Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs
- 1 September 2015
- journal article
- Published by American Public Health Association in American Journal of Public Health
- Vol. 105 (9), 1935-1942
- https://doi.org/10.2105/ajph.2015.302737
Abstract
Objectives. The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions. Methods. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year. Results. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%. Conclusions. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions.Keywords
This publication has 29 references indexed in Scilit:
- Lessons Learned from Mental Health Enhancement and Suicide Prevention Activities in the Veterans Health AdministrationAmerican Journal of Public Health, 2012
- Suicide Among Veterans in 16 States, 2005 to 2008: Comparisons Between Utilizers and Nonutilizers of Veterans Health Administration (VHA) Services Based on Data From the National Death Index, the National Violent Death Reporting System, and VHA Administrative RecordsAmerican Journal of Public Health, 2012
- Suicide Among Patients in the Veterans Affairs Health System: Rural–Urban Differences in Rates, Risks, and MethodsAmerican Journal of Public Health, 2012
- Characteristics and VA Health Care Utilization of U.S. Veterans Who Completed Suicide in Oregon Between 2000 and 2005Suicide and Life-Threatening Behavior, 2011
- Comorbid anxiety as a suicide risk factor among depressed veteransDepression and Anxiety, 2009
- Higher-risk periods for suicide among VA patients receiving depression treatment: Prioritizing suicide prevention effortsJournal of Affective Disorders, 2009
- Evaluation of clinical prognostic models for suicide attempts after a major depressive episodeActa Psychiatrica Scandinavica, 2008
- A Clinical Tool for Assessing Risk After Self-HarmAnnals of Emergency Medicine, 2006
- Suicide Attempts Among Substance Use Disorder Patients: An Initial Step Toward a Decision Tree for Suicide ManagementAlcohol: Clinical and Experimental Research, 2006
- Suicide Prevention StrategiesJAMA, 2005