Assessment Tool Developed for Predicting Suicide Risk After Self-Harm

Sensitivity was 82 percent and specificity 54 percent for risk of suicide within 12 months using 1-percent cutoff

By Elana Gotkine HealthDay Reporter

MONDAY, July 10, 2023 (HealthDay News) — A clinical assessment tool has been developed to predict risk of suicide among individuals with episodes of self-harm, according to a study published online June 29 in BMJ Mental Health.

Seena Fazel, M.B.Ch.B., M.D., from the University of Oxford in the United Kingdom, and colleagues developed and validated a predictive model for suicide following self-harm, the Oxford Suicide Assessment Tool for Self-harm (OxSATS), using data from Swedish population-based registers. A total of 53,172 individuals aged 10 years and older with health care episodes of self-harm were split into development and validation samples (37,523 individuals with 391 suicides within 12 months, and 15,649 individuals with 178 suicides within 12 months, respectively). Eleven factors were included in the final model: age, sex, and variables related to substance misuse, mental health and treatment, and history of self-harm.

The researchers indicated that the model to predict suicide was developed using sociodemographic and clinical risk factors; in external validation, the model showed good discrimination (c-index, 0.77) and calibration. Using a 1-percent cutoff, the sensitivity was 82 percent and specificity 54 percent for risk of suicide within 12 months. OxSATS is available as a web-based risk calculator.

“Using a clinical prediction model may assist clinical decision-making and resource allocation,” the authors write. “Probability scores, if calibration has been tested and shown to be good, provide one way to stratify risk in a clinically feasible way and underscore safety planning.”