Using Risk Models to Help Screen for Suicide
Author Information
Author(s): Walsh Colin G. MD, Ripperger Michael A. BS, Novak Laurie PhD, Reale Carrie MSN, Anders Shilo PhD, Spann Ashley MD, Kolli Jhansi BS, Robinson Katelyn BA, Chen Qingxia PhD, Isaacs David MD, Acosta Lealani Mae Y. MD, Phibbs Fenna MD, Fielstein Elliot PhD, Wilimitis Drew BS, Musacchio Schafer Katherine PhD, Hilton Rachel MSN, Albert Dan MS, Shelton Jill BSN, Stroh Jessica BSN, Stead William W. MD, Johnson Kevin B. MD MS
Primary Institution: Vanderbilt University Medical Center
Hypothesis
Does interruptive clinical decision support (CDS) lead to higher rates of in-person suicide risk assessment compared to noninterruptive CDS?
Conclusion
Interruptive CDS was significantly more effective at prompting in-person suicide risk assessments than noninterruptive CDS.
Supporting Evidence
- Interruptive CDS led to 42% of encounters resulting in a decision to screen.
- Noninterruptive CDS resulted in only 4% of encounters leading to a decision to screen.
- Interruptive CDS increased documented screening rates compared to the prior year.
Takeaway
This study found that using alerts on screens helped doctors ask more patients about suicide risk compared to just showing a warning without an alert.
Methodology
A randomized clinical trial comparing interruptive and noninterruptive CDS in prompting suicide risk assessments.
Potential Biases
Potential performance bias as clinicians might have used the tools more frequently due to being part of the trial.
Limitations
The study was not powered to detect changes in rates of suicide attempts or deaths, and there may have been leakage of suicide risk assessment regardless of CDS presence.
Participant Demographics
Mean age was 59.3 years; 52% were women, and 51% were White.
Statistical Information
P-Value
<0.001
Confidence Interval
95% CI, 6.42-48.79
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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