Pediatric Suicide Attempt Non-Disclosure: an Analysis of Discrepant Screening Results
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
The Ask-Suicide Screening Questions (ASQ) is a validated tool developed to assess suicidal risk in pediatric medical settings with one item assessing historical attempts. While the psychometric properties of the ASQ are well-established, little is known about how youth respond to this question upon repeated administrations. We conducted a retrospective analysis of electronic medical record data by youth who received the ASQ from December 2019 to November 2023 at an urban academic children's hospital. Youth who disclosed a suicide attempt but denied an attempt history at a subsequent visit were identified. Multivariate regression and manual chart review were utilized to identify demographic and clinical variables related to non-disclosure of a previously disclosed attempt. Of 1861 encounters (1460 unique patients) with a disclosed historic suicide attempt, re-screening occurred in 503 future encounters. One hundred forty instances of nondisclosure occurred (127 unique patients). Encounters were classified into false positives (N = 26), encounters where nondisclosure by patients did not impact clinical response (N = 40), and encounters where nondisclosure resulted in no further suicide risk assessment (N = 74). Of this last group, 47.3% received no risk assessment at the initial visit. Compared to the initial visit, the nondisclosure visit was more likely to have a medical presenting complaint and to have negative responses on ASQ questions related to recent suicidal ideation. Denial of a historic attempt upon repeat administration of the ASQ is not uncommon among pediatric patients, and this is more likely to occur at an encounter for a medical presenting complaint.
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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 | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 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 it