HEADS-ED as a Predictor of Hospitalization in Children Seeking Emergency Department Care With Mental Health Concerns
Bibliographic record
Abstract
OBJECTIVE: To evaluate the association between the Home, Education/Employment, Activities, Drugs, Suicidality, Emotions, Discharge (HEADS-ED) tool and hospitalization among children presenting with mental health concerns for emergency department (ED) care. METHODS: We conducted a cross-sectional analysis of data from a prospective quasi-experimental study evaluating an acute mental health care bundle in 2 pediatric EDs in Alberta, Canada. Participants were <18 years and presented with a mental health concern. A high-risk HEADS-ED score was defined by a total score ≥8 (range: 0-14) and/or suicide score of 2 (range: 0-2). Primary outcome was index ED visit hospitalization. RESULTS: Seven hundred and fourteen eligible participants had complete data available for analysis. Median participant age was 14.0 (interquartile range [IQR]: 12.0, 15.0) years, 12.0% (86/714) of whom were hospitalized at the index ED visit. The HEADS-ED score was ≥8 for 16.9% (121/714) of participants and 28.6% (204/714) had a suicide risk score of 2; 35.7% (255/714) met one or both high-risk criteria. Exactly 79.1% (95%confidence interval [CI]: 69.0, 87.1) of hospitalizations were among children who had high-risk scores, whereas 70.2% (95%CI: 66.5, 73.8) of children who were discharged had low-risk scores. Similarly, including follow-up through 30 days after the index visit, 77.7% (95%CI: 67.9, 85.6) of hospitalizations were among children who had high-risk scores, while 70.7% (95%CI: 66.9, 74.2) of children who were not hospitalized had low-risk scores. Among children ≥14 years, HEADS-ED scores were inversely correlated with well-being scores. CONCLUSION: In our study population, high-risk HEADS-ED scores are moderately associated with hospitalization. Adolescents with higher HEADS-ED scores reported lower well-being.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".