What's Happening?
Seena Fazel, MD, Professor of Forensic Psychiatry at the University of Oxford, has conducted a systematic review of prognostic risk-prediction models for self-harm and suicide. The study identified 196
models, most of which were development-only models, with few externally validated models. Outcomes evaluated included self-harm, suicide mortality, and composite outcomes, with strong discriminative performance noted. However, calibration was infrequently reported, limiting clinical interpretability. The review highlighted high risk of bias due to inadequate sample sizes and poor handling of missing data. Fazel emphasized the need for models to augment clinical judgment and called for prioritizing methodological rigor and external validation.
Why It's Important?
The review by Seena Fazel underscores the importance of developing reliable risk-prediction models for self-harm and suicide. These models can enhance clinical judgment by providing structured risk information, supporting consistency in risk management and safety planning. The study highlights the need for methodological rigor and external validation to ensure models are effective in clinical settings. Improved models could lead to better identification of high-risk individuals and more effective interventions, potentially reducing suicide rates and improving mental health outcomes.
