Resource Tag: MEDICAL RECORDS--DATA PROCESSING

Background: Studies on COVID-19 pandemic-associated changes in mortality following self-harm remain scarce and inconclusive. Aims: To compare mortality risks in individuals who had self-harmed to those for individuals who had not, before and during the COVID-19 pandemic (Waves 1 and 2) in Wales, the United Kingdom, using population-based routinely collected data. Method: We linked whole population health data to all-cause […]

Objective Hospital emergency departments lack the resources to adequately support young people who present for suicidal crisis. Digital therapeutics could fill this service gap by providing psychological support without creating additional burden on hospital staff. However, existing research on what is needed for successful integration of digital therapeutics in hospital settings is scant. Thus, this […]

Background: Reliable assessment of suicide and self-harm risk in emergency medicine is critical for effective intervention and treatment of patients affected by mental health disorders. Teams of clinicians face the challenge of rapidly integrating medical history, wide-ranging psychosocial factors, and real-time patient observations to inform diagnosis, treatment, and referral decisions. Patient outcomes therefore depend on the […]

Background: Prior suicide attempts are a relatively strong risk factor for future suicide attempts. There is growing interest in using longitudinal electronic health record (EHR) data to derive statistical risk prediction models for future suicide attempts and other suicidal behavior outcomes. However, model performance may be inflated by a largely unrecognized form of “data leakage” during […]

Background: Individualising mental healthcare at times when a patient is most at risk of suicide involves shifting research emphasis from static risk factors to those that may be modifiable with interventions. Currently, risk assessment is based on a range of extensively reported stable risk factors, but critical to dynamic suicide risk assessment is an understanding of […]

Introduction Prior literature establishes noteworthy relationships between suicidal symptoms and substance use disorders (SUDs), particularly opioid use disorder (OUD). However, engagement with health care services among this vulnerable population remains underinvestigated. This study sought to examine patterns of health care use, identify risk factors in seeking treatment, and assess associations between outpatient service use and emergency department (ED) visits. Methods […]

Objective: To apply deep neural networks (DNNs) to longitudinal EHR data in order to predict suicide attempt risk among veterans. Local explainability techniques were used to provide explanations for each prediction with the goal of ultimately improving outreach and intervention efforts. Materials and methods: The DNNs fused demographic information with diagnostic, prescription, and procedure codes. Models were […]

Background Suicide prevention requires a shift from relying on an at-risk individual to engage with the healthcare system. Understanding patterns of healthcare engagement by people who have died by suicide may provide alternative directions for suicide prevention. Methods This is a population-based case-series study of all suicide decedents (n = 3895) in New South Wales (NSW), Australia […]

Objective Preventing suicide in US youth is of paramount concern, with rates increasing over 50% between 2007 and 2018. Statistical modeling using electronic health records may help identify at-risk youth before a suicide attempt. While electronic health records contain diagnostic information, which are known risk factors, they generally lack or poorly document social determinants (e.g., […]

Bipolar disorder (BPD) is associated with high rates of suicide attempts but the anti-suicidal effect of mood stabilizing agents remains unclear. This study aimed to examine the association between mood stabilizing agents (lithium, valproate, lamotrigine, carbamazepine or antipsychotics) and risk of suicide attempts in patients with BPD using self-controlled case series study design. Among 14,087 […]

Growing evidence has shown that applying machine learning models to large clinical data sources may exceed clinician performance in suicide risk stratification. However, many existing prediction models either suffer from “temporal bias” (a bias that stems from using case-control sampling) or require training on all available patient visit data. Here, we adopt a “landmark model” […]

Objective: The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. Methods: Data from a population-based survey (N=123,995) were linked to health administrative data (2002-2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox […]

Introduction: The aim was to investigate psychiatric health care utilization two years before death by suicide among individuals with previous suicide attempts (PSA) compared with those without (NSA). Method: A retrospective population-based cohort study was conducted including 484 individuals who died by suicide in Sweden in 2015 and were in contact with psychiatric services within the two […]

Objective: Develop a stakeholder-informed ethical framework to provide practical guidance to health systems considering implementation of suicide risk prediction models. Methods: In this multi-method study, patients and family members participating in formative focus groups (n = 4 focus groups, 23 participants), patient advisors, and a bioethics consultant collectively informed the development of a web-based survey; survey results (n = […]

Objective: The aim of this research was to examine predictors and characterize causes of suicide death in people with traumatic brain injury (TBI) and conduct sensitivity analyses with and without people whose first diagnosis of TBI occurred within 3 days of their suicide death. Methods: This case-control study examined suicide risk for people with TBI in eight […]

Background: Taiwan is a high-risk area for suicide. Repeated suicide attempts are an important factor of suicide mortality. Yet there has been little research on the factors associated with repeated suicidal behavior in Taiwan. Aims: To explore the characteristics of repeated suicide attempts. Methods: Data were obtained from the National Health Insurance Research Database for 2005 to 2008. […]

Background: Hospital-presenting self-harm is a strong predictor of suicide and has substantial human and health service costs. Aims: We aimed to identify changes in case ascertainment after implementation of a new self-harm reporting field at a tertiary hospital in New South Wales, and to report event rates, demographic, and clinical characteristics. Method: Self-harm events presenting to the emergency department (October […]

Suicide is strongly associated with mental health and substance use disorders, which makes mental health- and substance misuse services important areas for suicide prevention. The aim of The Norwegian Surveillance System for Suicide in Mental Health and Substance Use Services is to describe all suicide deaths in Norway that occur within one year after contact […]

Growing evidence has shown that applying machine learning models to large clinical data sources may exceed clinician performance in suicide risk stratification. However, many existing prediction models either suffer from “temporal bias” (a bias that stems from using case-control sampling) or require training on all available patient visit data. Here, we adopt a “landmark model” […]

Background There have been no studies examining how neighbourhood deprivation modifies the effects of sexual minority status on suicide-related behaviours (SRB). Sexual minority individuals in deprived areas may face unique challenges and stressors that exacerbate their risk of SRB. This study aims to investigate the association between sexual minority status and clinical SRB, and examine […]

Suicide risk prediction models can identify individuals for targeted intervention. Discussions of transparency, explainability, and transportability in machine learning presume complex prediction models with many variables outperform simpler models. We compared random forest, artificial neural network, and ensemble models with 1500 temporally defined predictors to logistic regression models. Data from 25,800,888 mental health visits made […]

Introduction: The role of digital health in providing psychological treatment and support for the prevention of suicide is well documented. Particular emphasis has been placed on digital health technologies during the COVID-19 pandemic. Providing psychological support reduces the burden of mental health conditions. The challenge is to provide support in the context of patient isolation, […]

Background: The increasing use of digital mental health (DMH) platforms and digital mental health interventions (DMHIs) is hindered by uncertainty over effectiveness, quality and usability. There is a need to identify the types of available evidence in this domain. Aim: This study is a scoping review identifying evaluation of the (1) DMH platform/s used; and (2) DMHI/s […]