Estimating the trends in attempted suicide using administrative data and patient chart review: a pilot study
Notice bibliographique
Résumé
Suicide is a major public health problem and attempted suicide is a known risk factor of suicide death.There is an accepted figure that between 10 to 20 attempts occur for every death by suicide.However, reliable data on attempted suicide seeking medical assistance are scarce and unrepresentative notwithstanding advances in medical charting.Many have tried to contravene this by novel ways of taking the census of attempted suicide with interesting results but few were applicable to very large population.Our study goals are firstly to estimate the level of underestimation of attempted suicide treated in hospital settings; secondly to find, by the adjunction of the Canadian Emergency Department Triage and Acuity Scale (CTAS) used by nurses in emergency triage, to usually used administrative databases a new affordable and dependable way to identify more accurately the number of attempted suicide treated in hospitals.Thirdly, this study seeks to prove that lethality is the main indicator of attempted suicide coding without regards to intention.This study used administrative data that covered physical and psychological diagnosis that could have been or induced by a suicide attempt.The second step added nursing triage notes that suggested that the main complaint of the patient was related to suicidal behavior.Then, attention was brought to cases bearing exclusive suicide attempt diagnosis and if their first unit of hospitalization was intensive care unit to verify if lethality was meaningful in the recording of their diagnosis.This study found that 95% of the attempted suicides seeking medical assistance were not coded as such and their physical or psychological diagnosis was the main diagnosis appearing in the administrative database.CTAS was efficient in locating attempts of low to moderate lethality in emergency department but was not efficient for high lethality case as these would bypass nursing triage and receive immediate medical care.For monitoring purpose, usual administrative databases and CTAS should be associated with another means that could identify suicide attempts with high lethality to give a more realistic estimate of this phenomenon.This study also found that lethality is a major factor in the labelling of attempted suicide but there seems to be other elements interfering other then intentions as only a quarter of very lethal cases were coded as attempted suicides.I would like to thank Dr Gustavo Turecki and Dr Elham Rahme for giving me the instrumental support to pursue my studies.It was appreciated.I also
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,023 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».