Recueil de l’opinion des médecins généralistes d’Isère, Savoie et Haute-Savoie sur la grille d'estimation de la dangerosité d’un passage à l'acte suicidaire
Bibliographic record
Abstract
Context: GPs are more and more often consulted for psychiatric problematics, especially linked with anxiety and depression : they have to face complex and intricated situations. Epidemiologic data show that suicide attempt rates stay elevated, associated with the fact that patients rarely ask for help directly, even when they visit their doctor during the weeks preceding the attempt. It has been suggested by a literature review the exploitation of the GEDPAS, a tool built in Quebec, infrench, and used by the social workers of this province, to evaluate the possibility of its utilisation in primary care and potential contribution to general medicine.Another review of the literature described the absence of a screening and management tool for suicidal risk in general practice. Method : The researchers have reunited eighteen doctors from Isère, Savoie and Haute Savoie in focus groups to lead a qualitative study in order to evaluate this Grid and discuss the way they usually reason and behave when faced with problematics of evaluation and gestion of suicidal risk ; by using a semi-directive interview lead with a guide built in advance. Objectives: The main objective was to gather doctors' opinions about the GEDPAS, its usefulness in general practice and its implementation in practice. In addition, it would help to introduce the tool to general practitioners. Results :The Grid was greeted favorably, judged as clear, concise and pertinent. It allows to better organise the consultation and a full evaluation without omission, and to give means of intervention for future consultations. But the color-coded cotation system makes it unusable without complementary explanations according to some of the interviewed doctors. It presents deficiency, principaly a lack of a clear definition of the lethal mean, and doesn’t really provide help for the pursuit of the care process. Above all, it can not be efficient without the therapeutic link between the doctor and his patient, which is and must stay the base of the consultation. The Grid is a complementary tool but not the main stake of the consultation. Conclusion: The GEDPAS can become a supplementary tool for GPs to help them for evaluation and gestion of suicidal risk. Usable on several supports and able to give a common language to diverse health professions, it can however never substitute itself to the therapeutic link. Future studies, making it possible to link a protocol to the colour code, would make this grid more attractive and improve the management of suicidal risk, particularly through better communication between health services.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.042 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.004 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".