在美国海军初级保健中对基于平民的统计自杀风险模型进行外部验证和更新
Michael A Ripperger1, Jhansi Kolli1, Drew Wilimitis1
1Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.
JAMA network open
|November 8, 2023
概括
一个经过验证的平民自杀风险模型在与美国海军数据进行重新训练时得到了显著改善. 这种方法可以加速军事初级保健机构的自杀预防自动化.
科学领域:
- 军事卫生研究军事卫生研究
- 公共卫生监督是对公共卫生的监督.
- 在医疗保健中的数据科学.
背景情况:
- 自杀是美国军方的一个关键问题,但统计风险模型并未广泛用于海军人员.
- 现有的平民自杀风险模型需要对军事人口进行外部验证和调整.
研究的目的:
- 为美国海军现役服役人员外部验证民间开发的统计自杀风险模型.
- 用服务特定数据重新训练和更新模型,以提高其准确性和适用性.
主要方法:
- 对现役美国海军服务人员 (2007-2017年) 的回顾性队列研究.
- 在海军医疗中心波茨斯 (NMCP) 和相关诊所对平民自杀风险模型的外部验证.
- 使用NMCP数据进行模型再培训和再校准,并结合国防部 (DoD) 特定的计费代码和人口统计数据.
- 使用接收器操作曲线 (AUROC) 下面的面积和精度召回曲线 (AUPRC) 下面的面积进行性能评估.
主要成果:
- 最初的民用模型表现出有限的性能 (AUROC 0.77).
- 使用海军特定数据重新训练模型显著提高了性能 (AUROC 0.92,AUPRC 0.66).
- 重新训练的模型表现出更好的风险分层 (需要选的数量:200对366).
结论:
- 对平民自杀风险模型的外部验证和再培训提高了它对美国海军服务人员的实用性.
- 将现有模型与军方特定数据相适应,为改善自杀风险预测提供了一个可行的策略.
- 这种方法可以加速在军事医疗保健中实施自动自杀预防工具.
相关概念视频
Data Validation
5.1K
Data validation is an essential part of a comprehensive assessment. Validation is confirming or verifying and opening the door to gathering more assessment data as it clarifies vague or unclear data. The process of checking and verifying the collected information is called data validation. The primary purpose of data validation is to ensure data is as free from error, bias, and misinterpretation as possible.
Nursing assessment guides are generally based on holistic models rather than medical...
Nursing assessment guides are generally based on holistic models rather than medical...
5.1K
Actuarial Approach
80
The actuarial approach, a statistical method originally developed for life insurance risk assessment, is widely used to calculate survival rates in clinical and population studies. This method accounts for participants lost to follow-up or those who die from causes unrelated to the study, ensuring a more accurate representation of survival probabilities.
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
Consider the example of a high-risk surgical procedure with significant early-stage mortality. A two-year clinical study is conducted,...
80
Diagnostic and Statistical Manual of Mental Disorders (DSM)
59
The Diagnostic and Statistical Manual of Mental Disorders (DSM) serves as the primary classification system for mental health disorders, providing standardized diagnostic criteria for clinicians and researchers. First published by the American Psychiatric Association (APA) in 1952, the DSM has undergone several revisions to reflect evolving psychiatric understanding. The fifth edition, DSM-5, released in 2013, introduced key updates that expanded diagnostic categories and modified diagnostic...
59
Longitudinal Research
12.0K
Sometimes we want to see how people change over time, as in studies of human development and lifespan. When we test the same group of individuals repeatedly over an extended period of time, we are conducting longitudinal research. Longitudinal research is a research design in which data-gathering is administered repeatedly over an extended period of time. For example, we may survey a group of individuals about their dietary habits at age 20, retest them a decade later at age 30, and then again...
12.0K
Regression Toward the Mean
6.3K
Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
6.3K


