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Related Concept Videos

Actuarial Approach01:20

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Related Experiment Video

Updated: May 14, 2026

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Identifying suicidal behavior among adolescents using administrative claims data.

S Todd Callahan1, D Catherine Fuchs, Richard C Shelton

  • 1Division of Adolescent and Young Adult Health, Department of Pediatrics, Vanderbilt School of Medicine, Nashville, Tennessee, USA. todd.callahan@vanderbilt.edu

Pharmacoepidemiology and Drug Safety
|February 16, 2013
PubMed
Summary

An algorithm using administrative claims data can identify medically treated suicidal behavior in youth. Combining ICD-9-CM codes and hospitalization records improves accuracy for detecting self-harm in children and adolescents.

Keywords:
administrative claimsadolescencepharmacoepidemiologysuicidal behavior

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Published on: November 21, 2013

Area of Science:

  • Child and Adolescent Psychiatry
  • Public Health
  • Health Informatics

Background:

  • Psychotropic medication safety in youth requires accurate identification of suicidal behavior.
  • Medical claims data offers a potential source for identifying suicidal acts but requires robust algorithms.
  • Distinguishing suicidal behavior from other injuries is crucial for safety assessments.

Purpose of the Study:

  • To develop and validate an algorithm using administrative claims data to identify medically treated suicidal behavior in children and adolescents.
  • To improve the accuracy of identifying suicidal behavior in youth within large datasets.

Main Methods:

  • A cohort of 80,183 youth (6-18 years) from Tennessee Medicaid (1995-2006) prescribed antidepressants was analyzed.
  • Potential suicidal behavior episodes were identified using external cause-of-injury (E-codes) and ICD-9-CM codes.
  • Medical records were reviewed to confirm self-inflicted injury and suicidal intent.

Main Results:

  • 2676 potential self-harm episodes were reviewed, with 1162 classified as suicidal behavior.
  • 96% of confirmed suicidal behavior episodes had claims for suicide and/or poisoning.
  • The positive predictive value of code groups ranged from 0-88%, improving with hospitalization.

Conclusions:

  • ICD-9-CM codes for suicide or drug poisoning were present in nearly all confirmed suicidal behavior episodes in youth.
  • An algorithm combining ICD-9-CM codes and hospitalization data significantly enhanced the positive predictive value for identifying medically treated suicidal behavior.