Accuracy of clinician predictions of future self-harm: A systematic review and meta-analysis of predictive studies
Auteurs
R Woodford, M J Spittal, A Milner, K McGill, N Kapur, J Pirkis, A Mitchell, G Carter.
Résumé
Assessment of a patient after hospital-treated self-harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self-harm. Through systematic review and a series of meta-analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18-0.50), specificity 0.85 (0.75-0.92), positive predictive value 0.22 (0.21-0.23), and negative predictive value 0.89 (0.86-0.92). Clinician classification was too inaccurate to be clinically useful. After-care should therefore be allocated on the basis of a needs rather than risk assessment. TENTATIVE PATIENT-PSYCHIATRIQUE CONGÉ-HOSPITALIER ÉVALUATION-CLINIQUE DÉPISTAGE POTENTIEL-SUICIDAIRE REVUE-LITTÉRATURE MÉTA-ANALYSE
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