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Predicting suicidal and self-injurious events in a correctional setting using AI algorithms on unstructured medical

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Summary

Artificial intelligence (AI) can predict suicidal and self-injurious events in jails using progress notes. This AI approach improves healthcare triage and prevention efforts, outperforming traditional methods.

Keywords:
Class imbalanceDeep learningMachine learningNLPSuicidal and self-injurious eventsUnder sampling

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Area of Science:

  • Medical Informatics
  • Artificial Intelligence
  • Public Health

Background:

  • Suicidal and self-injurious incidents in correctional settings strain resources and staff.
  • Traditional statistical analyses are limited by structured data collection and high implementation costs.

Purpose of the Study:

  • To extract actionable insights from medical and mental health progress notes using AI.
  • To predict suicidal and self-injurious events for improved healthcare triage and prevention in Orange County Jails.

Main Methods:

  • Utilized AI algorithms, specifically a Transformer Encoder model, to analyze unstructured progress note data.
  • Compared AI model performance using notes data alone versus a hybrid approach combining notes data with structured Electronic Health Record (EHR) data.
  • Employed under-sampling techniques to address class imbalance in the dataset.

Main Results:

  • Progress notes contained richer information on suicidal/injurious behaviors than structured EHR data.
  • The Transformer Encoder model using notes data achieved an AUC-ROC of 0.862, Sensitivity of 0.816, and Specificity of 0.738.
  • Integrating notes data into traditional Machine Learning models improved Sensitivity to 0.89 (AUC-ROC: 0.77, Specificity: 0.65).

Conclusions:

  • AI analysis of clinical notes offers a more effective method for predicting inmate self-harm than structured data alone.
  • Hybrid models incorporating AI-extracted features show promise for enhancing predictive accuracy.
  • Under-sampling is a viable strategy for managing imbalanced data in this context.