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Related Experiment Video

Updated: Jun 7, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Surrogate endpoints in suicide research.

Hal S Wortzel1, Peter M Gutierrez, Beeta Y Homaifar

  • 1VISN 19 MIRECC, Denver VA Medical Center, Denver, CO 80220, USA. hal.wortzel@ucdenver.edu

Suicide & Life-Threatening Behavior
|November 2, 2010
PubMed
Summary
This summary is machine-generated.

Investigating suicide attempts as surrogates for completed suicides is appealing but problematic. Evidence suggests these surrogates may not accurately reflect suicide risk due to distinct underlying factors.

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Last Updated: Jun 7, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
06:55

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index

Published on: January 8, 2020

Area of Science:

  • Psychiatry
  • Epidemiology
  • Biostatistics

Background:

  • Rare outcomes like completed suicides are often substituted with more accessible surrogate endpoints in research.
  • Suicide attempts are frequently used as a surrogate for completed suicides due to their higher incidence.
  • Concerns exist regarding the validity of using suicide attempts as a direct proxy for completed suicide risk.

Purpose of the Study:

  • To critically evaluate the utility and limitations of using suicide attempts as surrogate endpoints for completed suicides.
  • To highlight the statistical and scientific concerns associated with surrogate endpoints in suicide research.
  • To advocate for improved phenotypic refinement and standardized nomenclature in suicide research.

Main Methods:

  • Review of existing literature on surrogate endpoints in medical research.
  • Analysis of evidence from psychometric, neurochemical, genetic, and neuroimaging studies relevant to suicide.
  • Discussion of statistical science perspectives on surrogate validity.
  • Examination of the phenotypic heterogeneity of suicide-related behaviors.

Main Results:

  • Surrogate endpoints, while convenient, pose significant statistical challenges.
  • Growing evidence indicates that suicide attempts may be particularly problematic surrogates for completed suicides.
  • Psychometric, neurochemical, genetic, and neuroimaging data suggest distinct underlying mechanisms for attempts versus completed suicides.

Conclusions:

  • Greater phenotypic refinement of suicide-related behaviors is crucial.
  • Development and adoption of a shared suicide nomenclature are necessary for consistent research.
  • Investigational results should be interpreted conservatively, specific to the population and behavior studied.
  • The use of suicide attempts as surrogates for completed suicides requires cautious and nuanced consideration.