The Manchester Self Harm Rule had Good Sensitivity but Poor Specificity for Predicting Repeat Self Harm or Suicide

In this commentary, Hatcher notes that the study by Cooper et al (2006) is a good example of how to derive a clinical decision rule. However, 3 specific concerns regarding this rule for predicting repeat self-harm or suicide are also discussed. Problems with deriving clinical rules to identify such patients are outlined. (1 ref.)