October 27, 2017: Bringing Machine Learning to the Point of Care to Improve Suicide Prevention

Speakers

Greg Simon, MD, MPH
Senior Investigator
Kaiser Permanente Washington Health Research Institute

Susan Shortreed, PhD
Associate Investigator
Kaiser Permanente Washington Health Research Institute

Don Mordecai, MD
Associate Professor
National Leader for Mental Health and Wellness
Kaiser Permanente

Topic

Bringing Machine Learning to the Point of Care to Improve Suicide Prevention

Keywords

Pragmatic clinical trial; Clinical research; SPOT Trial; Kaiser Permanente, Suicide prevention

Key Points

  • The Suicide Prevention Outreach Trial (SPOT) was designed to test two prevention strategies in adults with thoughts of suicide, compared to a control group receiving routine care.
  • The primary research question for the trial is whether responses on the PHQ-9 Depression Questionnaire predict a patient’s subsequent suicide attempt or suicide death?
  • The Suicide Risk Prediction Model (SRPM) is used to leverage machine learning (teaching a computer to use specific variables to predict outcomes) for the prevention of suicide attempts.
  • Health care providers can use computer-generated risk scores to inform their outreach to high-risk patients who cancel visits or don’t schedule the necessary follow-up visits.

Discussion Themes

Computers do very well in prediction when given a specific set of instructions, but there are challenges when predicting real-world human behavior, so a large amount of past patient data is critical to improving future accuracy.

False negatives (suicide attempts when computer did not predict) are certainly costly in terms of danger to patients; however, false positives (incorrectly predicting suicide attempts) are also costly in terms of provider time and healthcare funds.

Linking electronic health record (EHR) data to mortality data is key in ensuring that the full picture is available when creating computer-based prediction models.

The SPOT trial does not yet look at risk of suicide attempts after an emergency room visit, but that is the next planned step for the investigators.

For More Information

For information on the SPOT trial, visit the Living Textbook http://bit.ly/2jvIJSd

Tags

@Collaboratory1, @GregSimonKPWHRI, @sshortreed, @KPWaResearch, #clinicalresearch, #SuicidePrevention, #EHRs, #pctGR