TY  - JOUR
PY  - 2019//
TI  - Predicting future suicide: clinician opinion versus a standardized assessment tool
JO  - Suicide and life-threatening behavior
A1  - Randall, Jason R.
A1  - Sareen, Jitender
A1  - Chateau, Dan
A1  - Bolton, James M.
SP  - 941
EP  - 951
VL  - 49
IS  - 4
N2  - OBJECTIVE: To compare the effectiveness of clinician prediction of risk to a standardized assessment of presentation status. <br><br>METHODS: All adult psychiatry emergency department consults in the two main hospitals in Winnipeg, Canada, were assessed using a standardized form (n = 5,376). This form includes two risk scales for a gestalt physician assessment of risk (Suicide Likelihood scale, suicide Attempt Likelihood scale) and the Columbia Classification Algorithm of Suicide Assessment (C-CASA). Regression determined whether assessments predicted future suicide attempts and deaths. The area under the curve (AUC) determined the prediction accuracy of these methods. <br><br>RESULTS: Although the regression results were significant, the AUCs were either moderate or poor. Clinician assessment was not effective at predicting deaths (AUC = .546,.36-.73), but moderately accurate at predicting future attempts (AUC = .728,.66-.79). C-CASA assessment was moderately accurate at predicting both attempts and deaths (AUC = .666 and.678). <br><br>CONCLUSIONS: Clinician assessment does not significantly outperform a simple assessment of the occurrence of suicidal thoughts and behaviors during presentation to the emergency department. Behavior-based standardized assessments should be further researched in this field. Assessment of suicidality at presentation using C-CASA or similar assessment should be standard for psychiatric patients assessed in the emergency department.<br><br>© 2018 The American Association of Suicidology.<p />  <p>Language: en</p>
LA  - en
SN  - 0363-0234
UR  - http://dx.doi.org/10.1111/sltb.12481
ID  - ref1
ER  -