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Which Chart Elements Accurately Identify Emergency Department Visits for Suicidal Ideation or Behavior?
Sarah A Arias1, Edwin D Boudreaux2, Elizabeth Chen3
1a Department of Psychiatry and Human Behavior , Brown University, Butler Hospital , Providence , RI , USA.
Summary
Identifying suicide-related emergency department (ED) visits is crucial. Combining ICD-9-CM codes, presenting complaints, and discharge diagnoses offers a robust method for accurate identification.
Area of Science:
- Emergency Medicine
- Public Health
- Health Informatics
Background:
- Accurate identification of suicide-related emergency department (ED) visits is vital for timely intervention and prevention.
- Current methods may not fully capture all relevant cases, necessitating improved data extraction strategies.
Purpose of the Study:
- To evaluate the concordance between comprehensive chart review and a subset of specific chart elements for identifying suicide-related ED visits.
- To determine the most effective combination of discrete data fields for this identification process.
Main Methods:
- Retrospective review of 3,776 adult medical records from 8 US EDs.
- Comparison of a standardized comprehensive chart review against identification using ICD-9-CM codes, free-text presenting complaints, and free-text physician discharge diagnoses.
Main Results:
- A combination of ICD-9-CM codes, presenting complaints, and discharge diagnoses demonstrated high accuracy.
- This combined approach yielded 85% sensitivity, 96% specificity, 92% positive predictive value (PPV), and 92% negative predictive value (NPV).
Conclusions:
- Key discrete fields within the medical record can be effectively extracted to identify suicide-related ED visits.
- Utilizing ICD-9-CM codes, presenting complaints, and discharge diagnoses offers a robust and efficient method for surveillance and research.
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