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Risk of death by su...
Risk of death by suicide following self-harm presentations to healthcare : development and validation of a multivariable clinical prediction rule (OxSATS)
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- Fazel, Seena (author)
- Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Oxford, UK
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- Vazquez-Montes, Maria D. L. A. (author)
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
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- Molero, Yasmina (author)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
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- Runeson, Bo (author)
- Karolinska Institutet
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- D'Onofrio, Brian M. (author)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden; Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, Indiana, USA
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- Larsson, Henrik, 1975- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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- Lichtenstein, Paul (author)
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
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- Walker, Jane (author)
- Psychological Medicine Research Department of Psychiatry, University of Oxford, Oxford, UK
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- Sharpe, Michael (author)
- Psychological Medicine Research Department of Psychiatry, University of Oxford, Oxford, UK
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- Fanshawe, Thomas R (author)
- Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK
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(creator_code:org_t)
- BMJ Publishing Group Ltd, 2023
- 2023
- English.
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In: BMJ Mental Health. - : BMJ Publishing Group Ltd. - 2755-9734. ; 26:1
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- BACKGROUND: Assessment of suicide risk in individuals who have self-harmed is common in emergency departments, but is often based on tools developed for other purposes. OBJECTIVE: We developed and validated a predictive model for suicide following self-harm.METHODS: We used data from Swedish population-based registers. A cohort of 53 172 individuals aged 10+ years, with healthcare episodes of self-harm, was split into development (37 523 individuals, of whom 391 died from suicide within 12 months) and validation (15 649 individuals, 178 suicides within 12 months) samples. We fitted a multivariable accelerated failure time model for the association between risk factors and time to suicide. The final model contains 11 factors: age, sex, and variables related to substance misuse, mental health and treatment, and history of self-harm. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis guidelines were followed for the design and reporting of this work.FINDINGS: An 11-item risk model to predict suicide was developed using sociodemographic and clinical risk factors, and showed good discrimination (c-index 0.77, 95% CI 0.75 to 0.78) and calibration in external validation. For risk of suicide within 12 months, using a 1% cut-off, sensitivity was 82% (75% to 87%) and specificity was 54% (53% to 55%). A web-based risk calculator is available (Oxford Suicide Assessment Tool for Self-harm or OxSATS).CONCLUSIONS: OxSATS accurately predicts 12-month risk of suicide. Further validations and linkage to effective interventions are required to examine clinical utility.CLINICAL IMPLICATIONS: Using a clinical prediction score may assist clinical decision-making and resource allocation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- Adult psychiatry
- Depression & mood disorders
- Substance misuse
- Suicide & self-harm
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Fazel, Seena
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Vazquez-Montes, ...
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Molero, Yasmina
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Runeson, Bo
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D'Onofrio, Brian ...
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Larsson, Henrik, ...
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Lichtenstein, Pa ...
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Walker, Jane
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Sharpe, Michael
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Fanshawe, Thomas ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Psychiatry
- Articles in the publication
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BMJ Mental Healt ...
- By the university
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Örebro University
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Karolinska Institutet