自杀风险评估工具和预测模型:新的证据,方法创新,过时的批评
Aida Seyedsalehi1, Seena Fazel2,3
1Department of Psychiatry, University of Oxford, Oxford, UK.
BMJ mental health
|March 14, 2024
概括
自杀风险预测模型具有潜力,但需要细微的解释. 专注于概率估计和临床背景,而不是简单的分类,对于有效的自杀预防策略至关重要.
科学领域:
- 精神病学和心理健康 精神病学和心理健康
- 生物统计学和流行病学
- 临床决策 - 临床决策
背景情况:
- 越来越多的自杀相关结果的预测模型.
- 模型旨在分层风险,改善临床决策,并个性化预防自杀.
- 关于这些模型对自杀风险评估的有用性存在不同的观点.
研究的目的:
- 为了解决对自杀风险预测研究的批评中常见的误解.
- 倡导对预测模型性能和实用性的更细致的理解.
- 引导制定和实施更有效的预防自杀策略.
主要方法:
- 视角的作品讨论了分类方法与概率估计的局限性.
- 在临床环境中对标准性能指标 (例如,积极的预测值) 的批评.
- 强调区分能力,校准,临床效用和健康经济价值评估.
主要成果:
- 将个人分类为低风险与高风险有局限性;概率估计更有利.
- 适当的风险值取决于临床背景,校准经常被忽视.
- 临床效用和健康经济价值需要具体的措施,如净益处和决策分析建模.
结论:
- 关于自杀预测模型的讨论需要更大的统计专业知识和细微差别.
- 当前的指导方针和预防策略应纳入更高质量的模型性能证据.
- 更好地理解和应用预测模型可以提高自杀风险评估和预防.
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