UMass Chan Medical School Faculty Publications

Title

Validation of a Secondary Screener for Suicide Risk: Results from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE)

UMMS Affiliation

Department of Emergency Medicine

Publication Date

2020-06-01

Document Type

Article

Disciplines

Emergency Medicine | Patient Safety | Psychiatry | Psychiatry and Psychology | Quality Improvement

Abstract

BACKGROUND: Validated secondary screeners are needed to stratify suicide risk among those with nonnegligible risk. This study tested the predictive utility of the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE) Secondary Screener (ESS), one of the screeners listed by The Joint Commission's Patient Safety Goal 15 resources as a potential secondary screener for acute care settings.

METHODS: The researchers performed secondary analyses of data collected for the ED-SAFE study. Data were collected during an emergency department (ED) visit for 1,376 patients who endorsed active suicide ideation or a suicide attempt in the past week. Participants were followed for 12 months using telephone-based assessments, review of health care records, and National Death Index query. The study examined the predictive validity of the individual items, total score, and a scoring algorithm using the total score and critical items. Bivariable analyses, multivariable logistic regression, and test operating characteristics were calculated.

RESULTS: Of the 1,376 patients enrolled, most were positive for at least one indicator. Four of the indicators were significantly associated with several outcomes. Based on score and critical items, the patients were trichotomized: The three strata were associated with significantly different rates of prospective suicidal behavior, with 52% of the high-risk group engaging in suicidal behavior within 12 months.

CONCLUSION: The ESS possesses adequate operating characteristics for triage purposes. The researchers recommend validation in new samples to confirm its operating characteristics and potentially reduce its length by removing the substance and agitation items, which offered little predictive utility in this study. reserved.

DOI of Published Version

10.1016/j.jcjq.2020.03.008

Source

Boudreaux ED, Larkin C, Camargo CA Jr, Miller IW. Validation of a Secondary Screener for Suicide Risk: Results from the Emergency Department Safety Assessment and Follow-up Evaluation (ED-SAFE). Jt Comm J Qual Patient Saf. 2020 Jun;46(6):342-352. doi: 10.1016/j.jcjq.2020.03.008. Epub 2020 Apr 25. PMID: 32417230; PMCID: PMC7276296. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Joint Commission journal on quality and patient safety

PubMed ID

32417230

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