TY  - JOUR
PY  - 2015//
TI  - Predictive modeling and concentration of the risk of suicide: implications for preventive interventions in the US Department of Veterans Affairs
JO  - American journal of public health
A1  - McCarthy, John F.
A1  - Bossarte, Robert M.
A1  - Katz, Ira R.
A1  - Thompson, Caitlin
A1  - Kemp, Janet
A1  - Hannemann, Claire M.
A1  - Nielson, Christopher
A1  - Schoenbaum, Michael
SP  - 1935
EP  - 1942
VL  - 105
IS  - 9
N2  - 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. <br><br>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. <br><br>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%. <br><br>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. (Am J Public Health. Published online ahead of print June 11, 2015: e1-e8. doi:10.2105/AJPH.2015.302737).<p />  <p>Language: en</p>
LA  - en
SN  - 0090-0036
UR  - http://dx.doi.org/10.2105/AJPH.2015.302737
ID  - ref1
ER  -