Journal article

Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales

Gregory Carter, Allison Milner, Katie McGill, Jane Pirkis, Nav Kapur, Matthew J Spittal

BRITISH JOURNAL OF PSYCHIATRY | CAMBRIDGE UNIV PRESS | Published : 2017

Abstract

BackgroundPrediction of suicidal behaviour is an aspirational goal for clinicians and policy makers; with patients classified as 'high risk' to be preferentially allocated treatment. Clinical usefulness requires an adequate positive predictive value (PPV).AimsTo identify studies of predictive instruments and to calculate PPV estimates for suicidal behaviours.MethodA systematic review identified studies of predictive instruments. A series of meta-analyses produced pooled estimates of PPV for suicidal behaviours.ResultsFor all scales combined, the pooled PPVs were: suicide 5.5% (95% CI 3.9-7.9%), self-harm 26.3% (95% CI 21.8-31.3%) and self-harm plus suicide 35.9% (95% CI 25.8-47.4%). Subanaly..

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