Predicting Future Suicide: Clinician Opinion versus a Standardized Assessment Tool.

<bold>Objective: </bold>To compare the effectiveness of clinician prediction of risk to a standardized assessment of presentation status.<bold>Methods: </bold>All adult psychiatry emergency department consults in the two main hospitals in Winnipeg, Canada, were assessed using a standardized form (n ...

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Publicado en:Suicide & Life-Threatening Behavior Vol. 49; no. 4; pp. 941 - 952
Autores principales: Randall, Jason R., Sareen, Jitender, Chateau, Dan, Bolton, James M.
Formato: journal article
Publicado: Wiley-Blackwell Aug2019
Materias:
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2019
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      pub: Wiley-Blackwell
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        10.1111/sltb.12481
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        atl: Predicting Future Suicide: Clinician Opinion versus a Standardized Assessment Tool.
      aug:
        au:
          Randall, Jason R.
          Sareen, Jitender
          Chateau, Dan
          Bolton, James M.
        affil:
          Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg MB, Canada
          Manitoba Centre for Health Policy, Department of Community Health Sciences, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg MB, Canada
          Injury Prevention Centre, School of Public Health, University of Alberta, Edmonton AB, Canada
          Department of Psychiatry, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg MB, Canada
      su:
        Winnipeg (Man.)
        Canada
        Suicide prevention
        Suicide risk factors
        Health risk assessment
        Suicidal ideation
        Suicidal behavior
        Emergency medical services
        Psychosocial factors
        Suicide risk assessment
        Psychiatric emergencies
        Risk assessment
        Predictive tests
        Evaluation research
        Research funding
        Probability theory
        Hospital emergency services
        Research methodology
        Research
        Comparative studies
        Algorithms
      sug:
        subj:
          Suicide prevention
          Suicide risk factors
          Health risk assessment
          Suicidal ideation
          Suicidal behavior
          Emergency medical services
          Psychosocial factors
          Winnipeg (Man.)
          Canada
          Emergency and Other Relief Services
          Municipal police services
          Administration of Public Health Programs
          Suicide risk assessment
          Psychiatric emergencies
          Risk assessment
          Predictive tests
          Evaluation research
          Research funding
          Probability theory
          Hospital emergency services
          Research methodology
          Research
          Comparative studies
          Algorithms
      ab: <bold>Objective: </bold>To compare the effectiveness of clinician prediction of risk to a standardized assessment of presentation status.<bold>Methods: </bold>All adult psychiatry emergency department consults in the two main hospitals in Winnipeg, Canada, were assessed using a standardized form (n = 5,376). This form includes two risk scales for a gestalt physician assessment of risk (Suicide Likelihood scale, suicide Attempt Likelihood scale) and the Columbia Classification Algorithm of Suicide Assessment (C-CASA). Regression determined whether assessments predicted future suicide attempts and deaths. The area under the curve (AUC) determined the prediction accuracy of these methods.<bold>Results: </bold>Although the regression results were significant, the AUCs were either moderate or poor. Clinician assessment was not effective at predicting deaths (AUC = .546, .36-.73), but moderately accurate at predicting future attempts (AUC = .728, .66-.79). C-CASA assessment was moderately accurate at predicting both attempts and deaths (AUC = .666 and .678).<bold>Conclusions: </bold>Clinician assessment does not significantly outperform a simple assessment of the occurrence of suicidal thoughts and behaviors during presentation to the emergency department. Behavior-based standardized assessments should be further researched in this field. Assessment of suicidality at presentation using C-CASA or similar assessment should be standard for psychiatric patients assessed in the emergency department.
      pubtype: Academic Journal
      doctype: journal article
      src: R
    language: English
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