Self-Harm Presentations to a Pediatric Trauma Centre During the First Year of the COVID-19 Pandemic.
Bibliographic record
Abstract
Background: The COVID-19 pandemic raised concerns regarding increased youth suicidal behaviour. Trends in the volume and characteristics of hospital self-harm presentations may inform future suicide-prevention strategies. Objective: We compared the number and characteristics of pre - vs. intra-pandemic self-harm presentations to the Emergency Department (ED) of a major Canadian pediatric trauma centre. Method: Using time series analysis, we compared intra-pandemic (March 2020-February 2021) monthly self-harm presentation counts to forecasts based on the previous nine years. We compared the proportion of ED presentations for self-harm between the intra-pandemic period and the preceding three years. A detailed chart review of ED self-harm visits from March 2019 to February 2021 examined the demographic, clinical, and psychosocial features of pre- vs. intra-pandemic presentations. Results: Compared to pre-pandemic forecasts, ED self-harm presentation counts were decreased in March and May 2020 but increased in December 2020-January 2021. The self-harm proportion of ED presentations during the pandemic's first year was double that of the preceding three years (0.19% vs. 0.09%; OR=2.08, 95% CI=1.62-2.67). Compared to pre-pandemic self-harm presentations, patients presenting intra-pandemic were more likely to be seen for a psychiatry consultation in the ED or hospital ward (OR=2.38, 95% CI=1.04-5.43), to be admitted to a medical unit (OR=3.81, 95% CI=1.28-11.39), and to be living with parents (OR=2.58, 95% CI=1.09-6.09). Conclusions: The pandemic's association with the volume of self-harm visits to a pediatric ED appears to have varied throughout its duration. During the pandemic, self-harm visits had an increased representation among ED presentations and exhibited potential indicators of increased medical and psychiatric acuity.
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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 | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".