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Related Experiment Videos

A clinical tool for assessing risk after self-harm.

Jayne Cooper1, Navneet Kapur, Joel Dunning

  • 1Centre for Suicide Prevention, University of Manchester, Manchester, England. jayne.cooper@manchester.ac.uk

Annals of Emergency Medicine
|September 26, 2006
PubMed
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A new 4-question rule can help emergency department (ED) staff identify patients at higher risk of self-harm repetition or suicide within 6 months. This tool aids in focusing psychiatric resources effectively.

Area of Science:

  • Emergency Medicine
  • Psychiatry
  • Public Health

Background:

  • Self-harm presents a significant challenge in emergency departments (EDs).
  • Accurate risk stratification is crucial for effective patient management and resource allocation.

Purpose of the Study:

  • To develop and validate a risk-stratification model for patients presenting to EDs with self-harm.
  • The model aims to assist clinical staff in assessing the risk of self-harm repetition or suicide.

Main Methods:

  • A clinical decision rule was derived using recursive partitioning on data from 9,086 patients across 5 EDs.
  • The study utilized data from the Manchester and Salford Self-Harm Project (1997-2001).
  • The model was validated on a separate set of ED data.

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Main Results:

  • A 4-question rule demonstrated high sensitivity (94%) in identifying patients at higher risk.
  • The rule identified 17% of patients who reattended within 6 months and 22 who died by suicide.
  • Specificity was 25%, indicating efficient resource targeting.

Conclusions:

  • The derived 4-question rule is a simple and highly sensitive tool for ED use.
  • Its application can improve patient assessment and psychiatric resource allocation for high-risk individuals.