Which chart elements accurately identify emergency department visits for suicidal ideation or behavior?

In an emergency department (ED) sample, we investigated the concordance between identification of suicide-related visits through standardized comprehensive chart review versus a subset of 3 specific chart elements: ICD-9-CM codes, free-text presenting complaints, and free-text physician discharge diagnoses. The method for this study was review of medical records for adults (≥18 years) at 8 EDs across the United States. A total of 3,776 charts were reviewed. A combination of the 3 chart elements (ICD-9-CM, presenting complaints, and discharge diagnoses) provided the most robust data with 85% sensitivity, 96% specificity, 92% PPV, and 92% NPV. These findings highlight the use of key discrete fields in the medical record that can be extracted to facilitate identification of whether an ED visit was suicide-related.